“Doctors Don’t Know Anything”: The Clinical Gaze in Migrant Health

Abstract Issue Sporadic accounts of initiatives, interventions and good practices in Migrant Health at the Municipality level account for Norways' lower score on “Measures to achieve change” in the Migrant Integration Policy Index (MIPEX). While the structure and organization at the municipality level should enable intersectoral action (as all under one umbrella), the municipal counties say lack of intersectoral collaboration is one of the main barriers for long-term public health work. Description of the Problem 51 municipalities have an immigrant population larger than the national average 17,8% (2019). In a recent Country Assessment (part of Joint Action on Health Equity Europe), limited inter-sectoral action on the social determinants of health including migration was observed. Although multiple agencies are engaged in attempts to address these issues. While there is a drive to promote public health and primary health care in municipalities, these initiatives do not pay special attention to migrants. In the first stage of this project, we have reviewed municipal policy documents to map policy and measures on public health, migrant health and intersectoral collaboration. In the second stage, municipalities will be contacted to engage them in the implementation of intersectoral actions. Results The desk review and mapping show that only 8 of the “top” 32 municipalities mention “intersectoral” in the municipal master plan (5 were not available online), its mentioned in 9 action program/budgets, but not necessarily by the same municipalities. 15 of the municipalities mention migrants, but rarely in relation to health. We observe that, the size of the municipality, financial resources and support from the County are factors that may play a significant role in prioritising migrant health and intersectoral collaboration. Lessons Advocating for and supporting the local/municipal level for intersectoral action is highly relevant, timely and essential. Key messages Intersectoral action on the social determinants of migrants’ health needs to be implemented through municipal policies to reduce inequities in migrants’ health. Implementation on the local level is the main arena for good public health work and is crucial to ensure good health for migrants.

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Developing an evidence assessment framework and appraising the academic literature on migrant health in Malaysia: a scoping review

BMJ Open ◽

10.1136/bmjopen-2020-041379 ◽

2021 ◽

Vol 11 (1) ◽

pp. e041379

Author(s):

Allard Willem de Smalen ◽

Zhie X Chan ◽

Claudia Abreu Lopes ◽

Michaella Vanore ◽

Tharani Loganathan ◽

...

Keyword(s):

Scoping Review ◽

Multiple Correspondence Analysis ◽

Population Data ◽

Good Health ◽

Migrant Health ◽

High Quality ◽

Level Of Evidence ◽

Cross Sectional ◽

Academic Literature

BackgroundA large number of international migrants in Malaysia face challenges in obtaining good health, the extent of which is still relatively unknown. This study aims to map the existing academic literature on migrant health in Malaysia and to provide an overview of the topical coverage, quality and level of evidence of these scientific studies.MethodsA scoping review was conducted using six databases, including Econlit, Embase, Global Health, Medline, PsycINFO and Social Policy and Practice. Studies were eligible for inclusion if they were conducted in Malaysia, peer-reviewed, focused on a health dimension according to the Bay Area Regional Health Inequities Initiative (BARHII) framework, and targeted the vulnerable international migrant population. Data were extracted by using the BARHII framework and a newly developed decision tree to identify the type of study design and corresponding level of evidence. Modified Joanna Briggs Institute checklists were used to assess study quality, and a multiple-correspondence analysis (MCA) was conducted to identify associations between different variables.Results67 publications met the selection criteria and were included in the study. The majority (n=41) of studies included foreign workers. Over two-thirds (n=46) focused on disease and injury, and a similar number (n=46) had descriptive designs. The average quality of the papers was low, yet quality differed significantly among them. The MCA showed that high-quality studies were mostly qualitative designs that included refugees and focused on living conditions, while prevalence and analytical cross-sectional studies were mostly of low quality.ConclusionThis study provides an overview of the scientific literature on migrant health in Malaysia published between 1965 and 2019. In general, the quality of these studies is low, and various health dimensions have not been thoroughly researched. Therefore, researchers should address these issues to improve the evidence base to support policy-makers with high-quality evidence for decision-making.

