Migration Health Evidence Portal for COVID-19

This evidence portal is a repository of research publications and high-yield evidence briefs on COVID-19 and its intersection with migration health.

The scientific literature and knowledge base on the epidemic rapidly expand daily. Tremendous efforts are being made by the global community of clinicians, researchers and journal editors to advance scientific evidence to guide policy and decision making at the field level. However, there is a need to build evidence platforms to share and distill key findings emergent from this growing body of scientific literature that is relevant to migration, health, and human mobility to ultimately assist evidence-informed decision making from a migration lens.

The portal contains:

Research Publications on COVID-19 and Migration Health

This section reflects the output of the publication mapping exercise involving the quantitative assessment of a set of published scientific articles (i.e., bibliometric analysis) on COVID-19 with reference to migrants, migration, and human mobility. Bibliometric analysis provides an important snapshot of a specific field of interest/domain. The baseline information from bibliometric analysis helps identify research gaps that future studies can investigate. The bibliometric analysis conducted by IOM and MHADRI on international migration and health is one example.

Key messages

  • As of 30 March 2020, the publications related to COVID-19 totaled 21,779 (no restriction set in terms of language and subject area). From this, a total of 43 publications were relevant to migration health and human mobility.
  • Most of the studies investigated the cases and disease transmission dynamics of COVID-19 in the context of national and international population movement, with most studies undertaken in China. The distribution of research to date indicates the role of travel and migration in the importation of the virus.
  • Research on the epidemiology of the disease among migrant groups such as migrant workers, internally displaced persons (IDPs), refugees and asylum seekers is lacking. Evidence with attribution to migrant groups within clinical datasets are seldom reported.
  • Despite multiple studies from high-income countries (HICs) using mathematical modelling to predict spread, and model social distancing, border closures and impacts on health care system capacities, there were only a few studies that model outbreak in low-to-middle-income countries (LMICs) contexts. None hitherto have focused on camps and camp-like situations.
  • There is a real need to strengthen the current knowledge base on the epidemiology and social determinants of COVID-19 and examine health-related outcomes in specific migrant groups, especially migrant workers.
  • Investigations on COVID-19 and migration health should not be limited to the role of movement/mobility in the dynamic importation of cases in a pandemic; a more inclusive research strategy that integrates the relevant interests of migrant populations should be considered.
  • Advocating for the right to health of migrants and migrant inclusion within the global, regional, national and sub-national pandemic preparedness and response plans is of critical importance.
  • The most productive authors and institutions come from Hong Kong, whose geographical proximity to and socio-economic ties with China were likely contributing factors in their early contributions to the field.

Network map of common keywords

The network map below shows an overview of the common keywords that appear in the title, abstract, and keywords of the relevant publications retrieved on the topic of COVID-19 and migration health. Network maps of keywords reveal key topics in a research area or domain as well as the relationship (co-occurrence) between common keywords. It is a relative indicator of important research areas that are drawing attention in the field. 

  • The large circles in the figure represent the most frequently occurring author keywords in the research publications (N=43) such as ‘pneumonia’ (n=26), ‘epidemic’ (n=22), ‘travel’ (n=19), ‘quarantine’ (n=18), ‘outbreak’ (n=15), and ‘disease transmission’ (n=14). 
  • The lines connecting the circles represent the co-occurring keywords. The distance between two keywords approximates how strongly the words are related based on the number of their co-occurrences (i.e., the more publications in which two keywords co-occur, the stronger the relation between them). Thus, the strongly related words appear closer together on the map. 
  • Each distinct color represents a cluster of keywords that are strongly related to each other. In the figure, ‘pneumonia’, ‘travel’, and ‘disease transmission’ are strongly related to ‘virology’, ‘animals’, ‘nonhuman’, ‘zoonosis’, ‘fever’, ‘genetics’, and ‘pandemic’ (red cluster). The keyword ‘epidemic’ is strongly related to ‘outbreak’, ‘quarantine’, ‘mass screening’, ‘air travel’, ‘travel medicine’, ‘global health’, ‘infection control’, and ‘risk assessment’ – these keywords are shown to be closer together forming the green cluster. 
  • These topics on COVID-19 and migration health can be classified into the following thematic areas: disease epidemiology (i.e., travel, disease transmission, virology, animals, nonhuman, zoonosis, genetics, pandemic); clinical management (i.e., pneumonia and fever); and public health intervention (i.e., quarantine, control, etc.).

Note: See the full paper for the Methodology and Limitations of this analysis.

World Migration Report 2020

The International Organization for Migration has just published its 2020 World Migration Report. Read and download it here!

