This occasional paper is the start of a series that explores the impacts of COVID-19 and ensuing responses on migration and the wellbeing of migrant and mobile communities in Africa. This paper provides insight into how vaccine nationalism is impacting the rollout of vaccination programs, including the inclusion or exclusion of migrant groups. The paper demonstrates that
“the vast majority of international migrants, refugees, asylum seekers and IDPs are being excluded from state-based vaccine roll-out programmes either via formal policy directives or through various forms of de facto exclusion, such as barriers to access healthcare at the local and national level. These forms of exclusion are likely to have far-reaching public health implications across the continent, affecting both citizens and migrants alike.”
The Migration and Coronavirus in Southern Africa Coordination Group (MiCoSA) is hosted by the Migration and Health Project Southern Africa (maHp) at the African Centre for Migration & Society (ACMS), Wits University, Johannesburg. MiCoSA is an informal network of migrant-led organisations, non-governmental organisations, international organisations, civil society, activists, lawyers, researchers, government officials and policy advisors. Through an online platform and virtual meetings, MiCoSA brings together national and SADC regional partners who are concerned with the health and well-being of asylum-seekers, refugees and migrants during the current Coronavirus pandemic. To date, MiCoSA has over 150 members; to join this network, please email email@example.com
The IOM Migration Health Division (MHD) Research and Epidemiology Unit is currently updating the Bibliometric Analysis of COVID-19 in the Context of Migration Healthfull paper and repository, harnessing relevant research publications on COVID-19 in relation to migrants, migration, and human mobility. See Migration Health Evidence Portal for COVID-19, for reference.
To efficiently do this, we are seeking the help of interested MHADRI members, specifically in screening and tagging relevant publications in which MHADRI members can participate as reviewers. The MHD Research and Epidemiology Unit will then organize and deliver a quick training for the reviewers to guide them on the step-by-step process. Rest assured too that we will acknowledge your work in the paper.
Those interested may contact the MHD Research and Epidemiology Unit at firstname.lastname@example.org. Deadline for submission: 5th Feb 2021.
This evidence portal is a repository of research publications and high-yield evidence briefs on COVID-19 and itsintersection 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:
An interactive, open-source, searchable (and downloadable) repository of research publications on COVID-19 in relation to migrants, migration, and human mobilitybased on the quantitative analysis of the thematic trends and impact of relevant publications.
The full paper of the quantitative analysis of publications on COVID-19 and migration health (i.e., bibliometric analysis).
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.
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.
What do we know about the landscape of migration health research? Who is doing the research? What are they researching on? Which migrant categories are included? What are the health related themes? How can we better understand the research and evidence gap in migration and health? What collaborations are taking place, and can we map who funds this research?
These are some of the questions that a group of scholars, policy makers and International Organization for Migration (IOM) staff investigated at a workshop on bibliometrics analysis of migration health research held in November 2019 at IOM’s Global Administrative Centre in Manila, Philippines.
The workshop was the first of this kind, harnessing research collaboration not only within IOM but also with the government agencies, clinicians and research institutions, mainly from South and Southeast Asia.
“Bibliometric analysis is a useful research method as it lets you look at the patterns of research activities such as publications. In any global health field, it is extremely helpful to know where the work is being done, who is doing it, where the collaborations are happening, and what topics are being explored,” said Dr. Margaret Sampson, an international expert on bibliometric analysis who facilitated the workshop.
Jointly organized by IOM, together with the Migration Health and Development Research Initiative (MHADRI) and the Migration & Health South Asia Network, the workshop served as a platform to develop research capacity, with particular focus on researchers in the Global South, in undertaking bibliometric analysis to identify the gaps in research output on migration health.
BackgroundIn 2018, IOM and MHADRI undertook the first-ever bibliometric analysis of global migration health research in peer-reviewed literature focusing on international migrants. The study revealed major gaps in research productivity especially in the Global South as most literature is from high-income migrant destination countries, despite the significant migration flows within the countries in Asia, Latin America, Africa, Middle East, and Eastern Europe. For example, according to the study, only 6.2 per cent of the total published research output on the health of migrants focused on migrant workers, despite 60 per cent of international migrants represented within this category. Supporting the networking, capacity development of researchers, especially those from developing nations, to undertake migration health-related research was highlighted. The importance of undertaking more in-depth mapping of migration health research output for both international and internal migrants in low to middle income countries were also highlighted in the research by IOM and MHADRI.
