Southeast Asian Studies, Vol. 49, No. 4, March 2012

A Comparative Study of Filipino and Indonesian Candidates
for Registered Nurse and Certified Care Worker Coming
to Japan under Economic Partnership Agreements:
An Analysis of the Results of Questionnaire Surveys on
the Socioeconomic Attribution of the Respondents
and Their Motivation to Work in JapanHIRANO O. Yuko,* OGAWA Reiko** and OHNO Shun***

Abstract
The widely disputed issue over foreign nurse and certified care-worker candidates under the Economic
Partnership Agreements in Japan seems endless. To establish more sustainable Economic Partnership
Agreements, we should discuss the issue from a holistic perspective through cross-sectional and longitudinal approaches.
This article addresses the socioeconomic characteristics and motivations of nurse and certified careworker candidates who enter Japan under the Indonesia-Japan Economic Partnership Agreement (IJEPA)
and the Japan-Philippines Economic Partnership Agreement (JPEPA). The correlation between the socioeconomic characteristics of the respondents and their motivations to work in Japan were examined basedon a cross-sectional analysis. In addition, the transition of nurse and certified care-worker candidates isdiscussed using a longitudinal approach, by comparing the data of previous groups obtained by our research
team.
The results of this study indicate that the socioeconomic characteristics of the respondents differedby country, as well as by occupation. Filipino candidates are more likely to cite economic condition as thereason they chose to go to Japan than the Indonesian candidates. While Filipino nurse and certified careworker candidates and Indonesian nurse candidates are still predominantly females, a “masculinization of
migration” is being observed among Indonesian certified care-worker candidates.
Keywords: EPA (Economic Partnership Agreement), Philippines, Indonesia, Japan, nurse,
certified care worker, migration

I Introduction
Since August 2008 when Japan began to accept foreign nurse and care-worker candidates under the
Economic Partnership Agreement (EPA) program, many discussions among those with various social* 平野裕子，Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki 852-8520,
Japan
Corresponding author’s e-mail: hirano@nagasaki-u.ac.jp** 小川玲子，Faculty of Law, Kyushu University, 6-10-1 Hakozaki, Higashi-ku, Fukuoka 812-8581, Japan*** 大野 俊，Center for Southeast Asian Studies, Kyoto University594

HIRANO O. Y. et al. : A Comparative Study of Filipino and Indonesian Candidates for Registered Nurse and Certified Care Worker

and political backgrounds, including the mass media, researchers, stakeholders and even those without
any direct connection with foreign nurses and care workers have pertained to the regulations for introducing foreign nurses and care workers under the EPA program. Some of these arguments seem tomiss the main point of this issue, which can lead to misunderstandings, which further confuse theproblem.
Observing the discussions from a medical sociological perspective, one can say that the discussants
are likely to represent their political status and benefits, but less likely to point out the issues from aholistic approach.
For example, members of Reform Mass Media which endorses “opening the country” are likely
to point out that “offering the national board examination only in Japanese is too much of a burden tothese foreign candidates. . . . We should therefore make the exam easier so that we can accept more
foreign candidates” [[Asahi Shimbun, November 29, 2009]. However, they do not refer to the fact thatthe foreign nurses and care workers who can only pass the “easy” examination are more likely to cause
medical accidents. Downgrading the exam might also encourage a stereotype of foreign nurses andcare workers as low-skilled laborers.
On the other hand, the Ministry of Health, Labour and Welfare adheres to the position that “InJapan, a potential nursing force of more than 900,000 exists. The government should utilize such a
potential work force first. Accepting foreign nurse and care-worker candidates under the EPA programis therefore a special case. We open the domestic market to foreigners not due to the lack of a workforce in Japan, but as a matter of trade” [Japan, Minister’s Secretariat, International Division, Ministryof Health, Labour and Welfare 2010]. The ministry does not address the fundamental issue of why the
number of potential Japanese nurses who choose not to work in the nursing field is increasing nor does
it offer any decisive policy to utilize the potential work force. It is therefore essential to discuss ways
to improve the work environment for nurses in Japan, regardless of their nationality; otherwise, evenforeign nurses who pass the board examination will choose not to work in Japan.
Other issues regarding the domestic market for care workers have not been thoroughly discussed
either. The Ministry of Health, Labour and Welfare has also failed to enact any clear policies that would
prevent the continual decrease in the number of Japanese care workers, nor have any concrete suggestions been made to improve the work environment for care workers in Japan.
Such narrow, one-sided perspectives may stifle any effective advocacy related to this issue. A
holistic approach, generated by obtaining data from the sending countries and the host country, is required to analyze the needs and demands of migrants and the host country accurately and objectively.
The authors of this study have worked as a research team since 2007 attempting to develop a moresustainable EPA program. The authors employ a qualitative and quantitative analysis of the two major
sending countries, Indonesia and the Philippines, and the receiving country (Japan) to establish a crosssectional and longitudinal framework.
The objectives of this article are as follows:
1) To describe the socioeconomic characteristics and motivations of the nurse and certified careworker candidates coming to Japan under IJEPA and JPEPA.
595

東南アジア研究 49 巻 4 号

2) To determine the correlation between the socioeconomic characteristics of the respondents andtheir motivations to work in Japan.
3) To compare those figures with the data obtained by our research team from previous groups ofcandidates.

