Introduction

This report was based on the responses to the call for countries to submit information about promising practices and experiences in promoting the health of refugees and migrants formulated and/or implemented since May 2019. The aim was to showcase how different countries – with different health systems and different challenges and facilitators to implementation of health care for all – have implemented practices to promote the health of refugees and migrants. The country case examples do not assess or evaluate implementation but explore collaboration among different organizations and stakeholders, governance models to promote the health of refugees and migrants and the lessons learned during implementation of practices. The country and local experiences have been used to support provision of general policy considerations for progression of health and well-being for all, including refugees, migrants and the host populations they live with. This report contains an initial set of 49 case studies to form the basis of a live repository of projects that it is hoped will be further populated by Member States and partners to facilitate sharing and learning on refugee and migrant health.

Background

There are over 1 billion migrants globally, about one in eight of the global population. These include 281 million international migrants (2020) and 763 million internal migrants (2005). The number of forcibly displaced people reached 101.1 million in June 2022.

Migration and displacement are key determinants of health and well-being. Refugees and migrants remain among the most vulnerable members of society, often faced with xenophobia; discrimination; poor living and working conditions; and inadequate access to health services, despite frequently occurring physical and mental health problems.

The public health impact of population movement is undeniable. A detailed overview of the health of refugees and migrants and the associated public health challenges are provided in the 2022 WHO World report on the health of refugees and migrants.

The access of refugees and migrants to quality health services is of paramount importance to rights-based, responsive and sensitive health systems, global health security, health promotion and public efforts aimed at reducing health inequities and meeting global commitments. These commitments include those set in the 2030 Agenda for Sustainable Development and its 17 Sustainable Development Goals (SDGs), particularly SDG 3 on health, SDG 5 on gender equality, SDG 10 on reducing inequalities and SDG 16 on promoting peace and ending violence. Target 3.8 on universal health coverage (UHC) provides an opportunity to promote a more coherent and integrated approach to health beyond the treatment of specific diseases, and to provide it for all populations, including refugees and migrants, irrespective of their legal status. However, UHC is only a reality if health systems take account of all community members, including refugees and migrants.

In 2018 the United Nations General Assembly adopted the Global Compact on Refugees and the Global Compact for Migration, in which the concept of access of refugees and migrants to quality health services is also encompassed. The 2019 United Nations political declaration on UHC specifically reflects the inclusion of refugees and migrants, clearly stating that “no one should be left behind” and calls on States to address the needs and vulnerabilities of migrants.

While several advancements have been made at country and local level, there is still much room to prioritize and promote the public health aspects of migration, addressing the root causes of disease, creating the conditions for good health and well-being for all, and supporting Member States in working for UHC.

Investing in refugee and migrant health will make a vital contribution to the overall improvement of global health, allowing the health and well-being of migrants to be addressed in an inclusive and comprehensive manner as part of holistic efforts to respond to the health needs of all.

At the World Health Assembly in 2019, Member States agreed a five-year global action plan to promote the health of refugees and migrants (GAP). Created in alignment with global frameworks, the GAP asserts the need for improving the health and well-being of refugees and migrants by focusing on achieving UHC and the highest attainable standard of health for all populations. It laid down six priority areas of action and several objectives for WHO work in the field of refugee and migrant health.

Promote the health of refugees and migrants through a mix of short-term and long-term public health interventions.

Promote continuity and quality of essential health care, while developing, reinforcing and implementing occupational health and safety measures.

Advocate the mainstreaming of refugee and migrant health into global, regional and country agendas and the promotion of: refugee-sensitive and migrant-sensitive health policies and legal and social protection; the health and well-being of refugee and migrant women, children and adolescents; gender equality and empowerment of refugee and migrant women and girls; and partnerships and intersectoral, intercountry and interagency coordination and collaboration mechanisms.

Enhance capacity to tackle the social determinants of health and to accelerate progress towards achieving the Sustainable Development Goals, including universal health coverage.

Strengthen health monitoring and health information systems.

Support measures to improve evidence-based health communication and to counter misperceptions about migrant and refugee health.

Aim of this report

The purpose of this report is to map promising practices and experiences in promoting the health of refugees and migrants. These grounded experiences showcase how the GAP has been implemented at national and subnational levels to foster and ensure collaboration across governments on refugee and migrant health.

This report offers a snapshot of country and local experiences in advancing the GAP, including an overview of common challenges and facilitators to implementation, and provides general policy considerations on how WHO Member States can continue progressing in this subject.

The country case examples do not assess or evaluate implementation but explore the types of collaboration on the ground among different organizations and stakeholders, the governance models to promote the health of refugees and migrants and the lessons learned from the implementation of practices.

These examples will form the basis of a live repository of projects that Member States and partners will be invited to populate. It will facilitate sharing and learning on refugee and migrant health.

Target audience

This report is intended for stakeholders working towards promoting the health of refugees and migrants. These stakeholders include high-level decision-makers responsible for setting policies, strategies and plans and for developing budgets for refugees and migrants at national and subnational levels. The report is also designed to support wider health communities: specialists in health financing, gender specialists, health insurance authorities, national statistical offices, monitoring specialists, advocates, researchers, consultants and civil society organizations active in the field of refugee and migrant health.

Source: World Health Organization