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Housing satisfaction and migrant health in urban China: empirical evidence and implications for housing policy

Journal of Housing and the Built Environment ◽

10.1007/s10901-021-09886-1 ◽

2021 ◽

Author(s):

Heyuan You ◽

Xuxu Guo ◽

Xin Wu ◽

Mengshuang Wu

Keyword(s):

Empirical Evidence ◽

Housing Policy ◽

Migrant Health ◽

Urban China ◽

Housing Satisfaction

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Health promotion for migrants in Morocco: Progress, challenges et prospects

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.494 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Maaroufi

Keyword(s):

Civil Society ◽

Health Information System ◽

Migrant Health ◽

Civil Society Organizations ◽

Free Access ◽

Health Coverage ◽

Stimulate Action ◽

Migrant Populations ◽

Hospital Units ◽

Building Program

Abstract Morocco has become a land of permanent settlement for migrants. In promoting their health, we have made a significant progress with persistence of challenges Progress: Development and implementation of a National Strategy to promote the health of migrantsFree access to primary care and emergency care and screening services;Free access to health coverage program for regular migrants. Challenges: Development of a health surveillance system for the migrant populationStrengthening the skills of healthcare professionals to take care of the specific health needs of the migrant population (tropical diseases);Strengthening of medical, psycho-social assistance for migrants, protection of particularly vulnerable categories (women and children) and intersectoral coordination;Stimulate action by civil society and the community in promoting the health of migrants. Prospects for action: Integrate migrant health data into the health information system of health facilities and health programs;Develop and implement a health education plan adapted to the specificities of migrant populations;Establish a network of hospital units specializing in tropical pathology, acting as national reference teams;Define and implement a capacity building program for health professionals (doctors, nurses and social workers);Support civil society organizations to improve their intervention capacity in the area of migrant health.

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Human rights-based conceptions of deservingness: health and precarity

International Journal of Migration Health and Social Care ◽

10.1108/ijmhsc-07-2019-0071 ◽

2020 ◽

Vol 16 (3) ◽

pp. 279-292

Author(s):

Sarah Marshall

Keyword(s):

Health Care ◽

Human Rights ◽

Health Care Providers ◽

Health Care Access ◽

Migrant Health ◽

Dominant Negative ◽

Care Providers ◽

Content Type ◽

Care Access ◽

Health Related

Purpose Ideas of health-related deservingness in theory and practise have largely been attached to humanitarian notions of compassion and care for vulnerable persons, in contrast to rights-based approaches involving a moral-legal obligation to care based on universal citizenship principles. This paper aims to provide an alternative to these frames, seeking to explore ideas of a human rights-based deservingness framework to understand health care access and entitlement amongst precarious status persons in Canada. Design/methodology/approach Drawing from theoretical conceptualizations of deservingness, this paper aims to bring deservingness frameworks into the language of human rights discourses as these ideas relate to inequalities based on noncitizenship. Findings Deservingness frameworks have been used in public discourses to both perpetuate and diminish health-related inequalities around access and entitlement. Although, movements based on human rights have the potential to be co-opted and used to re-frame precarious status migrants as “undeserving”, movements driven by frames of human rights-based deservingness can subvert these dominant, negative discourses. Originality/value To date, deservingness theory has primarily been used to speak to issues relating to deservingness to welfare services. In relation to deservingness and precarious status migrants, much of the literature focuses on humanitarian notions of the “deserving” migrant. Health-related deservingness based on human rights has been under-theorized in the literature and the authors can learn from activist movements, precarious status migrants and health care providers that have taken on this approach to mobilize for rights based on being “human”.

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Diverse and Complex Challenges to Migrant and Refugee Mental Health: Reflections of the M8 Alliance Expert Group on Migrant Health

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17103530 ◽

2020 ◽

Vol 17 (10) ◽

pp. 3530 ◽

Cited By ~ 2

Author(s):

Danny Sheath ◽

Antoine Flahault ◽

Joachim Seybold ◽

Luciano Saso

Keyword(s):

Mental Health ◽

Forced Migration ◽

Disease Outbreaks ◽

Good Health ◽

Migrant Health ◽

Lessons Learned ◽

World Health ◽

Expert Group ◽

Good Mental Health ◽

University Of Rome

Forced migration is likely to continue to grow in the coming years due to climate change, disease outbreaks, conflict, and other factors. There are a huge number of challenges to maintaining good health, and specifically good mental health, among migrants at all stages of migration. It is vital to fully understand these diverse challenges so that we can work towards overcoming them. In 2017, as a response to the growing health challenges faced by migrants and refugees, the M8 Alliance created an expert group focussing on migrant and refugee health. The group meets annually at the Sapienza University of Rome, Italy, and this article is based on the discussions that took place at the third annual meeting (6–7 June 2019) and a special session on “Protecting the Mental Health of Refugees and Migrants,” which took place on 27 October at the World Health Summit 2019 in Berlin. Our discussions are also supported by supplementary literature to present the diverse and complex challenges to the mental health of migrants and refugees. We conclude with some lessons learned and hope for the future.

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