Jhabindra Bhandari 

With increasing numbers of people on the move, migrant health has become a key global public health issue in recent years. According to the International Organisation for Migration, the number of people who migrated across international borders surged 41 percent in the last 15 years to reach 244 million in 2015. Globally, migration has been at the forefront of political and development discussions. Such a huge population movement has important public health implications, and therefore requires adequate response from the health sector. Not surprisingly, many migrants often lack access to health services and financial protection for health. Their right to health needs to be protected and promoted at all levels.

It is important to note that migration has been included in the 2030 Agenda for Sustainable Development. Globally, it is increasingly realised that without ensuring access of migrants to quality and essential health services, we cannot achieve Sustainable Development Goal 3.8 on universal health coverage.

Looking at migration and health more closely, the migration process can also expose migrants to several health risks, and unfortunately, many migrants lack access to adequate and equitable health services and financial protection. More importantly, migration is a social determinant of health. It is our responsibility to improve the health status of migrants and their families by ensuring easy access to quality health services as and when needed.

In most of the developing countries, health systems often do not have sufficient capacity to effectively manage the health care needs of migrants. They face many obstacles in accessing essential health care services due to a number of factors including irregular immigration status, language barriers, lack of migrant-inclusive health policies and inaccessibility of services.

In this context, we often face a strong challenge for prevention and control of epidemics. One example is the Ebola crisis that demands strong health systems for preparedness, targeted health services and surveillance in the affected countries and communities. However, many developing countries are still facing the challenge of integrating the health needs of migrants into national plans, policies and Interestingly, the government of Nepal has prioritised migration and health in its policies and strategies. Recently, the Ministry of Health and Population addressed the health care needs of migrants in its national health policy for the first time ever. In this context, concerted efforts are needed to effectively implement migrant-sensitive health policies, strategies and plans to improve the health and social well-being of migrants and their families.

Last year, the government of Nepal convened multi-stakeholder consultations for Global Compact on Migration which aimed to identify issues, challenges and priorities related to broader migration management. Similarly, a migration governance indicators assessment also revealed that the health and education rights of migrants and their families should be a priority agenda in national development policies and plans. More specifically, one of the emerging concerns is about the social protection of migrants which aims to promote the health rights of migrants and their families.

Undoubtedly, the major health risks and vulnerabilities of migrants are related to workplace accidents, communicable and non-communicable diseases, traffic accidents, occupational injuries and disabilities. In addition, issues of mental health and suicides are equally important challenges for migrants and their families.

Moreover, a survey of health problems of Nepali female migrant workers in the Middle East and Malaysia showed that female migrant workers are facing several workrelated health risks which are often related to exploitation. Moreover, they also suffer from fever, severe illness and accidents. Therefore, it is very urgent to raise awareness campaigns on health risks and rights in relation to health care services at the workplace in the countries of destination.

Much more coordinated efforts are needed to ensure that migrant health is addressed without discrimination throughout the migration cycle. Addressing the health needs of migrants and affected populations reduces long-term health and social costs, facilitates integration, and contributes to social and economic development.

Globally, increasing priority is being accorded to migrant-sensitive health policies and inter-sectoral policy coherence to address health inequalities and vulnerabilities affecting migrants. However, much more needs to be done to ensure that migrants are able to lead healthy lives and contribute as productive members of society.

At most regional and national-level consultations related to migration, the health care needs of migrants are most often discussed as a matter of priority. The increasing morbidity and mortality of labour migrants in the country of destination presents a worrying scenario because it adversely impacts on individuals, families and communities. The engagement of multi-sector partners is necessary to create an enabling policy environment to address the health care needs of migrants at all levels.

That is why, more pragmatic and strategic actions are urgently needed to advocate migrant health in global, regional and country agendas in order to address the health needs of migrants in accordance with international human rights obligations and instruments. Strengthening the capacity of governments, civil society organisations, the private sector and migrant communities is an important strategy to promote migrant-sensitive health polices and plans.

By addressing the social determinants of health, we can significantly overcome the migrants’ barriers to health at large. Therefore, there are emerging needs for mainstreaming migrant health into key national development policies for equitable migrant health services at all levels.

Published on: 1 February 2019 । The Kathmandu Post