This document summarizes a workshop on developing a migrant health toolkit for the East Midlands region of England. The workshop aimed to gather information on migrant health issues from local stakeholders to inform the development of a comprehensive online toolkit. Participants shared what they had learned about the demographics, health needs, and challenges facing different migrant groups in the region. Recommendations included making the continually-updated toolkit accessible to professionals, including resources, research, best practices, and a service directory.

1. Development of a migrant health toolkit for the East Midlands Stakeholder Workshop, Leicester 30th June 2010

2. Introduction Project Aim Bring together a comprehensive knowledge bank of the main issues around migrant health in the East Midlands, working with regional service providers to develop a toolkit to inform future service commissioning.

4. Informing commissioning and provision of health services

5. Strengthening engagement and links between stakeholders

6. Identifying gaps in information, service provision and resources

8. What the Project Consisted of Review of academic research Stakeholder engagement - Workshops - In-depth interviews x20 Final report

9. Who we spoke to Professionals across the East Midlands Representatives from: - Nottingham City Council - Nottingham Fire & Rescue - Leicester City Council - Health Protection Agency - Northamptonshire County Council - One East Midlands - Boston Borough Council - Refugee Action - NHS Nottingham City - EMAC Derby - NHS Leicester City - BEGIN - NHS Derby City

10. What we learned Asylum Seekers Prevalent Countries of Origin - Middle East: Iraq, Iran, Afghanistan - Africa: Zimbabwe, Eritrea, Somalia, Sudan, DR Congo - South Asia: Sri Lanka - East Asia: China

11. What we learned Asylum Seekers Influences on health - Individual characteristics - age, gender, ethnicity - Pre-migratory factors - circumstances of migration - cultural practices - prevalence of infectious diseases

12. What we learned Asylum Seekers Influences on health - Post-migratory factors - destitution - housing conditions - language - entitlement - stage of legal process

13. What we learned Asylum Seekers Prevalent health issues - Mental Health - post-trauma stress - stage in legal process - destitution & housing conditions

14. What we learned Asylum Seekers Prevalent health issues - Maternal health - rape & sexual violence - FGM - low uptake of breast and cervical screening

15. What we learned Asylum Seekers Prevalent health issues - Communicable diseases - Tuberculosis - HIV - Malaria

17. What we learned Asylum Seekers Other significant issues - High Mobility - Health registration - Cultural expectations of services - Language - Nutrition

18. What we learned Economic Migrants Countries of origin - EU - Eastern Europe A10 (c. 75% Poland) - Non EU - India & Pakistan the most prevalent - also significant African and East Asian populations

19. What we learned Economic Migrants (EU) Prevalent health issues - Vaccine preventable diseases - TB - MMR - Sexual health - Variable STI rates

20. What we learned Economic Migrants (EU) Prevalent health issues - Work-related injury - high employment in “3D” jobs - sensory / musculoskeletal injuries - different perceptions of “risk” - confusion over responsibility

21. What we learned Economic Migrants (EU) Prevalent health issues - Mental Health - discrimination - work-related stress - social isolation

22. What we learned Economic Migrants (EU) Prevalent health issues - Lifestyle factors - many young male - high rates of smoking - heavy drinking - high fat diet

23. What we learned Economic Migrants (EU) Prevalent health issues - Lifestyle factors - many young male - high rates of smoking - heavy drinking - high fat diet

24. What we learned Economic Migrants (Non-EU) Prevalent health issues – South Asian - Diabetes - genetic predisposition - deprived living conditions

25. What we learned Economic Migrants (Non-EU) Prevalent health issues – South Asian - Cardio-vascular disease (CVD) - high rates of smoking - low physical activity rates - Blood diseases - sickle cell anaemia - Thalassaemia

26. What we learned Economic Migrants (Non-EU) Prevalent health issues – South Asian - Mental health - discrimination - deprived living conditions - family / cultural pressures

27. What we learned Economic Migrants (Non-EU) Prevalent health issues – African & East Asian - Mental Health - Communicable diseases - Blood diseases

28. What we learned Accessing health services - language - expectations of service - NRPF - entitlement - third sector - Key role of Refugee Action and Refugee forum - tailored & mainstream services

29. What we learned Toolkit development - Drawing together existing and new research - Continually updated - Centrally held and moderated - Best practice sharing - Online

31. Language Barriers

32. Cultural expectations

33. Mental Health

34. Coordinated Information Resource

35. Monitoring and research

37. Access to toolkit: pre-approval by moderator / System Manager

38. Toolkit structure: Resources

39. Academic research

40. Best practice case studies

41. Statistical information

43. Break-out 30 minutes What do you think? Stakeholder Workshop, Leicester 30th June 2010

44. Introduction In groups, consider: Do our findings reflect your experience? Do you agree with our recommendations for the toolkit? How might the toolkit work for you? Recommendations for further research

46. Consideration of recommendations

47. Development of toolkit:

48. scoping

49. developing

50. testing

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