II Methodology
We developed a four-page questionnaire after carefully examining the previous studies by our researchteam [Hirano et al. 2010: 153–162; Adachi et al. 2010: 163–174]. It was translated into English andpretested by Filipinos living in Japan. With the cooperation of the Philippine Overseas Employment
Administration (POEA), the questionnaire was distributed to all candidates who attended the predeparture orientation in May 2010. They answered and returned the questionnaires before the end of theorientation. The response rate was 100%.
For Indonesian candidates, the questionnaire was translated into Bahasa Indonesian and pretested
by Indonesians who lived in Japan. In cooperation with The Association for Overseas Technical Scholarship (AOTS), the questionnaire was distributed to all candidates who attended the language-intensive
course in August 2010. The response rate was 100%.
For this article, 118 Filipino candidates (46 nurse and 72 certified care-worker candidates) plus
114 Indonesian candidates (40 nurse and 74 certified care-worker candidates) were included in theanalysis. The author of this study divided the data by occupation as well as by country of origin because
nurses and certified care workers have different job descriptions.
Chi-square tests, Fisher’s exact tests and t-tests were performed to compare each group, using
the SPSS 19.J software program. The Institutional Research Board of Nagasaki University approved
this study.

III The Results
The distribution of females among the Filipino certified care-worker candidates was 98.6%, significantly higher than that of Indonesian certified care-worker candidates (p<0.001). The average age ofFilipino nurse candidates was 31.8 years (SD4.7), significantly older than Indonesians’ at 26.7 (SD2.2),(p<0.001). The average age of Filipino certified care-worker candidates at 26.8 years (SD4.1) was alsosignificantly older than that of Indonesian certified care-worker candidates at 23.7 (SD2.6), (p<0.001).
Indonesian nurse candidates were more likely to be the oldest sibling than Filipino nurse candidates(p<0.01).
More of the Filipino nurse candidates (26.7%) and certified care-worker candidates (21.4%) were
married than the Indonesian nurses candidates (7.7%) and certified care-worker candidates (5.6%),(p<0.05, p<0.01 respectively). Filipino nurse candidates were also more likely to have a child/children(52.2%) than Indonesian nurse candidates (27.5%), (p<0.05).
Of the Filipino nurse candidates, 34.8% had prior experience working abroad as a nurse before
participating in the EPA program. This was a significantly higher percentage than for Indonesian nurse
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HIRANO O. Y. et al. : A Comparative Study of Filipino and Indonesian Candidates for Registered Nurse and Certified Care Worker

Table 1 Socio-demographic Characteristics of the Respondents (Filipinos/Indonesians)
Filipino Indonesian
Nurse
Nurse p value
Female (%)
Age (SD)

95.7

87.2 n.s.

Filipino Indonesian
CertifiedCertified p value
Care Worker Care Worker
98.6

68.9 p<0.001
23.7 (2.6) p<0.001

31.8 (4.7)

26.7 (2.2) p<0.001

26.8 (4.1)

Married (%)

26.7

7.7 p<0.05

21.4

5.6 p<0.01

Have child/children (%)

52.2

27.5 p<0.05

45.8

45.9 n.s.

Oldest sibling (%)

20

47.4 p<0.01

31.9

45.9 n.s.

Economic condition at difficult
to survive (%)

2.2

2.5 n.s.

4.2

1.4 n.s.

Have experience to work abroad
as a nurse (care worker) prior
to entry to Japan (%)

34.8

7.5 p<0.01

10.3

16.7 n.s.

Have lived in Japan before (%)

4.3

0 n.s.

12.5

1.4 p<0.01

Know well/fairly well about
Japanese society and culture (%)

23.9

25 n.s.

43.1

47.2 n.s.

candidates (p<0.01). In addition, 12.5% of the Filipino certified care-worker candidates had experienced
living in Japan previously. Again, it was significantly higher than the percentage of Indonesian certifiedcare-worker candidates, who had previously lived in Japan (p<0.01) (Table 1).
Table 2 shows the differences by country of origin in the distribution of reasons candidates choseto go to Japan. Filipino nurse and certified care-worker candidates were more likely to select “I wasjobless at the time when I applied for this program” (p<0.01, p<0.01 respectively) than their Indonesiancounterparts. This tendency also held true for “I can earn a higher salary in Japan than in other countries” (p<0.01, p<0.01 respectively) and “I was frustrated with my salary in the Philippines/Indonesia”(p<0.001, p<0.001 respectively).
Indonesian nurse candidates tended to select “I have some family/relative(s) who has (have) already
lived in Japan” (p<0.05) and “I want to marry a Japanese partner” (p<0.001) than Filipino nurse candidates. Indonesian certified care-worker candidates were also more likely to choose “My family recommended me to go to Japan” (p<0.001) than Filipino certified care-worker candidates. The Filipino nurse
candidates were more likely to answer, “I wish to support my family economically” (p<0.05) thanIndonesian nurse candidates.
Table 3 notes the distribution of reasons a candidate wanted to go to Japan by gender. Among theIndonesian nurse candidates, females tended to answer “I want to utilize my experiences in Japan for
my future work at the hospital/elder home in other countries” (p<0.05) than male nurse candidates.
Among Indonesian certified care-worker candidates, males were more likely to answer “I was joblessat the time when I applied for this program,” (p<0.05) than females. The female Indonesian certifiedcare-worker candidates were more likely to answer “I am not required to pay commission fees foroverseas placement” (p<0.05) than males.
Table 4 summarizes the distribution of reasons the participants wanted to go to Japan by marital
status. Among the Filipino certified care-worker candidates, those who were unmarried were more597