The Manila Consensus Group forged at the workshop aimed at further refining and testing the search strategies for bibliometrics research and provide analytical rigour to apply these methods for migration health research.
The group committed to developing methodological guidelines in undertaking bibliometric analysis as well as to work on providing a standardized approach to undertaking bibliometric analysis relevant to research on international and internal migration dynamics.
The group committed to publishing these outputs in open source platforms supported by IOM so as to make this publicly available so that researchers, policy makers and UN agencies can utilize to undertake tailored analytics.
“It boils down to how you frame your question, the right key words, and the right way to search – maybe we are making it too wide or too tight – maybe we are not getting the right information. So, the tools and strategies presented were really helpful,” said one of the workshop participants, Dr. Roomi Aziz, Technical Lead Health Data and Communication, Pathways to Impact in Pakistan
The Manila Consensus group will delve into questions focusing on the research productivity relating to migration and health in Philippines, internal migration and health related research in South Asia as well as the research productivity relating to health assessments of migrants and refugees at pre- and post-migration phases and health outcomes in areas ranging from Infectious disease, communicable disease and occupational health.
“The workshop provided an excellent opportunity to build research capacity among Global South scholars, to enable them to go back and take deep dives to understand the research productivity in the field of migration health in their local areas and use that as evidence to move the field forward,” said Associate Professor Charles Hui, Chairperson of MHADRI network and Chief of Infectious Diseases at Children’s Hospital Eastern Ontario, Ottawa.
In addition to harnessing the synergies created through this initiative, IOM seeks to work with member states, partner organizations and research networks to replicate such mapping and collaboration in other regions.
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:
Lifestyle, networking, and risk-taking behaviours
Support from local organisations
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.
Assessing the current status of research activity and identifying gaps in research output in international and internal migration and health is an important step in mapping the evidence-base in migration health. Through bibliometric analysis, indicators of published literature in global migration health pertaining to migrants across different categories. Further sub-set analysis along geographic clusters and by health themes such as mental health, malaria, tuberculosis and migration may also be investigated. While there are limitations, bibliometrics allows analysis of size, growth patterns, distributions and mapping of global research productivity.
Patterns in publications, authorship analysis, geographical distribution, international research collaboration, important themes discussed, and highly cited articles in the health of migrants can be examined. Bibliometrics is also an important first step in undertaking systematic review.
In 2018, MHADRI network members and IOM undertook a Bibliometric analysis of global migration health research. The data showed gaps in the research productivity ‘heat map’ at global level. Two migration health research workshops held in Nepal and South Africa in 2019 facilitated by a coalition of organizations (IOM, ACMS, QMUL-Migration&Health South Asia network and MHADRI) highlighted the importance of undertaking national, sub-regional and regional ‘deep dives’ into mapping migration health research output for both international and internal migrants.
A pilot bibliometric training workshop will be held in Manila, Philippines in November 2019, with the aim of engaging scholars from the South Asian region to build their skills and capacities to undertake such bibliometric analysis.
Developing a conceptual framework to guide Bibliometric analysis at
national, sub-regional and regional levels – for South & South East
Framework to guide Bibliometric analysis on Health Assessments for
Migrants and Refugees
To provide an overview and technical instruction on performing an in-depth bibliometric analysis of migration and health-related publications using Scopus.
To discuss the use of appropriate visualization tools and software in data representation and reporting.
To provide guidance on structuring publications resulting from the bibliometric analysis.
To define a framework combining bibliometric review with more conceptual-theoretical and critical review to synthesize thematic and empirical gaps in knowledge.
We are currently embarking on an evaluation of the MHADRI network, taking stock of where we are in 2019. With the support of MA student intern Tinyiko Sithole, we will share the key lessons learned and use these to inform the way forward for the MHADRI network into 2020.
Led by Dr Rebecca Walker, a postdoctoral fellow at the African Centre for Migration & Society (ACMS) at Wits University, this initiative is conducting a global mapping of actors, agencies and networks engaged in delivering training and capacity building/developing programmes in the field of migration and health. The aim is to develop a baseline understanding of work that is being done, by whom and where. The online survey is currently being finalised and will soon be shared with the MHADRI network.