A/HRC/23/41 their understanding of the underlying determinants of mental health for migrant workers, in accordance with the right to health.149 69. For returnee migrant workers, the lack of psychosocial services may result in mental health issues being severely ignored. Where it is recognized that migrant workers in particular sectors or countries are exploited and abused, sending States should implement measures to effectively address their mental health concerns. Such policies should be developed, implemented and monitored in consultation with returned migrant workers. F. Women and sexual and reproductive health 70. States should undertake a gender analysis to identify and address health vulnerabilities of female migrant workers resulting from different biological and sociocultural factors that influence their health. Women comprise a significant percentage of migrant workers but often face greater health vulnerabilities due to gender inequalities. 150 Poverty, family responsibilities and barriers to education and information make women more vulnerable before departing; while violence against women is pervasive during transit in some regions.151 Systematic exploitation and abuse within informal industries dominated by migrant women, such as domestic work and sex work, stems from and reinforces women‟s vulnerability during the migration process. 71. Domestic and sexual violence, lack of redress for rights violations and lower wages than male counterparts reflect gender-based discrimination and aggravate its negative effects in the health-care setting and access to health care faced by migrant workers generally.152 Furthermore, gendered power imbalances and lack of access to health services, information and redress affects the ability of women, especially sex workers, to negotiate safe sex, which increases their vulnerability to HIV.153 Sending and receiving States should therefore address the compounded vulnerability of female migrant workers, particularly those with irregular status, in the development and implementation of evidence-based and participatory health policies and strategies. 72. The right to health requires States to ensure access to health facilities, goods and services, especially for vulnerable groups, such as migrant women workers. Health services, information and education should be tailored to the specific needs of women – such as sexual and reproductive health needs, including access to contraception and safe legal abortion – and pay attention to the special vulnerability of low-skilled migrant workers, regardless of immigration status. 149 150 151 152 153 Leda Perez and Jacqueline Martinez, “Community Health Workers: Social Justice and Policy Advocates for Community Health and Well-Being”, American Journal of Public Health, vol. 98, No. 1 (January 2008), pp. 11-14. Committee on the Elimination of Discrimination against Women (CEDAW), general recommendation No. 26 (2008) on women migrant workers, para. 5; Gloria Moreno-Fontes Chammartin, “Female migrant workers‟ situation in the labour market (ILO, 2006), available at http://www.ilo.org/public/english/protection/migrant/download/unfpa_newyork_report_2006.pdf. IOM, Migration and Health in SADC: A review of the literature (2010), p. 19. CEDAW, general recommendation No. 26, para. 2. United Nations Population Fund (UNFPA), State of the World Population 2006, A Passage to Hope: Women and International Migration (2006), pp. 38-9; Kenda Crozier, Pleumjit Chotiga and Michael Pfeil, “Factors influencing HIV screening decisions for pregnant migrant women in South-East Asia”, Midwifery (2012), p. 1, available from http://dx.doi.org/10.1016/j.midw.2012.08.013. 21