東南アジア研究 49 巻 4 号

Table 2 Reason to Go to Japan by Country (Filipinos/Indonesians)
Filipino Indonesian
Nurse
Nurse p value

Filipino Indonesian
CertifiedCertified p value
Care Worker Care Worker

I was jobless at the time I applied
for this program.

45.7

12.5 p<0.01

73.6

I have some family/relative(s) who
has (have) already lived in Japan.

28.3

52.5 p<0.05

20.8

28.4 n.s.

I wish to develop my professional
career.

100

100 –

100

98.6 n.s.

My family recommended me to go
to Japan.

45.7

42.5 n.s.

16.7

51.4 p<0.001

I can have a chance to workin Japan with this program sooner
than work in another country.

89.1

92.5 n.s.

93.1

86.5 n.s.

I am interested in Japanese culture
such as animation and comics.

97.8

92.5 n.s.

90.1

90.5 n.s.

I wish to support my family
economically.

100

87.2 p<0.05

100

94.6 n.s.

I wish to learn advanced Japanesetechnology.

100

100 –

100

97.2 n.s.

I wish to realize my dream to live
abroad.

93.5

92.3 n.s.

90.3

86.3 n.s.

I wish to contribute to the government-to-government program.

97.8

95 n.s.

100

95.8 n.s.

I can earn a higher salary in Japan
than in other countries.

93.5

62.2 p<0.01

94.4

I want to utilize my experiencesin Japan for my future workat the hospital/elderly homein other countries.

82.2

92.5 n.s.

88.9

89.2 n.s.

I want to marry a Japanese partner.

2.2

33.3 p<0.001

11.3

11 n.s.

I am not required to pay commission fees for overseas placement.

93.5

44.9 n.s.

94.4

86.5 n.s.

I wish to show the caring natureof the Filipinos/Indonesians to
the Japanese people.

100

100 –

98.6

100 n.s.

I was frustrated with my salaryin the Philippines/Indonesia.

69.6

10.3 p<0.001

50

50 p<0.01

74 p<0.01

9.6 p<0.001

likely to answer “I am interested in Japanese culture such as animation and comics” than the marriedcandidates (p<0.05).
Table 5 illustrates the distribution of reasons the candidates chose to go to Japan based on thepresent economic conditions. Among the Indonesian certified care-worker candidates, those who did
not find it difficult to survive and those who found it difficult, but manageable, were more likely to answer“I wish to learn advanced Japanese technology” (p<0.05) than those who found it very difficult tosurvive.
Fig. 1 shows the frequencies of the primary reasons that motivated Filipino nurse candidates to go
to Japan. Twenty-two candidates (47.8%) chose “I wish to develop my professional career,” followed
598

50
100
100
100

I can have a chance to work in Japan with this program
sooner than work in another country.

I am interested in Japanese culture such as animation and comics.

I wish to support my family economically.

I wish to learn advanced Japanese technology.

0
50
100
0

I wish to show the caring nature of the Filipinos/Indonesians
to the Japanese people.

I was frustrated with my salary in the Philippines/Indonesia.

50

I want to utilize my experiences in Japan for my future workat the hospital/elderly home in other countries.

I am not required to pay commission fees for overseas placement.

50

I can earn a higher salary in Japan than in other countries.

I want to marry a Japanese partner.

100

I wish to contribute to the government-to-government program.

50

100

I wish to realize my dream to live abroad.

100

My family recommended me to go to Japan.

0

I wish to develop my professional career.

0

I was jobless at the time I applied for this program.

I have some family/relative(s) who has (have) already lived
in Japan.

male
(n=2)

72.7 n.s.

100 –95.5 n.s.

2.3 n.s.

83.7 n.s.

95.5 n.s.

97.7 n.s.

95.5 n.s.

100 –

100 –

97.7 n.s.

90.9 n.s.

43.2 n.s.

100 –29.5 n.s.

47.7 n.s.

femalep value(n=44)

Filipino Nurse

0

100

100

60

60

100

100

100

100

100

80

100

40

100

80

0

male
(n=5)

12.1 n.s.

100 –93.5 n.s.

