**4. Discussions**

Our findings show that females accounted for the majority of the population sampled. The high number of females reported in the study indicates that the phenomenon of female migration has increased in recent times. Similar studies by Awumbila et al. [4] have also demonstrated that the migration of young females has become a common phenomenon due to the benefit of remittances from female members who work as head porters and domestic workers in the city.

The majority of those sampled for the study were young people. This is because most of the respondents at that stage of life want to explore the opportunities that migration can offer them. Similar findings from UNICEF [14] also note that the ages of most migrant workers often range from 15–24 years, accounting for one-eighth of the age groups that are often seen moving in search of better economic opportunities. One may be tempted to believe that migration in its widest sense is beneficial. However, certain age groups and categories of the population are particularly vulnerable to abuse, exploitation, discrimination, social exclusion, and violence. These have the tendency to expose them to poor health outcomes. Furthermore, the study found that most of the migrants had attained only a low level of education. It is not surprising, therefore, that most of them find themselves in low-paid work in the informal sector, with its associated long working hours. Such labor disparities do not only pose a health risk to them and their families but also contradict the ILO Constitution, which sets forth the principle that workers should be protected from sickness, disease, and injury arising from their employment [60].

Our finding also suggests that most of the migrants were from the three northern regions. The motivation behind the movement to Agbogbloshie was the need to seek better employment opportunities. This finding demonstrates the Harris–Todaro [19] model of migration, which explains why people move from rural areas to urban centers despite the high unemployment rates in the cities. Building on the works of early scholars, such as Ravenstein, Harris, and Todaro, see migration as an economic activity that for the individual migrant could be a rational decision despite the existence of urban unemployment. For most of the migrants that were sampled in this study, the unavailability of job opportunities in their places of origin forced them to seek better opportunities in the informal settlement of Agbogbloshie in the city of Accra. This makes migration to the city by many of the youth a gamble in seeking better opportunities [19].

We also found various precarious work activities ranging from scrap dealerships, electronic waste dealerships, head porterage, commercial motorbike riding, hawking on the main street of Accra, and pushing of trucks loaded with goods to be conveyed to their destinations, as well as long working hours and generally dirty, dangerous, and demeaning conditions under which this work is performed for a meager income. As noted by Piper et al. [61], this phenomenon is often common with migrants in search of better work and wages who often find themselves battling for jobs on the lowest rungs of the labor market. The work is often insecure, arbitrarily remunerated, and thinly regulated. This finding is consistent with Harris and Todaro's [19] model of migration, which further argues that migration occurs in response to rural-urban differences in expected income rather than actual earnings [19]. In the case of the migrants at Agbogbloshie, emigration to their current destination offers them employment opportunities despite the precarious nature of the work they find for themselves. As highlighted in the ecological models, individuals are understood to influence and be influenced by the people and organizations with whom they

interact, available resources and institutions, and societal norms and rules [39]. Generally, efforts to address structural changes, such as equal geographic development, to address rural-urban migration and policies to regulate the activities in the informal sector of the economy can go a long way to address precarious work activity among migrants.

Results from the logistic regression that was performed on whether or not the type of work undertaken by the migrants resulted in poor health outcomes, using motor riders as a reference in the analysis, suggested that people who are engaged in electronic waste have the same odds of poor health outcomes when compared to motor riders (OR =1.0 [95%CI: 0.09–10.17]; P = 1.0). Scrap dealers have reduced the odds of falling sick when compared to motor riders. However, the reduced odds are not statistically significant (OR = 0.69 [95%CI: 0.10–4.72]; P = 0.71). Migrants who are head porters have in excess of 25% increased odds of falling sick when compared to motor riders even though the p-value is not significant (OR = 0.25 [95%CI: 0.22–6.97]; P = 0.80). The odds of street hawkers falling sick when compared to motor riders is (OR = 0.5 [95%CI: 0.03–7.45]; P = 0.62). However, the resulting p-value is insignificant.

Truck pushers have a reduced odds of experiencing sickness when they are compared to motor riders. The p-value is, however, insignificant (0.83[95%CI: 0.05–13.63]; P=0.90). In other studies, evidence of job insecurity and vulnerability have been shown to have significant adverse effects on self-reported physical and mental health. For example, results show that, relative to workers who remained in secure employment, self-reported morbidity was higher among workers reporting insecurity in their jobs [62]. As suggested by the ecological model, such behaviors that make migrants indulge in precarious work activities will need specific health behavior interventions in order to promote their health and wellbeing [42, 45, 47, 63–65].

While national legislation and policies determining migrant status play an active role in producing precarity for migrant workers, our study found that the government, through the Ministry of youth and employment, though in the process of fully addressing the issue of precarious work activity among migrant workers, work has been slow in achieving this goal. Such actions only exacerbate the plight of migrant labor workers, potentially delaying the achievement of SDG 8. According to Anderson, [66] and Lewis et al., [67], policies of national governments are very important not only for regulating the flow of migrants into a country but also for the types of migrant labor available to employers, that is, that can be paid minimal amounts and offered on highly flexible and insecure terms, and which needs to be regulated.
