Strengthening Country Readiness for Pandemic-Related Mass Movement: Policy Lessons Learned.

The COVID-19 pandemic has thus far restricted the large movement of people; nonetheless, we cannot exclude the disruptive power of a virus with similar characteristics to COVID-19 affecting both high- and low-income countries, as a factor for future mass migrations. Indeed, the top 15 countries affected by COVID-19 host about 9 million refugees, and it is, therefore, important to investigate and strengthen the readiness of countries' health policies to ensure they are well equipped to deal with potential large influxes of 'epidemic-related refugees and migrants.' Using the Bardach Policy Framework as a tool for analysis, this article investigates the readiness of countries for a potential public health event (mass migration generated by future pandemics), therefore, aiming at a health response forecasting exercise. The article reviews the policies put in place by countries who faced large influxes of migrants between 2011 and 2015 (the policy-prolific years between the Arab Spring migration and the introduction of stringent measures in Europe) and new evidence generated in response to the COVID-19 pandemic (including the 'ECDC Guidance on infection prevention and control of COVID-19 in migrant and refugee reception and detention centres in the EU/EEA and the UK' and the 'WHO Lancet priority for dealing with migration and COVID-19') to formulate a policy option able to strengthen national system capacities for responding to influxes of epidemic-related migrants and the management of highly infectious diseases.

Survey on the health status, services utilization and determinants of health: Syrian refugee population in Turkey

This publication reports the results of a survey on the health status, services utilization and determinants of health of the Syrian refugee population in Turkey. The general goal of the survey is to determine and better understand the health status of Syrian refugees living outside camps. Among the data available in this report are the measurements of the demographic and socioeconomic characteristics of this population, health status including self-reported perceived health in six dimensions and the prevalence of self-reported morbidity for chronic diseases and mental health conditions and the prevalence of chronic diseases risk factors. Moreover, the report shows data concerning the health care service utilization, satisfaction and accessibility with special focus on the geographical variability among Turkish provinces and the health literacy of Syrian refugees. Finally, the report evaluates maternal and child health and health care access, in particular the prevalence of general health conditions among children, the presence of acute conditions among children under 5 years, the vaccination rate (reported by parents) and the antenatal and postnatal care accessibility and utilization by mothers and children.

Access to healthcare for undocumented migrants: analysis of avoidable hospital admissions in Sicily from 2003 to 2013.

Background: Access to healthcare services for undocumented migrants is one of the main public health issues currently being debated among European countries. Exclusion from primary healthcare services may lead to serious consequences for migrants' health. We analyzed the risk among undocumented migrants, in comparison with regular migrants, of being hospitalized for preventable conditions in the Region of Sicily (Italy). We performed a hospital-based cross-sectional study of the foreign population hospitalized in the Sicily region between 1 January 2003 and 31 December 2013. The first outcome was the proportion of avoidable hospitalization (AHs) among regular and irregular migrants. Second outcomes were the subcategories of AHs for chronic, acute and vaccine preventable diseases. 85 309 hospital admissions were analyzed. In the hospitalized population, in comparison to regular migrants, undocumented migrants show a higher proportion of hospitalization for diseases preventable through primary and preventive care (AOR1·48, 95%CI 1·37-1·59). The proportion of avoidable hospitalizations associated with the lack of legal status is higher for vaccine preventable conditions (AOR 2·06, 95%CI 1·66-2·56) than for chronic conditions (AOR 1·47, 95%CI 1·42-1·63) and acute conditions (AOR 1·37; 95%CI 1·23-1·53). Between 2003 and 2013, the proportion of avoidable hospitalizations decreased both in regular and undocumented migrants but decreased faster for regular than for undocumented migrants. Undocumented migrants experience higher proportion of hospitalization for preventable conditions in comparison with regular migrants probably due to a lack of access to the national healthcare service. Policies and strategies to involve them in primary healthcare and preventive services should be developed to tackle this inequality.

Review of possible public health activities to respond to changing migration patterns in Greece

This review lists a number of possible public health activities that could be implemented in Greece to respond to future refugee and migrant influxes. The content is based on a rapid field mission conducted by experts from the WHO Public Health Aspects of Migration in Europe (PHAME) programme. The document has been reviewed by the Office of the Secretary General of Public Health of the Hellenic Ministry of Health, Greece.

A desk review on institutional and non-institutional organizations active in the field of migrant's health in the WHO European Region.

BACKGROUND: Migrants have problematic access to health-care; non-institutional organizations (NGOs), as well as institutional bodies may play a role in facilitating their access to mainstream health care. AIM: Our research reviews actions that address the need of migrants in terms of health care in order to understand how, where, and who participates in this effort. METHOD: Data were from desk or web research, declaration from organisations and their websites, information from WHO Country Offices. RESULTS: 154 NGOs were identified in the WHO European Region. 58% were direct health care providers while the remaining provided either mediation services or were part of a network organization. 173 national institutes (GOVs) were found; less than the 20% were directly or indirectly involved in health care, whereas the majority were involved in research, policy development, international relations and human rights. CONCLUSION AND RECOMMENDATION: Some gaps, a certain fragmentation and lack of coordination were identified. WHO can play an overarching role in the exchange of expertise and harmonisation of the efforts in this field.

Second assessment of migrant health needs, Lampedusa and Linosa, Italy: joint report on a mission of the Ministry of Health of Italy, the Regional Health Authority of Sicily and the WHO Regional Office for Europe, 16−19 May 2012

In 2011, there was an unexpected flow of migrants to Greece, south Italy and Malta; about 60 000 migrants from Africa debarking on the Italian island of Lampedusa alone, historically a prominent destination for migrants seeking to enter the European Union (EU). In consequence, the WHO Regional Office for Europe carried out a series of assessment and operational missions in these countries; in Italy, the islands of Lampedusa and Linosa, in particular, were in focus. The main objectives of the missions to Italy in 2011 were: to review the situation and the readiness of the Italian health system to deal with displaced populations, migrants and refugees arriving in the country as a result of North African crisis; and to assess the preparedness of the system for coping with the possible public health consequences of a potential massive influx from North and sub-Saharan Africa to the islands of Lampedusa and Linosa. In this regard, at the request of the Ministry of Health of Italy, a second assessment mission to these islands took place on 16−19 May 2012 with the overall purpose of providing recommendations to the Ministry of Health of Italy on the development of preparedness guidelines for use by the local health authorities in the event of a large flow of migrants.