30.3 n.s.

97.1 p<0.05

54.8 n.s.

94.1 n.s.

90.9 n.s.

100 –84.8 n.s.

94.1 n.s.

91.2 n.s.

41.2 n.s.

100 –50 n.s.

14.7 n.s.

femalep value(n=34)

Indonesian Nurse

0

100

0

0

0

0

100

100

100

100

100

0

0

100

0

0

50.7 n.s.

98.6 n.s.

95.8 n.s.

11.4 n.s.

90.1 n.s.

95.7 n.s.

100 –90.1 n.s.

100 –

100 –

90 n.s.

94.4 n.s.

16.9 n.s.

100 –21.1 n.s.

74.6 n.s.

femalep value(n=71)

Filipino Certified
Care Worker
male
(n=1)

Table 3 Reason to Go to Japan by Gender (Filipinos/Indonesians)

17.4

100

73.9

8.7

91.3

72.7

100

95.7

95.7

95.7

95.7

87

60.9

100

21.7

69.6

male
(n=23)

6 n.s.

100 –92.2 p<0.05

12 n.s.

88.2 n.s.

74.5 n.s.

93.9 n.s.

82 n.s.

98 n.s.

94.1 n.s.

88.2 n.s.

86.3 n.s.

47.1 n.s.

98 n.s.

31.4 n.s.

41.2 p<0.05

femalep value(n=51)

Indonesian Certified
Care Worker

HIRANO O. Y. et al. : A Comparative Study of Filipino and Indonesian Candidates for Registered Nurse and Certified Care Worker

599

600
100
69.7

I wish to show the caring nature of the Filipinos/Indonesians
to the Japanese people.

I was frustrated with my salary in the Philippines/Indonesia.

393.9

I am not required to pay commission fees for overseas placement.

I want to marry a Japanese partner.

84.4

I wish to contribute to the government-to-government program.

I want to utilize my experiences in Japan for my future workat the hospital/elderly home in other countries.

97

I wish to realize my dream to live abroad.
90.9

97

I wish to learn advanced Japanese technology.

I can earn a higher salary in Japan than in other countries.

100

I wish to support my family economically.

100 n.s.

97
100

I am interested in Japanese culture such as animation and comics.

100 n.s.

84.8

I can have a chance to work in Japan with this program
sooner than work in another country.

100 –66.7 n.s.

100 –91.7 n.s.

0 n.s.

75 n.s.

100 n.s.

100 n.s.

83.3 n.s.

100 –

100 –

41.7 n.s.

100
45.5

25 n.s.

My family recommended me to go to Japan.

27.3

58.3 n.s.

8.6

100

94.1

37.1

91.7

57.6

94.4

91.4

100

85.7

91.7

91.7

38.9

100

52.8

11.1

33.3 n.s.

100 –100 n.s.

0 n.s.

100 n.s.

100 n.s.

100 n.s.

100 n.s.

100 n.s.

100 n.s.

100 n.s.

100 n.s.

66.7 n.s.

100 –33.3 n.s.

0 n.s.

50.9

98.2

94.5

14.8

90.9

96.3

100

90.9

100

100

94.4

92.7

16.4

100

23.6

76.4

40 n.s.

100 n.s.

93.3 n.s.

0 n.s.

80 n.s.

86.7 n.s.

100 –86.7 n.s.

100 –

100 –

73.3 p<0.05

93.3 n.s.

13.3 n.s.

100 n.s.

13.3 n.s.

60 n.s.

10.6

100

86.6

12.1

88.1

74.2

95.4

84.8

96.9

95.5

89.6

86.6

49.3

98.5

28.4

49.3

0 n.s.

100 n.s.

100 n.s.

0 n.s.

100 n.s.

75 n.s.

100 n.s.

100 n.s.

100 n.s.

75 n.s.

100 n.s.

75 n.s.

75 n.s.

100 n.s.

25 n.s.

25 n.s.

marriedp value(n=4)

Indonesian Certified
Care Worker

marriedunmarried
p value(n=15)(n=67)

Filipino Certified
Care Worker

marriedunmarried
p value(n=3)(n=55)

Indonesian Nurse

marriedunmarried
p value(n=12)(n=36)

I wish to develop my professional career.

42.4

I was jobless at the time I applied for this program.

I have some family/relative(s) who has (have) already lived
in Japan.

unmarried(n=33)

Filipino Nurse

Table 4 Reason to Go to Japan by Marital Status (Filipinos/Indonesians)

東南アジア研究 49 巻 4 号

Indonesian Nurse

Filipino Certified
Care Worker

Indonesian Certified
Care Worker

68.9

81.8

I want to utilize my experiences in Japan for my future workat the hospital/elderly home in other countries.

I was frustrated with my salary in the Philippines/Indonesia.

93.3

I can earn a higher salary in Japan than in other countries.

100

97.8

I wish to contribute to the government-to-government program.

I wish to show the caring nature of the Filipinos/Indonesians
to the Japanese people.

0 n.s.

