Healthcare is not universal if undocumented migrants are excluded

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Abstract

Helena Legido-Quigley and colleagues examine the barriers that migrants face in accessing healthcare and argue they are counterproductive for host countries

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Good Health at Low Cost 25 years on: lessons for the future of health systems strengthening.

Dina Balabanova, Anne Mills, Lesong Conteh … (2013)

In 1985, the Rockefeller Foundation published Good health at low cost to discuss why some countries or regions achieve better health and social outcomes than do others at a similar level of income and to show the role of political will and socially progressive policies. 25 years on, the Good Health at Low Cost project revisited these places but looked anew at Bangladesh, Ethiopia, Kyrgyzstan, Thailand, and the Indian state of Tamil Nadu, which have all either achieved substantial improvements in health or access to services or implemented innovative health policies relative to their neighbours. A series of comparative case studies (2009-11) looked at how and why each region accomplished these changes. Attributes of success included good governance and political commitment, effective bureaucracies that preserve institutional memory and can learn from experience, and the ability to innovate and adapt to resource limitations. Furthermore, the capacity to respond to population needs and build resilience into health systems in the face of political unrest, economic crises, and natural disasters was important. Transport infrastructure, female empowerment, and education also played a part. Health systems are complex and no simple recipe exists for success. Yet in the countries and regions studied, progress has been assisted by institutional stability, with continuity of reforms despite political and economic turmoil, learning lessons from experience, seizing windows of opportunity, and ensuring sensitivity to context. These experiences show that improvements in health can still be achieved in countries with relatively few resources, though strategic investment is necessary to address new challenges such as complex chronic diseases and growing population expectations. Copyright © 2013 Elsevier Ltd. All rights reserved.

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Bibliometric analysis of global migration health research in peer-reviewed literature (2000–2016)

Waleed M Sweileh, Kolitha Wickramage, Kevin Pottie … (2018)

Background The health of migrants has become an important issue in global health and foreign policy. Assessing the current status of research activity and identifying gaps in global migration health (GMH) is an important step in mapping the evidence-base and on advocating health needs of migrants and mobile populations. The aim of this study was to analyze globally published peer-reviewed literature in GMH. Methods A bibliometric analysis methodology was used. The Scopus database was used to retrieve documents in peer-reviewed journals in GMH for the study period from 2000 to 2016. A group of experts in GMH developed the needed keywords and validated the final search strategy. Results The number of retrieved documents was 21,457. Approximately one third (6878; 32.1%) of the retrieved documents were published in the last three years of the study period. In total, 5451 (25.4%) documents were about refugees and asylum seekers, while 1328 (6.2%) were about migrant workers, 440 (2.1%) were about international students, 679 (3.2%) were about victims of human trafficking/smuggling, 26 (0.1%) were about patients’ mobility across international borders, and the remaining documents were about unspecified categories of migrants. The majority of the retrieved documents (10,086; 47.0%) were in psychosocial and mental health domain, while 2945 (13.7%) documents were in infectious diseases, 6819 (31.8%) documents were in health policy and systems, 2759 (12.8%) documents were in maternal and reproductive health, and 1918 (8.9%) were in non-communicable diseases. The contribution of authors and institutions in Asian countries, Latin America, Africa, Middle East, and Eastern European countries was low. Literature in GMH represents the perspectives of high-income migrant destination countries. Conclusion Our heat map of research output shows that despite the ever-growing prominence of human mobility across the globe, and Sustainable Development Goals of leaving no one behind, research output on migrants’ health is not consistent with the global migration pattern. A stronger evidence base is needed to enable authorities to make evidence-informed decisions on migration health policy and practice. Research collaboration and networks should be encouraged to prioritize research in GMH. Electronic supplementary material The online version of this article (10.1186/s12889-018-5689-x) contains supplementary material, which is available to authorized users.

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"I spent nine years looking for a doctor": exploring access to health care among immigrants in Mississauga, Ontario, Canada.

Kathi Wilson, Jennifer Asanin (2008)

There is a growing body of research in Canada and from other countries acknowledging that immigrants face barriers in accessing health care services. As immigrants make up an increasing percentage of the population in many developed nations, a better understanding and eliminating these barriers is a major priority. This research contributes to current understandings of access among immigrant populations in Canada by exploring perceptions of access to care through focus groups with a diverse group of immigrants living in a Mississauga, Ontario neighbourhood. The results of eight focus groups reveal that immigrants face geographic, socio-cultural and economic barriers when attempting to access health care services in their community. This paper provides policy recommendations relevant to the federal, provincial and local levels for eliminating these barriers.

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Author and article information

Contributors

Helena Legido-Quigley: Role: associate professor

Nicola Pocock: Role: assistant professor

Sok Teng Tan: Role: research associate1

Leire Pajin: Role: director

Repeepong Suphanchaimat: Role: researcher

Kol Wickramage: Role: coordinator

Martin McKee: Role: professor

Kevin Pottie: Role: professor

Journal

Journal ID (nlm-ta): BMJ

Journal ID (iso-abbrev): BMJ

Journal ID (publisher-id): BMJ-UK

Journal ID (hwp): bmj

Title: The BMJ

Publisher: BMJ Publishing Group Ltd.

ISSN (Print): 0959-8138

ISSN (Electronic): 1756-1833

Publication date Collection: 2019

Publication date (Electronic): 16 September 2019

Volume: 366

Electronic Location Identifier: l4160

Affiliations

[1 ]Saw Swee Hock School of Public Health, National University of Singapore, Singapore

[2 ]London School of Hygiene and Tropical Medicine, London, UK

[3 ]Department of Nursing and Physiotherapy, University of Lleida, Spain

[4 ]United Nations University, International Institute for Global Health, Kuala Lumpur, Malaysia

[5 ]Instituto de Salud Global Barcelona, Barcelona, Spain

[6 ]International Health Policy Programme (IHPP), Ministry of Public Health, Nonthaburi, Thailand

[7 ]International Organization of Migration, Geneva, Switzerland

[8 ]Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada

Author notes

Correspondence to: H Legido-Quigley ephhlq@ 123456nus.edu.sg

Article

Publisher ID: legih048935

DOI: 10.1136/bmj.l4160

PMC ID: 6741752

PubMed ID: 31527060

SO-VID: 38dd13fd-5c76-4476-9578-99c6e8677269

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This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

Healthcare is not universal if undocumented migrants are excluded

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Most cited references 23

Good Health at Low Cost 25 years on: lessons for the future of health systems strengthening.

Bibliometric analysis of global migration health research in peer-reviewed literature (2000–2016)

"I spent nine years looking for a doctor": exploring access to health care among immigrants in Mississauga, Ontario, Canada.

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