Chapter 7 of the report (“Migration and Health: Key issues, governance and current knowledge gaps”) was written by MHADRI steering committee members Jo Vearey (Vice Chair), Charles Hui (Chair) and Kolitha Wickramage (Secretariat).

“The World Migration Report 2020 presents key data and information on migration as well as analysis of complex and emerging migration issues. Some of the topics covered in the report include human mobility and environmental change, migrants’ contributions in an era of disinformation, children and unsafe migration, migration and health, among others.”

The Director General of the IOM addresses the goals of the report (and indeed of the IOM as an agency) in his foreword:

“As the United Nations’ migration agency, IOM has an obligation to demystify the complexity and diversity of human mobility. The report also acknowledges IOM’s continuing emphasis on fundamental rights and its mission to support those migrants who are most in need. This is particularly relevant in the areas in which IOM works to provide humanitarian assistance to people who have been displaced, including by weather events, conflict and persecution, or to those who have become stranded during crises.”

“Likewise, IOM remains committed to supporting Member States as they draw upon various forms of data, research and analysis during policy formulation and review processes. Indeed, this is reflected in IOM’s Constitution where the need for migration research is highlighted as an integral part of the Organization’s functions. The World Migration Report is a central component of this important function.

In this era of heightened interest and activity towards migration and migrants, we hope this 2020 edition of the World Migration Report becomes a key reference point for you. We hope it helps you to navigate this high-profile and dynamic topic during periods of uncertainty, and that it prompts reflection during quieter moments. But most importantly, we hope that you learn something new from the report that can inform your own work, be it in studies, research and analysis, policymaking, communication, or migration practice.”

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Seasonal migration and health in India: Constraints for research and practice

Divya Ravindranath and Divya Varma

Ideas for India for more evidence-based policy (Published March 2019)

Seasonal migrants in India engage in temporary informal work in work environments that actively flout labour laws on wages, work hours, and living conditions. The most significant impact of this is on the health outcomes of workers and their children. In this note, Varma and Ravindranath describe the roadblocks in conducting in-depth enquiries into migrants’ health status and healthcare-seeking behaviour, and designing and implementing health programmes conducive to their needs.

Read full article here

How Labour Conditions at Construction Sites are Leading to Higher Rates of Child Malnutrition

Divya Ravindranath, Sep 27 2019

This commentary focuses on female workers in construction sites in India, and the impact of mothers’ work on the health and nutrition of their children. The sector provides good opportunities for work, but it also affects children’s health outcomes.

“A study of 131 migrant children living at various construction sites in Ahmedabad showed that half of the children surveyed were underweight (low weight for age), 41% were stunted (low height for age) and 22% were wasted (low weight for height). According to the National Family Health Survey (2015-’16), 35.5% of children under the age of five in the country are underweight, 38.4% are stunted, 21% are wasted.”

The article highlights various reasons why children are in this condition. Mothers do not have time or comfortable environments to breastfeed exclusively, and can also have difficulty finding the time to wean at the proper age. Mothers don’t have access to affordable, healthy food, so older children eat a lot of packaged food. The water in construction sites is often contaminated and not potable. Utilizing health services means taking time off work, which results in a loss of wages.

The author argues that NGO’s can be one way to help alleviate the situation, but they can be difficult to access as well. Dr Ravindranath’s main recommendation is that “it is also critical to view the role of parental work environment and migration as factors contributing to undernutrition. Policies and interventions designed to address undernutrition must consider these as key factors without which such children would continue to be denied a chance of improved nutrition and better health.”

Read full commentary here

The Health of Nepali Migrants in India: A Qualitative Study of Lifestyles and Risks

(Featured image shows first two themes out of a total five from this research)

Authors: Pramod R. Regmi, Edwin van Teijlingen, Preeti Mahato, MSc; Nirmal Aryal, Navnita Jadhav, Padam Simkhada, Quazi Syed Zahiruddin, and Abhay Gaidhane

International Journal of Environmental Research and Public Health, https://doi.org/10.3390/ijerph16193655, (Published Sep 2019).

Current research on Nepali migrant workers in India neglects work, lifestyle, and health care access in favor of focusing on sexual health. This article aims to gain a broader sense of migrant workers’ health by conducting focus groups and interviews. The researchers analyzed their data and determined five different themes:

  1. Accommodation
  2. Lifestyle, networking, and risk-taking behaviours
  3. Work environment
  4. Support from local organisations
  5. Health service utilisation

This qualitative study demonstrates that health risks for Nepali migrant workers’ emerge because of a wide range of factors. The authors recommend a larger quantitative study to gain more insight.