93.3

I wish to realize my dream to live abroad.

2.2

100

I wish to learn advanced Japanese technology.

93.3

100 n.s.

100

I wish to support my family economically.

I want to marry a Japanese partner.

100 n.s.

97.8

I am interested in Japanese culture such as animation and comics.

I am not required to pay commission fees for overseas placement.

100 n.s.

88.9

I can have a chance to work in Japan with this program
sooner than work in another country.

100 n.s.

100 –100 n.s.

100 n.s.

100 n.s.

100 n.s.

100 –

100 –

100 n.s.

100 –

100
44.4

100 n.s.

My family recommended me to go to Japan.

26.7

0 n.s.

I wish to develop my professional career.

46.7

I was jobless at the time I applied for this program.

I have some family/relative(s) who has (have) already lived
in Japan.

7.9

100

94.4

34.2

92.3

63.9

94.9

92.1

100

86.8

92.3

92.3

41

100

51.3

12.8

100 n.s.

100 –100 n.s.

0 n.s.

100 n.s.

0 n.s.

100 n.s.

100 n.s.

100 –100 n.s.

100 n.s.

100 n.s.

100 n.s.

100 n.s.

100 n.s.

0 n.s.

50.7

98.6

94.2

10.3

89.9

94.1

100

89.9

100

100

89.7

94.2

15.9

100

21.7

72.5

33.3 n.s.

100 n.s.

100 n.s.

33.3 n.s.

66.7 n.s.

100 n.s.

100 n.s.

100 n.s.

100 n.s.

100 –100 n.s.

66.7 n.s.

33.3 n.s.

100 –0 n.s.

100 n.s.

10

100

87.1

11.6

90

75.4

95.6

85.5

98.5

94.3

90

85.7

48.6

98.6

27.1

48.6

0 n.s.

100 –100 n.s.

0 n.s.

0 n.s.

0 n.s.

100 n.s.

100 n.s.

0 p<0.05

100 n.s.

100 n.s.

100 n.s.

100 n.s.

100 n.s.

100 n.s.

100 n.s.

Not
Not
Not
Not
difficult toVerydifficult toVerydifficult toVerydifficult toVerysurvive/ difficult tosurvive/ difficult tosurvive/ difficult tosurvive/ difficult top valuep valuep valuep valueable to surviveable to surviveable to surviveable to survive
survive
survive
survive
survive
(n=1)
(n=1)
(n=3)
(n=1)
(n=45)(n=39)(n=69)(n=70)

Filipino Nurse

Table 5 Reason to Go to Japan Based on Economic Condition (Filipinos/Indonesians)

HIRANO O. Y. et al. : A Comparative Study of Filipino and Indonesian Candidates for Registered Nurse and Certified Care Worker

601

東南アジア研究 49 巻 4 号

by 17 (37.0%), who selected “I wish to support my family economically.”
Fig. 2 displays the frequencies of the primary reasons Indonesian nurse candidates cited for goingto Japan. Sixteen (40.0%) of the respondents selected “I wish to develop my professional career”
followed by 10 (25.0%) who picked “I wish to support my family economically.”
Fig. 3 illustrates the frequencies of the primary reasons Filipino certified care-worker candidates
named for going to Japan. Twenty-four (33.3%) of the respondents chose “I wish to support my family
economically,” followed by 23 (31.9%) “I wish to develop my professional career.”Fig. 4 shows the frequencies of the primary reasons Indonesian certified care-worker candidates
identified for their going to Japan. Twenty-eight (37.8%) of the respondents picked “I wish to develop
my professional career,” followed by 20 (27.0%) “I wish to support my family economically.”

IV Discussions(a) Characteristics by Country of Origin
Because there are a limited number of respondents in this study, it is necessary to interpret the statistics cautiously. Nevertheless, this study provides sufficient information for a better understanding of
the EPA candidates.
Our study indicated that sociodemographic characteristics differ by country of origin. Regardlessof their intended occupation, the Filipino candidates, especially the nurse candidates, were generally
older and married with a child/children than their Indonesian counterparts (Table 1). This phenomenon
was also observed in the previous studies [Hirano et al. 2010: 153–162; Adachi et al. 2010: 163–174].
The authors assume that one of the reasons for such differences between the Filipinos and Indonesians may be due to the respondents’ prior experiences of going abroad before they applied to thisprogram. As Table 1 indicates, Filipino nurse candidates were more likely to have previous experience
working abroad (p<0.01) than Indonesian nurse candidates. Most countries that accept foreign nurses
require at least one year of clinical experience in the country of origin [Venzon 2003: 51–62], therefore,
one can assume that the Filipino nurse candidates, including a large number of returnees, are likely tobe older than Indonesians.
With regard to certified care-worker candidates, many repeat applicants to Japan were included(Table 1), and it was clear that Filipino certified care-worker candidates were more likely than Indonesians to have previously experienced living in Japan. According to the authors’ interviews of Filipino
certified care-worker candidates, some candidates who had formerly been entertainers in Japan were
included. One former entertainer in Japan, returned after the expiration of her entertainment visa, said
that she was “too old” to work in Japan as an entertainer, so she decided to return as a care-worker
candidate the next time. She needed to go back to Japan because she was married and had children to
feed. She hoped her six-month experience working in Japan would enable her to manage average daily
Japanese conversation fluently. She anticipated that her proficiency in Japanese would help her adjust
to her new life in Japan as a care-worker candidate.1) As represented by the above episode, many
1) An interview with a former entertainer in Japan in May 2009.
602

