2.2 Empirical Literature Review
2.2.3 Consequences of Migration
Migration may place individuals in situations that impact negatively on their physical and mental health. The movement of migrants exposes them to violent, psychosocial disorders, all forms of physical health and mental health challenges (Mladovsky, 2007; WHO, 2016).
Kirmayer et al. (2011) grouped the migrants' trajectory into three components, premigration, migration, and postmigration resettlement. No matter what the prevalent health challenge may be within a period, each of these periods is associated with its own physical and mental health challenges. The premigration period involves disruptions to normal social roles and networks, family separation, and conflicts, violence, and persecution (Corley & Sabri, 2020; Kirmayer et al., 2011). During the migration process, immigrants may experience persistent uncertainty
16 about their status, a situation that may expose them to violence. These uncertainties could either provoke or aggravate mental health challenges since migrants at this stage may not have the needed psychosocial resources to deal with the stressors (Kirmayer et al., 2011; Lazarus &
Folkman, 1984; Sabri & Granger, 2018). Furthermore, exposure to stressors at different levels at destinations could also create physical and mental health challenges for migrants. Issues such as disappointments, demoralisation, and depression can occur due to losses associated with migration. Before migration, migrants may have set goals and aspiration they want to achieve at their destination, if initial hopes and expectations are not realised due to obstacles they face through structural barriers and inequalities, discrimination, and uncertainty of migration status, migrants may experience challenges that may have consequences on their health and wellbeing (Corley & Sabri, 2020; Kirmayer et al., 2011).
There is further evidence of social implications and consequences of migration both to origin and destination countries. The movement within a geographical boundary causes population density to reduce, and birth rate falls (Orrenius & Zavodny, 2012). It has also been found that migrants who return to their areas of origin increase social expectations of their communities to provide better social facilities (De Haas, 2010). A report by Collinson (2010) on the dynamics of migration, health, and poverty in rural South Africa, revealed links between migration and mortality patterns, including a higher mortality among returnee migrants in comparison to permanent residents. Although migration brings about economic gains to the migrants, some of these migrants live and work in poor conditions at the host destination which becomes a hot spot for transmission of diseases (Collinson, 2010). In a different study to determine the influence of internal migration on mental health status in South Africa, Ajaero et al. (2017) reported a significant difference in the mental health status of migrants and non- migrants. Their study indicated that the mental health status of migrants declined significantly after a period. Migration undeniably predisposes migrants to issues of physical and mental health challenges because the migration process involves change in the social and cultural settings for the migrant and this change has implications on physical and mental health outcomes (Meyer, Lasater, & Tol, 2017; Mulcahy & Kollamparambil, 2016).
In broader terms, in Ghana, poverty levels in the cities are lower than in rural areas. There is, however, underestimation of the levels of poverty in the large cities which confront migrants in terms of paying more for food, accommodation, transportation, and water, which are at times free in the rural areas. Migrants, therefore, in trying to escape poverty from the rural areas by
17 moving to the urban centres, seem rather to transport the poverty from the place of origin to the areas of destination (Awumbila, Owusu, & Teye, 2014).
Migrant workers are supposed to be accorded the same rights as any other worker in society.
The ILO's 2002 resolution on decent work and informal economy provided a framework that recognised the diversity of the various sectors of the economy (ILO, 2002). Governments are expected to provide legal protection and recognition to those working in the informal sector.
The decent work framework further affirmed the right of workers regardless of them being in either the informal or formal sectors of the economy (ILO, 2013). Many countries across the globe have adopted labour policies and laws to protect workers in their labour forces (Alfers,
& Moussié, 2020). This is in respect of the aims and standards of the ILO towards promoting decent work for all through the promotion of social dialogue, through the extended social protection, employment generation, and respect of fundamental principles and rights at work.
Section 24 of the 1992 constitution of Ghana clearly lays down economic rights, including the right to work under acceptable, secure, and healthy conditions and to receive equal pay for equal work (Republic of Ghana, 1992). This law, however, focuses mainly on employees who work for an employer but not on the self-employed. There is no law protecting the rights of the self-employed, including the Kayayei. It is, therefore, important to understand how the dynamics of adjusting to urban life affect the physical and mental health of migrants. Ghana enacted major legal acts such as the Factories, Shops and Offices Act 1970, and the Labour Act of 2003, and integrated various components of former legislation that ratified ILO Conventions of 1919 to protect the health, safety, and welfare of all formal and informal workers (Hodges & Baah, 2006). Ghana, as a developing country, is progressively becoming an industrialised nation and, at the same time, has a rampant growing informal sector (Asumeng, Asamani, Afful, & Agyemang, 2015). This change resulted in exposing a large percentage of the workforce to various health and safety hazards in the workplace (Amponsah- Tawiah & Dartey-Baah, 2011). Despite the danger to which the informal sector workers are exposed. Ghana, as a country has no national policy on occupational health and safety management that could protect the informal sector workers as the ILO convention number 155 (1981) requires (Amponsah-Tawiah, & Dartey-Baah, 2011).
Informal work (employment) is all economic activities or work enragements by individuals, economic entities, or enterprises that in legal practice are not covered or partially covered by formal arrangements (Saha, Kar, & Baskaran, 2004). Informal employment is comprised of
18 employers, employees, own-account workers, and contributing family workers (Bonnet, Vanek, & Chen, 2019). Informal work is recognised as a major and relevant player in the economy of both developing and developed countries (Hussmanns, 2004). However, the proportion of informal employment is relatively higher in low and middle-income countries (LMICs) (90%) than in developed countries (18%) (OECD/ILO, 2019). Informal employment accounts for about 80 per cent of non-agricultural employment in SSA (ILO, 2002). In Ghana, over 80 per cent of the total working population is working in the informal sector (GSS, 2008).
According to the GSS (2008), most informal workers (75%) in rural Ghana engage mainly in agriculture, fishing and fish processing, agro-based processing while those in the urban areas engage more in non-agricultural activities such as petty trading, retailing, food processing, and craftsmanship. The informal sector in Ghana comprises small-scale businesses, including producers, wholesalers, and retailers (Osei-Boateng & Ampratwum, 2011). It is important to note that a substantial number of informal sector workers in Ghana are ensnared in poverty because they do not get enough revenue or have access to productive resources like credit capital that can help them lift themselves up from poverty (Osei-Boateng & Ampratwum, 2011). One advantage of the informal sector is that it has flexible work arrangements, including outsourcing and subcontracting and therefore it does have decent work aspects (Hendrickx, 2019).
According to Magidimisha and Gordon (2015), men have greater access relatively to wage employment both in formal and informal sector compared to women. Gender disparity traditionally persists when it comes to unemployment, even in informal economy in Africa sub- region (Robles, 2012). For instance, in 2007 the general female unemployment rate was 45.3 percent whiles that of their male counterparts was 30.9 percent (Magidimisha & Gordon, 2015).
Most women are engaged in informal self-employment or family businesses (Chen, 2011).
Although women are equally represented in the informal sectors in comparison to men in most developing countries, their efforts are not properly documented because they mostly engage in secondary activities such as processing agricultural products in rural areas (ILO, 2017;
Kraemer-Mbula & Wunsch-Vincent, 2016). Regardless of these omissions, women are still able to play a crucial and important role in the informal economies of SSA (Chen, 2008).
Despite the high informal workforce and the important role, they play in Ghanaian economy, the interests of informal workers continue to be neglected in the development of both social and economic policies (Alfers, 2013).
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