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.

Global mapping of actors, agencies and networks providing training and capacity building programmes in migration and health

In partnership with IOM and the African Centre for Migration & Society (ACMS) at Wits University, MHADRI is undertaking a global mapping of actors, agencies and networks engaged in delivering training and capacity building/developing programmes in the field of migration and health. We are interested in initiatives being undertaken by all actors, including within civil society organisations, government departments, international organisations and academic institutions.

We invite anyone involved in developing or implementing any training or capacity building initiative in the field of migration and health to participate in a short online survey.

We are using the information collected to develop an open source database of available training and capacity building initiatives in the field of migration and health.

For further information, please contact Dr Rebecca Walker.

Towards inclusive migrant healthcare

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4256 (Published 16 September 2019)

Denise L Spitzer, Sara Torres, Anthony B Zwi, Ernest Nene Khalema and Erlinda Palaganas

“Although the underlying political, economic, social, and environmental factors that lead to migration must be dealt with, we have an obligation and opportunity to support the health and wellbeing of migrants.

Health is a human right that transcends borders and juridical categorisations. Improving the wellbeing of the world’s migrants requires an intersectional lens that focuses on the diverse circumstances and locations in which migrants are situated. Empirically informed, community centred, culturally adapted intervention models that involve migrants will advance their healthcare”
.

Healthcare is not universal if undocumented migrants are excluded

Helena Legido-Quigley, Nicola Pocock, Sok Teng Tan, Leire Pajin, Repeepong Suphanchaimat, Kol Wickramage, Martin McKee and Kevin Pottie

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4160 (Published 16 September 2019)

“Although migration is high on the international policy agenda, there is scant research to inform policy. Research on migration and health is concentrated in high income countries that have been relatively unaffected by the large migration flows among countries in the global south. Migrants in different areas will have particular health needs, owing to previous experiences in their countries of origin and the journeys they have taken. To a greater extent than in other health research, it is necessary to take account of these differences. Migrants will differ in their willingness to become involved with researchers, reflecting their experiences, which may have affected their trust in others. Interventions should relate to the particular barriers to healthcare faced by migrants. These include health beliefs and cultural norms, such as gender roles, as well as legal, financial, and regulatory aspects of the health system.”

Building alliances for the global governance of migration and health

Jo Vearey, Miriam Orcutt, Larry Gostin, Christy Adeola Braham and Patrick Duigan

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4143 (Published 16 September 2019)

“A collective, alliance based programme of action on migration and health that brings together civil society, practitioners, policy makers, and researchers is needed. A central “point-person” to drive and coordinate this process would need to be identified within central government; in different contexts, different focal persons may exist. Sri Lanka is a rare example of a country with a dedicated—and well documented—national migration and health policy process that can provide helpful insight for other countries. To support innovation and context specific alliance building, research is required to document and evaluate existing migration and health interventions and policies.”

“Crucially, there is a need to develop ways to future proof the global governance of migration and health: this is a contemporary governance priority for both the global health and migration sectors. If migration and health governance continues to be sidelined, it jeopardises action towards major global health targets, including those associated with the sustainable development goals, most notably that of universal health coverage. Two global compacts (international principles for good practice) were adopted in December 2018: one focuses on international migration and the other on refugees. These compacts provide opportunities for nation states to implement good governance approaches to tackle migration and health. Whether nation states choose a governance approach based on increasingly nationalistic discourses or an evidence informed approach to healthy migration remains to be seen. Developing a national scorecard on Migration and Health in all Policies, similar to the established Health in All Policies approach, could be an important step in holding nation states to account on their commitments both to universal health coverage and the sustainable development goals. To truly “leave no one behind” there must be a concerted global effort to build alliances to include migration and health in all policies.”

Improving the health of migrants

Kolitha Wickramage, Paul J Simpson, and Kamran Abbasi

BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l5324 (Published 16 September 2019)

With this editorial we launch a new series from The BMJ. The series seeks to improve understanding of the complexities of delivering better health for migrants and communities affected by migration, tackle unhelpful stereotypes and prejudices aimed at migrants, and focus on the role of health in improving the societal response to migrants. Developed by The BMJ in collaboration with the UN Migration Agency (IOM) and the Migration Health and Development Research Network (MHADRI), the first three articles consider the migrant health system and political dimensions of navigating policy, politics, and diplomacy in this complex field.

Better health for migrants isn’t simply a moral imperative. It is an evidence informed, economically wise choice that will improve health for all. It is a choice that must be made in defiance of populism, prejudice, and political expediency.

BMJ series on migration and health

In partnership with the British Medical Journal (BMJ) and the International Organization for Migration (IOM), we are excited to launch a new series on migration and health. The first articles are now online.

Anti-immigrant rhetoric permeates today’s political discourse and soaks through much of society. In this highly politicized context, dominated by debates on immigration and border control, understanding and tackling what affects the health of migrants, their families, and communities is often overlooked and underserved. These gaps in understanding the relation between migration and health remain a challenge that policymakers, practitioners, civil society, and researchers must collectively embrace.

The BMJ’s migration health series aims to provide insights and perspectives by researchers, policymakers, practitioners, civil society, and migrants themselves on issues, challenges and complexities in advancing migration health. The series is being developed in collaboration with the UN’s Migration agency (IOM) and the Migration Health and Development Research Network (MHADRI) – a global network of migration health researchers.