HIRANO O. Y. et al. : A Comparative Study of Filipino and Indonesian Candidates for Registered Nurse and Certified Care Worker

Fig. 1 Primary Reason to Go to Japan (Filipino Nurse)

Fig. 2 Primary Reason to Go to Japan (Indonesian Nurse)603

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Fig. 3 Primary Reason to Go to Japan (Filipino Certified Care Worker)

Fig. 4 Primary Reason to Go to Japan (Indonesian Certified Care Worker)

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Filipinos have prior experience living and working abroad, and therefore, they are more likely to beolder, married, and have a family.
Table 2 demonstrates another characteristic of the Filipino candidates. Although no statisticallysignificant difference was found for the perceived economic condition of the families between Filipino
candidates and Indonesian candidates, by comparing each category based on their reason for going toJapan, it became clear that reasons related to the economic condition were more likely to be cited by
Filipino candidates than Indonesian candidates. Reasons such as being jobless at the time of theirapplications for the EPA program, having a need to support family economically, expecting a higher
salary in Japan than in other countries, and being frustrated with their salary in the Philippines influenced Filipino candidates more than Indonesian candidates with regard to being recruited to Japan forwork.
The interpretation of these results was consistent with the findings of previous studies. For
example, Hirano [2009a: 44–47] noticed that Filipino migrants were more likely to be financially
supporting families, in the name of “utang na loob” (reciprocity), a cultural value of the Filipinos[Hollunsteiner 1979: 38–43]. Based on this principle, one of the easiest ways to show love for theirfamilies is by sending money from abroad so to enable the family to enjoy a better life. Therefore,
Filipinos are more likely to go to Japan to uphold this tradition.
(b) Transitions of Nurse and Certified Care-Worker Candidates
The results of this study indicate that there are several points currently in transition for nurse andcertified care-worker candidates. The characteristics of the candidates differ by occupation as well as
by country of origin. The authors of this article will focus on two main points currently under transition:
gender distribution and the primary reason(s) for going to Japan.
Regarding the gender distribution, as Piper [2003: 21–48] recorded, a feminization of migration iscommonly observed in transnational migration. In this study, the phenomenon is clearly observed
among the Filipino candidates. The feminization of migration of Filipino candidates is even stronger
now than was true for the previous groups of candidates. For example, the proportion of female Filipino
nurse candidates has increased from 88.9% to 95.7%, and that of Filipino certified care-worker candidates has increased from 88.6% to 98.6%.
On the other hand, for Indonesian candidates, the gender distribution varies by occupation. For
nurse candidates, the ratio of females has increased from 82.0% to 87.2%, while for certified careworker candidates, the ratio of females has decreased from 77.0% to 68.9%. This may be because maleIndonesian certified care-worker candidates are more likely to choose the option to go abroad thanfemales when they are jobless, even if they are required to pay commission fees for overseas placement(Table 3). A statistically significant correlation between gender and “I am not required to pay commission fees from overseas placement” as a reason for going to Japan was not shown in the previous
studies [Adachi et al. 2010: 163–174], so this must be a new phenomenon affecting Indonesian careworker migration.
There may be several reasons for the irregular gender distribution by occupation among Indonesiancandidates. One can assume that it may be caused by the different characteristics between nurses and605

