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

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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.


How can Central American migrants become regularized in Mexico?

How can Central American migrants become regularized in Mexico?
Categoria: Immigration and Border Management
Autor: Guest Contributor

Thousands of migrants, asylum seekers and Central American refugees go north in search of better opportunities. Most of these people leave from Northern Central American countries (PNCA - Guatemala, Honduras and El Salvador).

Some resort to irregular migration, exposing themselves to travel dangers and the restrictions that this implies if they manage to reach their country of destination. However, an IOM study in which more than 2,800 interviews were conducted showed that in NTCA 97% of migrants in transit make a great effort to obtain documents to regulate their stay in Mexico. In addition, between 59% and 70% of people would be willing to be involved in local education, employment or entrepreneurship opportunities, as an alternative to irregular migration.

Migrants who leave the NTCA when they reach the southern border of Mexico have 3 options to request their regular stay in this country:

1. Regional Visitor: allows a person to remain in Mexico for a period not exceeding 7 days in the States of Campeche, Chiapas, Quintana Roo and Tabasco. The card is valid for 5 years, has no cost and does not allow paid activities.

2. Visitor Border Worker: for nationals of Belize and Guatemala, allows entry to the states of Campeche, Chiapas, Quintana Roo and Tabasco. It is valid for one year and includes the right to perform remunerated activities. However, this option requires having a job offer in advance.

3. Visitor for Humanitarian Reasons: valid for one year with the possibility of renewal and is granted in the following situations:

  • Be a victim or witness a crime committed in Mexico.
  • Be an unaccompanied migrant child
  • Be an applicant for political asylum, recognition of refugee status or complementary protection of the Mexican State, as long as their migration status is unresolved.

The condition of a visitor's stay may also be authorized for humanitarian reasons when there is a humanitarian cause that necessitates its admission or regularization in the country. The requesting person has permission to perform paid activities.

For migrants who want to reach the northern border of Mexico, they can only continue their journey as irregular migrants. For them, the way to regularize their immigration status is through a Visitor Visa for Humanitarian Reasons, request a waiting number to be interviewed in the US and qualify for the Migrant Protection Protocols (MPP). They can also cross the border irregularly and present themselves to migration authorities in the United States, and be returned to Mexico, also under the MPP category.

Those who return to Mexico through the MPP can wait for their appointment and request asylum in the United States or in Mexico, or return to their countries of origin.

Mexico has the potential to offer job opportunities to migrants in programs like Sembrando Vida or projects such as the creation of the free zone in the border strip, the Mayan Train or the construction of the Dos Bocas refinery in the state of Tabasco. For this, the visa options and conditions of regular stay for NTCA migrants must be strengthened and refined.

It is also essential that governments and organizations continue to strive to address the structural causes that force people to migrate, offer alternatives and continue to seek and support mechanisms that promote an orderly and safe migration.

 

Resources for migrants:

*IOM has resources to help people find out about regular migration options. The migrantinfo.iom.int website provides information on regular migration channels and opportunities for local learning, work and entrepreneurship development. On the other hand, the MigApp mobile application provides information on protection, migration procedures and services.