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  • Might seem obvious, but … <br /> Recent review paper about health indicators for foreign-born in US: African-Americans <br />
  • Health: <br />
  • Includes 30 countries <br />
  • Used singly or in combination <br />
  • 1 <br />

Dr denuwara migration health Dr denuwara migration health Presentation Transcript

  • What is Migration Health? Dr. L. B. H. Denuwara (MD Medical Administration) Consultant Medical Administrator Director Quarantine Ministry of Health
  • Outline • What is migration health? • What is migration? • Who is an international migrant? • Sources of international migration data • Migrant sensitive health system • Way forward
  • What is Migration Health? Migration + Health
  • What is Migration Health? Migration + Health
  • What is Health? • “Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity” (WHO, 1948)
  • What is Health? • “Health is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity” (WHO, 1948) • … it also applies to migrant populations (IOM, 2006)
  • Migration Health: beyond migrants themselves • Health issues, conditions and risks related to migrant populations, and the way in which it also affects: – Population of origin, – Communities in the places of transit and destination, and – Second and later migrant generations (Roux, 2004)
  • Migration Health • Specialized field within the medical sciences • Through all phases of the migration processes -Pre departure -Transit -Upon arrival -Upon return
  • Public Health implications of Migration • Better recognition of relationship between population mobility and emergence of unknown/known diseases ( ex: HIV/AIDS, SARS, TB, Avian Influenza) • Access to health services (language-culturally – gender appropriate, affordable, accessible, aware that services are available) • psychosocial problems underlie many other health problems experiences by migrants o Other health risk factors related to travel conditions o Rights-based approach/considerations
  • Migration and the determinants of health • Biological • Behavioral • Social environment • Physical environment • Policies and interventions • Access to care • MIGRATION- Related factors HEALTH
  • Migration-related factors Examples • Migration process – Reasons for migration (forced vs. voluntary) – Mode of travel • Country of birth • Duration of residence (e.g., recent vs. long-term) • Migration status (e.g., legal residents, temporary workers, refugees, unauthorized) • Language proficiency • Multi-country exposures (origin, transit, destination) – Culture – Environment – Disease prevalence – Living and working conditions – Access to care
  • What is migration? There is no universally accepted definition and consistency in the use of terminology to describe migration
  • What is migration? • Any process of movement of people, – either across an international border (i.e., international migration) or within a country (i.e., internal migration) – permanently or an a temporary basis, – whatever its causes Source: J. Weekers (IOM) Global Consultation on Migrant and Health, Madrid, Spain (3–5 March 2010); adapted from IOM Glossary on Migration (2004)
  • Who is an International Migrant? • Immigrants? • Aliens? • Migrants? • Illegals? • Foreign-born? • Migrant workers? • Mexicans? • Refugees? • Foreigners? • Ethnic groups? • Minorities? • Farmworkers? • Seasonal workers • Etc.
  • Why do we care about definitions? • To better understand migrant communities and migration patterns – Limit contradictory or misleading information • Achieve comparability of migration statistics among countries • Evidence-based program/policy-making
  • Great diversity among migrants • Country of birth • Migration pattern • Reasons for migration • Culture • SES • Education • Occupation • Language • Migration status • Health Risks Source: California Immigrant Integration Initiative of Grantmakers Concerned with Immigrants and Refugees
  • Migration Data Limitations • Available data on migration has many limitations – “Enormous blind spot” – Even basic questions: e.g., How many? Demographics? • Some improvements in recent years (Source: Commission on International Migration Data, 2009)
  • Initiatives to Harmonize and Improve Migration Data • United Nations – Recommendations on statistics of international migration rev. 1 (1998) – Principles and Recommendations for Population and Housing Censuses rev. 2 (2007) • European Parliament and the Council of the EU Regulation (EC) No. 862/2007 (2007) • Commission on International Migration Data (2009)
  • International Migrant Definitions UN Recommendations
  • International Migrant UN Recommendations (1998) • A person changing his/her country of usual residence • “Country of usual residence”: Where a person has lived (or intends to live) continuously for at least 12 months Sources:Sources: -UN Recommendations on International Migration Statistics (1998)UN Recommendations on International Migration Statistics (1998) - UN Expert Group Meeting on the use of censuses and surveys to measure international migration,UN Expert Group Meeting on the use of censuses and surveys to measure international migration, ESA/STAT/AC.132/1 (2007)ESA/STAT/AC.132/1 (2007)
  • International migrants: Immigrant vs. Emigrant • From the perspective of … – the country of departure the person will be an “emigrant” – the country of arrival the person will be an “immigrant” • “Migrant”: – More neutral term – It disregards the direction of movement UN Recommendations on International Migration Statistics (1998)UN Recommendations on International Migration Statistics (1998)