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care workers. Asakura [2005: 1120–1125] suggested that nursing is considered a female job in Japan.
For this reason, many of the first Indonesians were not able to match the requirements of the Japanesehospitals and they were not able to become candidates for work in Japan [Yomiuri Shimbun, July 29,
2008].2)
On the other hand, certified care-worker candidates are less likely to experience gender biases.
A staff member at a Japanese long-term care facility said that he preferred male certified care-worker
candidates, because males were stronger than females, so they could easily hold and lift the patients.
Additionally, Indonesian males tended to be shorter than Japanese males in height, so physically they
did not intimidate the patients. Possibly for these reasons, more Japanese institutions have begun toprefer male Indonesian care-worker candidates.3) This is one of the reasons responsible for accelerating the increased migration of male Indonesian certified care-worker candidates, which has been provenstatistically. The female distribution was 68.9% for Indonesian certified care-worker candidates, significantly lower than that of Filipino candidates (p<0.001) (Table 1). Further investigation is needed
to determine why this masculinization of migration appears only among the Indonesian candidates.
Regarding the changes in the primary reasons for going to Japan, there were clear differences bycountry, as was also true in our previous studies [Hirano et al. 2010: 153–162; Adachi et al. 2010:
163–174]. When asked their primary reason for going to Japan, the answers of the second group ofIndonesian candidates, especially nurse candidates, showed a monopolar distribution: 66.7% of the
respondents answered “I wish to develop my professional career.” In contrast, the Filipino candidate
constituted a bipolar distribution. For the Filipino nurses, “I wish to support my family economically”(42.7%), was closely followed by “I wish to develop my professional career” (36.5%) [Hirano et al. 2010:
153–162]. Adachi et al. [2010: 163–174] mentioned that the bipolar distribution was found also among
the first group of Filipino certified care-worker candidates.
In this study, Indonesian nurse candidates’ answers showed a more bipolar distribution than theprevious group (Fig. 2). One can assume that the differences in the economic backgrounds of thefamily resulted in the differences in their responses between Filipino and Indonesian nurse candidates.
This does not contradict the premise that no statistical differences in the economic conditions of thefamilies were established between the two groups.
More interestingly, the primary reason Filipino nurse candidates gave for emigrating to Japandiffered from that of the last group of candidates. In the last group, “I wish to support my family economically” was the primary reason, but in this group, the major reason had changed to “I wish to develop
my professional career” (Fig. 1). This may indicate a transition for Filipino nurse candidates in choosing Japan as a way to increase their career development. Asato [2010: 53–64] previously mentionedthat EPA nursing candidates were not developing their careers; in fact they had often been degradedand deskilled by not being allowed to perform nursing interventions. Similar complaints were derived

