The specific challenges we have encountered in our fieldwork in migration contexts highlight the need for better evidence to improve health-system responses to migration, mobility, and health. We have identified five core areas in which action is needed to support the development of a global research agenda on migration, mobility, and health.
[PAPER] Towards a migration-aware health system in South Africa: A strategic opportunity to address health inequity (2017)
Migration impacts the South African public healthcare system but not in the ways
often assumed, and sectors responsible for improving responses have a poor
understanding of migration. The need for better data is emphasised, existing policy
responses are outlined, and strategic opportunities for intervention are suggested.
Recommendations are made for migration-aware health systems that embed
population movement as central to the design of health interventions, policy, and
research. Such responses offer strategic opportunities to address health inequity, both
nationally and regionally, with resulting health and developmental benefits for all.
[PAPER] Infectious disease testing of UK-bound refugees: a population-based, cross-sectional study (2018)
Testing refugees in an overseas setting through a systematic HA identified patients with a range of infectious diseases. Our results reflect similar patterns found in other programmes and indicate that the yields for infectious diseases vary by region and nationality. This information may help in designing a more targeted approach to testing, which has already started in the UK programme. Further work is needed to refine how best to identify infections in refugees, taking these factors into account.
Healthcare practitioners who are dedicated to making the lives of children and their families better watched in disbelief as the ongoing situation of separating children from their parents unfolded at the southern border of the United States. We know that for many families the migration journey is traumatic and has lasting effects; separation and detention simply compound this trauma.
The conditions in which migrants travel, live, and work often carry exceptional risks to their physical and mental well-being. Even if certain migrant groups have access to health services, they tend to avoid them due to fear of deportation, xenophobic and discriminatory attitudes within society, and other linguistic, cultural, and economic barriers. Evidence indicates that social stigmatization and anxieties generated by restrictive immigration policies hinder undocumented immigrants’ access to health rights and minimizes immigrants’ sense of entitlement to such rights.
[PAPER] Prevention and assessment of infectious diseases among children and adult migrants arriving to the European Union/European Economic Association: a protocol for a suite of systematic reviews for public health and health systems (2017)
The European Centre for Disease Prevention and Control is developing evidence-based guidance for voluntary screening, treatment and vaccine prevention of infectious diseases for newly arriving migrants to the European Union/European Economic Area. The objective of this systematic review protocol is to guide the identification, appraisal and synthesis of the best available evidence on prevention and assessment of the following priority infectious diseases: tuberculosis, HIV, hepatitis B, hepatitis C, measles, mumps, rubella, diphtheria, tetanus, pertussis, poliomyelitis (polio), Haemophilus influenza disease, strongyloidiasis and schistosomiasis.
[PAPER] Immigrant Arrival and Tuberculosis among Large Immigrant and Refugee Receiving Countries, 2005–2009 (2017)
Australia, Canada, New Zealand, the United Kingdom, and the United States are the largest immigrant- and refugee-receiving countries in the world and are currently collaborating on preventing importation of TB into each of their countries. Joint efforts in a small number of high-burden countries can help prevent importation of TB cases and also contribute to control efforts within source countries.
[PAPER] Cross-border collaboration for improved tuberculosis prevention and care: policies, tools and experiences (2017)
This article first sets out general principles for cross-border collaboration and continuity of care. It then presents a series of case studies. Policies and practices on cross-border collaboration in selected low-incidence countries (Australia, Italy, Norway, The Netherlands, the United Kingdom and the United States) are described and critically appraised. Details of the World Health Organization's (WHO's) European Respiratory Society TB Consilium for transborder migration and those of the Health Network's TBNet activities are described. With increasing population movement, including migrants and travellers, it is time to build on good practices and existing tools and to remove legal, financial and social barriers to ensure early diagnosis, full treatment and continuity of care across our world.
[PAPER] Capacity strengthening through pre-migration tuberculosis screening programmes: IRHWG experiences (2017)
This article describes the collaborative experiences of five countries (Australia, Canada, New Zealand, United Kingdom and the United States of America, members of the Immigration and Refugee Health Working Group [IRHWG]), with similar pre-migration screening programmes for TB that are mandated. Qualitative examples of capacity building through IRHWG programmes are provided. Combined, the IRHWG member countries screen approximately 2 million persons overseas every year. Large-scale pre-entry screening programmes undertaken by IRHWG countries require building additional capacity for health care providers, radiology facilities and laboratories. This has resulted in significant improvements in laboratory and treatment capacity, providing availability of these facilities for national public health programmes.
[PAPER] Screening for tuberculosis in migrants and visitors from high incidence settings: present and future perspectives (2018)
This review provides an overview and critical assessment of TB screening practices that are focused on migrants and visitors from high to low TB incidence countries, including pre-migration screening and post-migration follow-up of those deemed to be at an increased risk of developing TB. We focus mainly on migrants who enter the destination country via application for a long-stay visa, as well as asylum seekers and refugees, but briefly consider issues related to short-term visitors and those with long duration multiple-entry visas. Issues related to the screening of children and screening for latent TB infection are also explored.
 Intergovernmental collaboration for the health and wellbeing of refugees settling in Australia
This article outlines how collaboration between like-minded national governments can improve premigration health screening through information sharing, collaborative learning and increased capability in countries of origin to not only screen for illness and disability, but to more effectively put measures in place to address these before, during and after arrival. Australia, Canada, New Zealand, the UK and the US have worked together for more than a decade on migration health screening policies to ensure better management of health needs and successful resettlement. A case study about the Syrian refugee cohort, which began arriving in Australia in late 2015, illustrates how intergovernmental collaboration can improve settlement.
[PAPER] Danger of blurring global migration governance and health security agendas in Southern Africa (2018)
This paper explores the potential risks associated with the blurring of global migration governance and health security agendas in Southern Africa, a region associated with high levels of population mobility, communicable, and – increasingly – non-communicable diseases.
 Interventions to Improve Vaccination Uptake and Cost Effectiveness of Vaccination Strategies in Newly Arrived Migrants in the EU/EEA: A Systematic Review
Targeting migrants for catch-up vaccination is cost effective for presumptive vaccination for diphtheria, tetanus, and polio, and there was no evidence of benefit of carrying out pre-vaccination serological testing. The cost-effectiveness is sensitive to the seroprevalence and adherence to vaccinations of the migrant. We conclude that scarce but direct EU/EEA data suggest social mobilization, vaccine programs, and education campaigns are promising strategies for migrants, but more research is needed. Research should also study cost effectiveness of strategies. Vaccination of migrants should continue to be a public heath priority in EU/EEA.
Drawing on discussions with policy makers, research scholars, civil society, and United Nations agencies held in Colombo, we emphasize the urgent need for quality research on international and domestic (in-country) migration and health to support efforts to achieve the Sustainable Development Goals (SDGs). The SDGs aim to ‘leave no-one behind’ irrespective of their legal status. An ethically sound human rights approach to research that involves engagement across multiple disciplines is required. Researchers need to be sensitive when designing and disseminating research findings as data on migration and health may be misused, both at an individual and population level. We emphasize the importance of creating an ‘enabling environment’ for migration and health research at national, regional and global levels, and call for the development of meaningful linkages – such as through research reference groups – to support evidence-informed inter-sectoral policy and priority setting processes.