Objectives: Labour migration contributes substantially to the gross domestic product of Nepal, with a large number of the population engaged in overseas employment. This paper describes and critically analyses the policies and the current situation of health services for the labour workforce, and identifies possible solutions to enhance worker safety and health throughout the migration process in Nepal. Methods: We conducted a narrative policy review to describe and analyse policies, practices and evidence regarding occupational safety and health of migrant workers during pre-departure, work and after returning to Nepal. Results: An estimated 2.2 million Nepalis are employed abroad, and around 1,700 individuals depart for destination countries each day. Migrant workers' health remains inadequately prioritised as Occupational Safety and Health (OSH) is not specifically addressed by laws or policies other than the Labour Act 2017. Although pre-departure medical examinations are mandatory, Nepal lacks policies and has no structured mechanism to address the periodic health examination for occupational diseases and their treatment among migrant workers while they are employed overseas and after return. OSH is not integrated into the public health system and has weak institutional frameworks. Furthermore, a comprehensive quality assurance framework for occupational health services has yet to be established in the country. Conclusions: In Nepal, occupational safety and health services are inadequate for the workforce within the country, and services for migrant workers are limited to pre-departure medical examination. Therefore, it is essential to enact policies and develop a system to ensure health services throughout the migration cycle for migrant workers.
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