2) This article reported that those who were not able to become candidates were all male. The first author of thisstudy found that majority of them were male, but some females were also included.
3) An interview with a care-worker staff member working for an institution in the Kyushu Region in November
2008.
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from the authors’ interviews. An Indonesian candidate complained “I am not coming here to clean
windows! I was an ICU nurse in Indonesia and I come here to learn advanced Japanese technology!” 4)
That opinion was not reported during interviews with Filipino nurse candidates. Their main complaints concerned the salary and the high cost of living that makes it more difficult to send a sufficient
remittance to their families in the Philippines.5)
The authors of this study interpreted this phenomenon as follows: The act of nursing depends onthe culture where it is being performed. This was clearly indicated in the authors’ interview [Hirano
2009a: 44–47]. If a nurse works in another culture, she/he may encounter different types of nursing
care under the different cultural contexts. Therefore, the experience of working abroad as nurses would
allow them to evaluate the nursing practices in their own countries more objectively. Indonesian nurse
candidates, with less experience going abroad than Filipino nurse candidates, may have fewer opportunities to be exposed to new nursing skills developed in other countries, thus they may tend to adhere
to their ethnocentrism. In other words, they believe that the standards of nursing care in Indonesia areuniversal, which is not true.
For example, if an ICU nurse believes that her/his work in Indonesian hospitals managing high-tech
medical equipment, is typical, it might be difficult for such a candidate to work in the field of occupational
therapy, which in psychiatric nursing, can include cleaning windows with patients. This interpretationof conflicting expectations is consistent with the findings of Alam and Wulansari [2010: 183–192]. Fromtheir interviews with Indonesian nurse candidates in Western Japan, they found that the initial friction
encountered by Indonesian nurse candidates later developed into innovative attitudes toward nursing,namely physical intimacy, empathetic nursing, and punctuality as a work ethic. But such “creative
friction” can be experienced only after they go abroad.
With their prior experiences working abroad as nurses, Filipino nurse candidates are more likely
to anticipate “something to learn” from the Japanese in terms of their career development, because
they understand nursing in Japan is different from that in the Philippines. Further studies on this issue
are needed to follow the transition of why Filipino nurse candidates choose to go to Japan.
(c) New Findings on the Migration Patterns of Indonesian Candidates
The focus of this study was to obtain quantitative data so that the authors could present a cross-sectional,
as well as a longitudinal, analysis. By utilizing a quantitative procedure, the authors can objectively
clarify some myths about the migration pattern exhibited by the past studies. For instance, the belief
that “the oldest siblings must go abroad to help the younger siblings go to school” is widely accepted
in Filipino society. However, this was not quantitatively proven in Hirano’s previous study of the firstgroup of Filipino candidates [Hirano et al. 2010: 153–162] nor in this study. On the contrary, respondents
who were the oldest siblings were more likely to be found among the Indonesian nurse candidates. This
fact should alert researchers, who obtain information through qualitative data analysis that they must test
their hypothesis carefully against a quantitative analysis to prevent interpreting the facts incorrectly.
4) An interview with an Indonesian nurse candidate in the Kyushu Region in May 2009.
5) An interview with Filipino nurse candidates in the Kansai Region in February 2011.
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This study also applies to migration studies because it provides quantitative data about the Indonesian candidates. Because of the large gap in the number of nurses recruited from the Philippines andthose from Indonesia,6) the migration pattern of Indonesian nurses has not been investigated as extensively due to the lack of data. By analyzing the Indonesian data in comparison with the Filipino data,
this study has uncovered some new findings about Indonesian migration patterns.
First, the chain migration pattern of Indonesian nurse candidates became clear. Hirano’s survey
results did not address differences between the second group of Indonesian nurse candidates and thefirst group of Filipino nurse candidates who answered that “I have some family/relative(s) who has(have) already lived in Japan” [ibid.]. But a year later, the third group of Indonesian nurse candidates
were more likely to answer that they came to Japan because they had some family/relative(s) who has(have) already lived in Japan than the second group of Filipino nurse candidates (p<0.05) (Table 2).
One can assume that the experience of having previous workers in Japan may lead to an increasein family members electing to work in Japan. This is particularly true of Indonesians, who started tosend nurse candidates to Japan a year earlier than Filipinos. Such chain migration is expected to increase, particularly in Indonesians, since more Indonesian candidates answered that “I want to marrya Japanese partner” in the previous studies [ibid.; Adachi et al. 2010: 163–174] and this proved true also
for this study. Marrying a Japanese partner is a key factor that allows them to become a permanent
resident of Japan [Murphy-Shigematsu 2000: 198–216]. That may result in their bringing their families
or siblings from Indonesia to Japan in the future.
Second, the family dynamics of Indonesian candidates must be discussed. In this study, Indonesiancertified care-worker candidates were more likely to answer “My family recommended me to go to
Japan” than Filipino certified care workers (p<0.001). This phenomenon can also be observed in
Adachi’s findings (p<0.01) [Adachi et al. 2010: 163–174].
When interpreting this phenomenon, one can assume that family approval is especially importantfor Indonesian candidates. Hirano [2010: 48–50] reported that family’s opinion is very influential on thecandidates and Indonesian candidates have even terminated their contacts halfway through to returnhome at the request of their families. The National Board for Placement and Protection of IndonesianOverseas Workers (BNP2TKI) of Indonesia, responsible for the placement of Indonesian candidates tobecome care workers in Japan, has also experienced a high degree of frustration because some candidates decide to withdraw from this program even after they have been officially matched to Japanesehospitals and/or care facilities. Therefore, the BNP2TKI is now considering whether the applicantsshould be required to submit a letter of agreement signed by their families. For the above reasons,Indonesian candidates appear to be obligated to have their family’s approval before going to Japan.
(d) Factors Required for the Development of Sustainable EPA Programs
According to the current EPA regulations, certified care-worker candidates may qualify with experience6) According to the POEA statistics of 2010, more than 13,014 nurses departed to work abroad. For Indonesians,
between 1989 and 2007, only 5,566 nurses left to work abroad before the IJEPA started [Panchaweda 2008:
46–51].
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other than a nursing background [Japan, Minister’s Secretariat, International Division, Ministry of
Health, Labour and Welfare 2010]. To become a Filipino certified care-worker candidate, she/he must
be a college graduate (with any major). Those, who graduated with a non-nursing major, however, mustcomplete a six-month caregiver course provided by the TESDA (Technical Education and Skills Development Authority). A similar 105-day intensive training course was offered for Indonesian certified careworker candidates at designated training centers in Indonesia in 2009. Such scheme may attract more
people with various backgrounds, including those who are interested in not only caring for the elderly,
but also in learning about Japanese culture or Japanese technology. The economic condition of thefamily may also affect their attitudes about working in Japan. For example, unmarried Filipino certifiedcare- worker candidates are more likely to come to Japan than married workers, in order to satisfy theirinterest in Japanese culture, such as animation and comics (Table 4). Some Indonesian certified careworker candidates who are not economically burdened at home might come to Japan because they areinterested in learning Japanese technology (Table 5) rather than because they can earn a better salaryin Japan.
For this reason, one can postulate that certified care-worker candidates are not always suited forand enthusiastic about caring for the elderly. The authors of this study found that some Japanese staff
at care facilities were embarrassed by the Indonesian certified care-worker candidates who had graduated from a Japanese language course in universities in Indonesia. A staff member said that the candidates had little motivation to care for people, since their primary purpose in coming to Japan was toimprove their Japanese proficiency.7) This attitude demonstrates the importance of maintaining benchmarks for the selection of certified care-worker candidates. Not only nursing, but also care work, is anemotional labor, which requires a commitment to deal with patients and provide them with humanecare. Therefore, the careful selection of candidates, based not only on their Japanese proficiency, butalso on their personality and attitude towards caring, is essential.
The review of the JPEPA will start by the end of 2011, and for the IJEPA by the end of 2012.
Therefore, in order to establish improved and more sustainable EPA programs, the recommendations
suggested by this study should be taken into consideration.

Acknowledgements
This work is a part of “A Global Sociological Study on Japan’s Opening of Its Labor Market Particularly in the Fieldof Care and Nursing” (Representative: Dr. Shun Ohno) funded by Kyushu University Program and Project on Education and Research as well as a part of “A Study on Support System for Foreign Nurses Introduced by Economic
Partnership Agreement” (Representative: Dr. Yuko Ohara-Hirano) funded by KAKENHI (Grant-in-Aid for Scientific Research (B) 21390166).

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