Building Responsive Health Systems to Help Communities Affected by Migration: An International Delphi Consensus

Abstract

Persons affected by migration require health systems that are responsive and adaptable to the needs of both disadvantaged migrants and non-migrant populations. The objective of this study is to support health systems for populations affected by migration. Materials and Methods: An international Delphi consensus process was used to identify policy approaches to improve health systems for populations affected by migration. Participants were leading migrant health experts from Americas, Europe, Middle East, Asia, and Australasia. We calculated average ranking scores and qualitatively analyzed open-ended questions. Results: Participants identified the following key areas as priorities for policy development: health inequities, system discrimination, migrant related health data, disadvantaged migrant sub-groups, and considerations for disadvantaged non-migrant populations. Highly ranked items to improve health systems were: Health Equity Impact Assessment, evidence based guidelines, and the International Organization for Migration annual reports. Discussion: Policy makers need tools, data and resources to address health systems challenges. Policies need to avoid preventable deaths of migrants and barriers to basic health services.

MIPEX in use

Participants identified International Organization of Migration Health Equity Impact Assessment (HEIA) [16], WHO essential drug program, evidence based migrant health guidelines, and community mediators as the top resources on health systems for disadvantaged populations. Existing population health research does not provide subgroup analyses and often does not provide decision makers with clear evidence on unique health system elements that would be relevant for migrants. The Migrant Integration Policy Index (MIPEX) tool is beginning to address this gap. This tool measures policies to integrate migrants in all EU migrant Member states, as well as evaluating and comparing what countries are doing to promote the integration and health care of migrants. (MIPEX http://www. mipex.eu/health).

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