Read the full article here.

Major depressive disorder prevalence and risk factors among Syrian asylum seekers in Greece

Danielle N. Poole, Bethany Hedt-Gauthier, Shirley Liao, Nathaniel A. Raymond, & Till Bärnighausen

BMC Public Health, https://doi.org/10.1186/s12889-018-5822-x, (Published July 2018).

This research provides necessary information on the mental health (specifically major depressive disorder or MDD) of refugees from Syria, as this information has not been collected or analyzed thoroughly as of yet. The researchers surveyed 135 Syrian refugees in a camp in Greece, specifically screening for MDD. The authors found that 44% of participants had symptoms of major depression. They found that women had an increased likelihood of MDD, and that time spent in the camp had a trend towards increased risk of depression.

“The development of depression during the asylum process is likely to undermine individual and societal functioning, which are essential for the survival and eventual resettlement of forced migrants. Depression is also likely to lead to adverse acculturation outcomes.”

To read the full article, click here.

‘And when a certain health issue happen, they try to cover it’: Stakeholder perspectives on the health of temporary foreign workers and their families

Bukola Salami, RN, PhD; Kathleen Hegadoren, RN, PhD; Anna Kirova, PhD; Salima Meherali, RN, MN, PhD; Christina Nsaliwa, PhD; & Yvonne Chiu, LLD

Social Work in Health Care, https://doi.org/10.1080/00981389.2017.1379458 (Published Sep 2017).

Like our other recent highlighted articles, this one again focuses on Alberta, Canada. This research was an exploratory study into the health and wellbeing of temporary foreign workers (TFWs) in the province.

They asked two primary research questions:

  • “What are the perspectives of stakeholders on the health and well-being of TFWs and their families in Alberta?”
  • “What do they see as potential threats to child and family health in this population?”

The authors found that stakeholders perceive TFWs as experiencing several different types of specific health challenges: mental health, family health, and occupational health. They also found that workers confront barriers in accessing mental health services as well as the fact that income and social status are social determinants of health.

If you wish to read the rest of the article, click here. Institutional access restrictions apply.

Sense of community belonging among immigrants: perspective of immigrant service providers

B. Salami, J. Salma, K. Hegadoren, S. Meherali, T. Kolawole, E. Diaz

Public Health, https://doi.org/10.1016/j.puhe.2018.10.017 (Published Feb 2019)

In this article, authors interviewed immigrant service providers in Alberta, Canada, to discuss how their clients experience belonging on a day-to-day basis. The research showed that there are two different groups within which migrants experience belonging; their specific ethnocultural group, and the mainstream society of Canada. The researchers saw that migrants feel more belonging in an ethnic group before becoming comfortable with people who live near them. The authors argue that lack of ethnocultural diversity in local organizations adds to this distance from Canadian society.

If you wish to read the rest of the article, click here. Institutional access restrictions apply.

Transnationalism, parenting, and child disciplinary practices of African immigrants in Alberta, Canada

Dominic A. Alaazi, Bukola Salami, Sophie Yohani, Helen Vallianatos, Philomina Okeke-Ihejirika, Christina Nsaliwa

Child Abuse and Neglect, https://doi.org/10.1016/j.chiabu.2018.09.013 (Published December 2018)

This article focuses on the parental disciplinary practices of African migrants in Alberta, Canada. The authors themselves are members of the immigrant community and so were better able to research these practices in a supportive and reflexive manner.

“We found that African immigrant parents used corporal discipline, persuasive discipline, and a hybrid of the two, as well as emerging practices involving transnational fostering and emotional isolation of children who persistently misbehaved. These practices, in their totality, appeared to be influenced by the transnational experiences of parents and precepts that are traceable to Canada’s legal and educational systems.”

Child discipline is a controversial subject, and these authors nuance the topic of discipline in African immigrant households by examining how parents negotiate new environments and expectations by adjusting practices as needed.

Read the full article here. (Note that institutional restrictions on access apply).

Access and utilization of mental health services for immigrants and refugees: Perspectives of immigrant service providers

Bukola Salami RN, PhD; Jordana Salma RN, PhD; Kathleen Hegadoren RN, PhD

International journal of Mental Health Nursing https://onlinelibrary.wiley.com/doi/full/10.1111/inm.12512 (Published 09 July 2018)

This paper focuses on migrant services for mental health in Alberta, Canada. The authors argue that health providers perceive several challenges to access and utilization of services, including stigma, language barriers, and cultural ideas about mental health. Service providers adopt different strategies to better provide for their patients in response to these different barriers. Read the full paper here