  • Internal Migrant UN Recommendations (1998) • A person changing his/her usual residence but within the same country – Rural to urban migration – Internally displaced persons (forced migration)
  • International Visitors • Persons traveling to another country, and who are admitted for short stays for purposes of: – Tourism – Visits to friends or relatives – Business – Religious pilgrimages • Do not intend to establish a usual residence in the destination country • Not generally considered international migrants
  • International migrants: Major categories • Authorized migrants (temporary or permanent residence visas) • Refugees • Asylum-seekers • Unauthorized migrants
  • Refugees • A person with a well-founded fear of being persecuted for reasons of race, religion, nationality, social group or political opinion, • is outside the country of his/her nationality and • is unable or unwilling to avail himself of the protection of that country • 15.2 million (2009) (Source: UN Convention Related to the Status of Refugees and the 1967 Protocol)
  • Asylum-seekers • Similar to a refugee, but the person is in the country of intended residence at the time of his/her application • 838,000 (2009)
  • Unauthorized migrants • “A person who, owing to illegal entry or the expiry of his/her visa, lacks legal status in a transit or host country” – A.K.A: irregular, clandestine or illegal migrant (IOM Glossary of Migration, 2004)
  • Post-migration mobility patterns • Settled permanently • Internal migration • Migrate to other country(ies) • Return migration • Circular migration
  • WEB DATA SITES o UN Population Division o Organization for Economic Cooperation and Development (OECD) o Research Centers, Think Tanks, Advocacy Groups: e.g., Migration Policy Institute
  • UN Population Division http://www.un.org/esa/population/migration/ind ex.html • Global Migration Database (1960-2010) • CDs for purchase: – Trends in International Migration Stock: The 2008 Revision (CD) – International Migration Flows to and from Selected Countries: The 2008 Revision (CD) • International Migration 2009 – Excel Table and Wall chart (Note: estimates of 2010 data)
  • Organization for Economic Cooperation and Development • 30 countries (e.g., E.U. States, U.S, Canada, Australia, Mexico, Japan) • OECD Migration Databases – http://stats.oecd.org/Index.aspx?datasetcode=MIG • International Migration Data 2009 – Excel Tables (2007 data) – Reports: • Sources and Comparability of Migration Statistics • Report: International Migration Outlook, 2009
  • Migration Policy Institute Migration Information Source http://www.migrationinformation.org/ • “Non-partisan” • U.S and Global data • Many reports and statistics
  • International migrant • Countries use different criteria: – Country of birth (i.e., native vs. foreign born) – Country of citizenship (i.e., nationals vs. foreigners) – Duration of residence – Legal admission categories – Purpose of entry – Country of residence – Ethnicity (e.g., Ethnic-Russian)
  • Migrant sensitive health system • Recognizing the importance of migration to the country, under overall guidance of the WHA resolution of Health of Migrants, adopted in 2008, Sri Lanka embarked the national migration Health agenda in 2009 o Migration Policy is accessed throgh www.health gov.lk • Sri Lanka’s migration health agenda focuses the strengthening of the health system to address the health issues of all types of migration; inbound, outbound, and internal and the families left behind.
  • Cont.,,, • National Steering Committee is the highest level decision making body in migration health and comprised of secretaries and the Director generals of the 12 key ministries. • Migration Health Task Force comprised technical focal points from each key agency that contributes actively to planning of programs related to, assisted by the IOM functions as the coordination hub and facilitate the addressing of emerging migrant health issues such as health service provision for the returning Sri Lankan refugees as well as the establishment of the health assessment for the inbound migrants
  • Migration Data The Way Forward 1. Harmonize definitions and data collection methods 2. Include a standardized module of key migration questions on main data sources 3. Use/disseminate currently available data (Adapted from Commission on International Migration Data, 2009)
  • Migration Data The Way Forward (Cont.) 4. International coordination in data collection and exchange (including origin and destination countries 5. Disaggregate data (e.g, gender, age, country of birth, time since arrival) 6. Specialized migrant surveys
  • References • International Organization for Migration (2004). Glossary on Migration • Batalova J, Mittlestadt M, Mather M, Lee M. 2008. Immigration: Data matters. Washington, DC. Migration Policy Institute and Population Reference Bureau. http://www.migrationpolicy.org/pubs/2008DataGuide.pdf • Center for Global Development. Commission on International Migration Data for Development Research and Policy (2009) Migrants Count Five Steps Toward Better Migration Data. http://www.cgdev.org/content/publications/detail/1422146/ • UN Expert Group Meeting on the use of censuses and surveys toUN Expert Group Meeting on the use of censuses and surveys to measure international migration, ESA/STAT/AC.132/1 (2007)measure international migration, ESA/STAT/AC.132/1 (2007) • International Organization for Migration. Managing Migration, 2004. www.iom.int//DOCUMENTS/PUBLICATION/EN/Migration_dec_2004.pdf
  • Thank you!