title: Health issues of female foreign domestic workers: a systematic review of the scientific and gray literature.
abstract: BACKGROUND
  Although the number of female foreign domestic workers (FDWs) is increasing worldwide, little is known about their health issues.
  
  
  OBJECTIVE
  To systematically review the literature on health issues of female FDWs to ascertain the problems studied, identify limitations, and suggest future research and policy implications.
  
  
  METHODS
  A systematic database (PubMed, EBSCO Host, and Google Scholar) and bibliographic search identified the English-language scientific and gray literature published during 1990-2012 addressing health issues of female FDWs living with the family of the employer, using qualitative and/or quantitative research methods. Studies in which female FDWs constituted less than half of the participants were excluded.
  
  
  RESULTS
  The health issues studied and identified were adverse work conditions and associated health problems (such as physical, verbal, and sexual abuse at the workplace, caregiving tasks associated with musculoskeletal strain, and chemical exposure associated with respiratory difficulty), mental health (psychotic, neurotic, and mood disorders), infectious diseases (most of the studies were on intestinal parasitic infections), and health knowledge/attitudes/practices (most of the studies were in context of sexual and reproductive health). Most of the studies were medical record reviews or questionnaire-based surveys utilizing convenience sampling or qualitative interviews/focus group discussions.
  
  
  CONCLUSIONS
  Female FDWs face numerous health problems. Studies on representative, possibly longitudinal, samples of female FDWs focusing on specific health conditions are needed to better understand the epidemiology of such conditions. Concerted efforts through the governments of both labor-sending and host countries are required to improve the health, work conditions, and safety of this vulnerable group of women.
authors.affiliation: Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore 169857.
authors.forename: Rahul
authors.initials: R
authors.lastname: Malhotra
authors.affiliation: Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore 169857.
authors.forename: Chandima
authors.initials: C
authors.lastname: Arambepola
authors.affiliation: Duke Global Health Institute, Duke University, Durham, USA.
authors.forename: Samiksha
authors.initials: S
authors.lastname: Tarun
authors.affiliation: Department of Community Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka.
authors.forename: Vijitha
authors.initials: V
authors.lastname: de Silva
authors.affiliation: Department of Community Medicine, Maulana Azad Medical College, Delhi, India.
authors.forename: Jugal
authors.initials: J
authors.lastname: Kishore
authors.affiliation: Program in Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore 169857.
authors.forename: Truls
authors.initials: T
authors.lastname: Østbye
mesh_terms: D003141:Communicable Diseases / Q000453:epidemiology; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006796:Household Work / Q000706:statistics & numerical data*; D006801:Humans; D038622:Internationality; D008603:Mental Health; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D016273:Occupational Exposure / Q000706:statistics & numerical data*; D016272:Occupational Health; D012742:Sex Offenses / Q000706:statistics & numerical data; D017132:Workplace