Universal health: three proposals for the inclusion of migrants


World Health Day forces us to reflect on the habits that could cause a negative effect on our health and on the measures, we must take to minimize the risks to a disease. It forces us to eat better, to perform more physical activity, to avoid stress and fundamentally to perform medical examinations that allow us to detect and treat all kinds of illness in time.

But what happens when people migrate? Many of those factors, habits and conditions that are already known and that determine your health are modified. You can now find multiple administrative barriers to access services, language limitations, stigma and discrimination and many other conditions that will limit access to basic services, thus affecting your health in an important way. There are still inequities very present in the region preventing the adequate access of large population groups to health services, with barriers based on their migratory status, nationality or other conditions.

Therefore, today we must also reflect on the close link between human mobility and health, and how we are responding as a society to everyone's needs. The campaign, promoted this year by the World Health Organization, "Universal Health Coverage: Everyone, Everywhere" means looking back at those populations that, because of their migratory status, are falling behind. Because of this, I consider it necessary to take action in the following aspects:

  1. Strengthen joint work in a multi-sectoral manner that guarantees access to quality health services, with cultural appropriation and sensibility to the migrant.
  2. Formulate policies that guarantee the inclusion of vulnerable populations and eliminate structural barriers that hinder access to universal health.
  3. Seeking partners, generate alliances, strengthen networks and promote joint and multi-sectoral work that allows us to address issues that merit a regional response, multinational and fundamentally multidimensional.

In Mesoamerica we have a regional and multi-sectoral coordination mechanism that aims to advance these proposals. It is the Joint Initiative of the Health of Migrants and their Families (INCOSAMI) that brings together governments, civil society organizations, regional associations, academia, United Nations agencies and development partners, in order to promote the health and migration agenda in the region.

“Without migrants, including internally displaced people, universal health coverage (UHC) would not be truly universal.”  -Jacqueline Weekers, IOM Director of the Migration Health Division.

On the other hand, it is important to emphasize that the access of migrant populations to universal health must also go beyond services. It is about carrying out actions in places where they are located, either in transit or destination communities. This leads us to the need to design prevention and health promotion campaigns with inclusive communication strategies. It invites us to sensitize and train all health personnel and migration authorities about the rights, contexts and conditions of the migration process.



   Sobre el autor:

Carlos Van der Laat is the IOM Regional Migration Health Officer for the Americas. Specialist in Family and Community Medicine, he has a Master's Degree in Human Rights and Education for Peace. He has worked for the Costa Rican Social Security Fund and the University of Costa Rica, as well as a consultant forespecia the Pan American Health Organization and UNICEF. He specializes in intercultural health, from where he has formulated and coordinated community projects.


‘Leaving no one behind’: how states can help migrants access health services

Categoria: Migration and Health
Autor: Karen Carpio

The health of migrants is not only determined by individual biological aspects, but also by broader socio-economic factors such as social and community networks, living conditions, education, employment, income and community safety.

When people migrate in a safe, orderly and regular fashion, migration can help migrants and their families by improving their socioeconomic status, offering better education opportunities, and improving their access to health services.

According to IOM’s 2018 World Migration Report, out of 250 million international migrants, 50 million of them are irregular; so, while the majority of migration flows are safe, a significant amount of people find themselves in unfavorable economic, political, social and/or environmental conditions in their country, making them vulnerable to health risks since their pre-departure.

For migrants in transit, health risks increase due to limitations to access safe means of transport and accommodation, sufficient and safe food, and access to medicines or health services when needed.  Upon their arrival, they may face inadequate housing conditions such as overcrowding, lack of ventilation and insecurity, along with limited access to drinking water and basic sanitation systems.

Once in the destination country, many migrants face difficulties integrating into the host community and might not be granted equitable access to affordable health care. Alternatively, local health systems may have limited capacities to meet migrant health needs.

The World Health Organization’s report details other barriers that migrants face to access health services including discrimination and stigmatization, language barriers, administrative hurdles, and restrictive norms generating fear of deportation or the loss of employment. Health services available to migrants may not be sensitive to their needs, leading to delayed or undiagnosed conditions or ineffective treatment.

Some of the main factors that hinder migrants’ access to healthcare are:

  • The lack of sufficient mechanisms to ensure migrants’ access to health insurance schemes
  • Lack of formal language interpretation services at health centers caring for international migrants
  • Administrative requirements to access health services, such as identification documents
  • Expensive out-of-pocket mandatory payments for health services
  • Stigmatization and fear of negative consequences of seeking healthcare, due to migrants’ irregular status
  • Limited availability of healthcare services at some locations, such as border communities

The United Nations 2030 Agenda for Sustainable Development is geared towards the commitment to “leave no one behind”, including migrant populations. However, achieving their inclusion is quite a challenge for most countries.

IOM outlines some considerations to promote the inclusion of migrants to public health systems, including a greater inclusion of migrant issues in health plans and strategies at national and regional levels. Instead of developing separate plans of actions for migrant populations, public health must be approached comprehensively to migrants and other vulnerable populations. Another important consideration is the continual collection of data on migration trends and migrants’ access to health services to develop informed health policies and actions. Access to robust data, such as knowing the actual costs and resources at hand, along with better coordination among stakeholders is key for planning effective responses.

IOM’s report on migration governance in the Caribbean also recommends the following actions to offer migrant-sensitive health services, such as:

  • Strengthening public health systems funding schemes
  • Making interpretation services available at health facilities (an example of this is the employment of multilingual staff, professional interpreters or cultural mediators)
  • Establishing mechanisms that allow for systematic data collection on migrants’ access and use of health services
  • Consistent adherence to international standards regarding migrant access to health care
  • Outreach initiatives for vulnerable populations such as elderly populations or unaccompanied minors
  • Sensitization campaigns for the general public and healthcare providers on migrant-sensitive approaches

A safe migration process means people’s physical and emotional integrity are not jeopardized, and that migrants are able to exercise their rights fully, including the right to health. migration is a driver for economic and human development in communities of origin and destination. IOM promotes regular, safe and orderly migration to boost migrant’s integration into host communities.