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.

 


How will COVID-19 affect the achievement of the goals of the 2030 Agenda?

How will COVID-19 affect the achievement of the goals of the 2030 Agenda?
Categoria: Migration Governance
Autor: Laura Thompson

 

There is no doubt that the current pandemic has a broad humanitarian, social and economic impact in the short, medium and long term, which in turn may affect or delay the achievement of many of the Sustainable Development Goals (SDGs) at different levels and in various ways.

The most evident impact, obviously, is on Goal 3, which seeks to guarantee a healthy life and promote well-being. The pandemic has put enormous pressures on health systems not only in relation to the treatment and management of the virus, but also affecting the ability to care for patients who have other diseases and increasing the risk of complications in populations with compromised health states. The pandemic has given greater visibility to the importance of universal access to health systems regardless of people's migratory status. However, the pandemic will also have implications for other aspects of the 2030 Agenda.

 

Impacts beyond health

COVID-19 is also having a negative impact on the employment, economic and social situation of many households around the world, and on their ability to meet their needs, even the most basic ones. The economic crisis that the countries of the region are facing and the growing unemployment will be decisive in this regard, since apart from the pandemic, Latin America and the Caribbean reached an unemployment rate of 8.1% at the end of 2019, according to the International Labor Organization. And according to ECLAC projections, labor unemployment will rise to 11.5% in the same region, as a result of the contraction of economic activity by COVID-19.

Unemployment and the loss of purchasing power affect more severely migrant populations, since they are very often employed in the informal sector of the economy and have more precarious contractual working conditions, particularly women migrant workers. In the case of Latin America and the Caribbean, informal work engages around 50% of the total number of people employed. The increase in unemployment will impact the scope of Goal 8 (on full and productive employment and decent work for all), but also Goal 1 (the fight against poverty), Goal 2 (the eradication of hunger, food security and better nutrition), Goal 5 (gender equality and empowerment of women and girls), and targets 5.2, 8.7 and 16.2, on trafficking and exploitation of people. ECLAC also emphasizes that Latin America and the Caribbean is already suffering a fall of -5.3% in GDP, the worst in its history.

Likewise, this pandemic could accentuate existing inequalities in societies, as well as the vulnerabilities of certain population groups, and consequently delay the achievement of Goal 10, which seeks to reduce inequalities between and within countries. In this context, migrants are one of those vulnerable groups that have been particularly affected by the pandemic and that are often left behind or forgotten in social protection and economic relaunch plans, or have limited access to them, either because of language barriers or because of their immigration status. All of this despite the enormous contribution that migrant workers make to the operation of essential basic services in many countries, as has become evident during this crisis.

Additionally, a decrease in the amount of international remittances is projected, which, according to the World Bank, would be reduced between 10% and 19.3% by 2020. Remittances are a fundamental component in the economy of some countries in the region, where they can amount to between 5% and 20% of the national Gross Domestic Product. A significant reduction in remittances would jeopardize the ability of many households in those countries to meet their most basic needs and their ability to invest in improving nutrition, education, and reducing child labor, among others, further emphasizing existing inequalities.

Finally, at the state level, due to the economic slowdown we are experiencing and urgent health needs, it is very likely that there will be a decrease in social spending or a reorientation of available resources, potentially at the expense of the more comprehensive vision contained in the Sustainable Development Goals, again affecting the scope of the transversal objectives of the 2030 Agenda.

 

Recovery and SDGs: the same path

But this should not lead us to pessimism and to think that we have lost the fight to achieve the SDGs. On the contrary, it is essential at this time to work together and forcefully to identify the additional difficulties that the current pandemic presents in achieving the 2030 Agenda. We must redouble our commitment and our efforts to ensure that the impact of the pandemic is incorporated into national plans and international assistance, as well as that the different realities and vulnerabilities of some specific groups are incorporated.

For this we must work from now on to ensure the universal attention of the health and education systems; in reducing remittance transfer costs (a topic included in Goal 10), as El Salvador is already doing, creating more resilient and inclusive cities in line with Goal 11 or strengthening forms of regular migration for migrant workers and decent working conditions (Goal 8).

The time is now: all organizations, governments and individuals have an important role in ensuring that the efforts for our Latin American region and the world to recover from the serious effects of the COVID-19 pandemic are aligned with the 2030 Agenda and that we make sure we do not leave anyone behind.