Abstract
BACKGROUND: International labor migration from Nepal, primarily to Malaysia and Gulf Cooperation Council (GCC) states, is a significant economic driver, with remittances forming a substantial portion of the nation’s GDP. However, this economic reliance often overshadows the profound health consequences and conditions of “induced poverty”— encompassing debt, precarious living, and compromised well-being—experienced by migrant workers. Existing research predominantly focuses on pre-departure or returnee migrants, leaving a critical gap in understanding the health perspectives and lived realities of those currently employed in destination countries. This study aimed to explore how male Nepali migrant workers in Malaysia and GCC countries perceive and experience the impact of induced poverty and their labor conditions on their physical and mental health. METHODS: Grounded in an interpretive paradigm, this qualitative descriptive study involved in-depth, semi-structured interviews with 17 male Nepali migrant workers currently employed in Malaysia and GCC countries. Initial participant recruitment utilized purposive and convenience sampling through self-registration via advertised flyers on a social media page, which was supplemented by snowball sampling to reach more participants. An overarching maximum variation strategy guided the final sample composition to ensure diverse perspectives. Data were analyzed inductively using applied thematic analysis. RESULTS: Four interconnected themes emerged: (1) The Body as a Site of Extraction, detailing severe occupational hazards, physical deterioration, and the normalization of ill-health driven by economic imperatives; (2) The Invisible Chains, highlighting mental health erosion due to social isolation; (3) The Remittance Trap, revealing how pre-migration debt and ongoing financial precarity create a cycle of overwork and declining health despite remittance outflows; and (4) Navigating Healthcare Deserts, which exposed systemic barriers, perceived discrimination, and inadequate access to essential health services, forcing workers into detrimental coping strategies. Collectively, these themes reveal a stark reality where induced poverty systematically dismantles migrants’ health in real-time within destination countries, challenging prevailing narratives of migration as purely an economic uplift. CONCLUSION: This research concludes that conditions of induced poverty and exploitative labor practices endemic to the current migration system systematically compromise the health of Nepali migrant workers. Their firsthand accounts reveal an urgent need for a paradigm shift in migration governance, moving beyond a purely economic focus to prioritize the fundamental human rights, health equity, and dignity of migrant workers. This requires robust policy interventions in both Nepal and destination countries, focusing on ethical recruitment, stringent enforcement of labor protections, and accessible healthcare, to ensure migration becomes a pathway to genuine well-being rather than a precursor to suffering. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-025-25503-0.