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PRIORITISING MIGRANTS AND REFUGEES
IN THE GLOBAL HEALTH DISCOURSE
A Policy Brief of the Global Health Hub Germany Community
on Global Health and Migration
Key Questions
1. Why prioritise migrants and refugees in this discourse?
2. How can awareness of their health challenges be improved in the context of
global health?
Abstract
This policy brief aims to provide a comprehensive framework with key policy
recommendations and actions that highlight the critical importance of addressing
the health challenges faced by migrants and refugees in host countries. By
addressing facilitators, barriers, frontline worker experiences, system integration,
and specific healthcare needs, the brief aims to inform policymakers and other
relevant stakeholders in Germany about the measures needed to ensure equitable
and effective healthcare for this vulnerable population and the opportunities that
migrants can offer to the host countries.
There is a crucial need to address the disconnect between global policy on migration
and individual national responses towards migrants and refugees. Displaced
populations, particularly those in low-resource settings, grapple with specific health
challenges that demand focused attention. Addressing their health needs is
paramount for advancing global health outcomes. The imperative to acknowledge
their distinct health concerns calls for strategic measures. There is a need to raise
awareness about these challenges and foster tangible actions to mitigate them.
COMMUNITY PAPER
Bhaskar S et al. (2024). Prioritising Migrants and Refugees in the Global Health
Discourse: A Policy Brief of the Global Health Hub Germany Community on Global
Health and Migration. DOI: 10.13140/RG.2.2.19053.77284 Published 20.02.2024
Retrieved from Berlin, Germany: https://www.globalhealthhub.de/de/news/detail/
policy-brief-global-health-and-migration
Suggested Citation:
Action Plan
Migrants and refugees should be recognised as central stakeholders in the global
health and One Health discourses.
To achieve this, we suggest the following key actions:
• Raise awareness about the unique social determinants and health challenges
faced by migrants and refugees, particularly those in low-resource settings, and
the opportunities they bring.
• Advocate for strategic integration of the needs of migrants and refugees within
German and global policy agendas to enhance domestic and global health
outcomes.
• Facilitate a participatory approach to discussions around migrants and refugees
where all stakeholders can partake in the co-design, co-authorship, and co-
production of the discussions and associated output.
About the authors
The policy brief reflects the results of discussions in the Hub Community on Global
Health and Migration of the Global Health Hub Germany. The Community is
comprised of a diverse group of professionals from various academic disciplines,
organizations, and civil society representatives who are dedicated to improving
the well-being of migrant populations and the health systems in the host societies
that serve them. Our work encompasses a range of important aspects related to
this topic, such as specific health system challenges faced by migrants and
refugees, which necessitate careful consideration and proactive measures. The
Hub Community on Migration and Global Health enthusiastically offers to
continue exchanging ideas and expertise on the challenges and opportunities
associated with migration. We are readily available for consultation and can
provide insights on relevant inquiries. Our goal is to contribute to the
development of a more inclusive, sustainable, and equitable healthcare system
that benefits all individuals.
Contributions to this paper were made by: Dr. Sonu Bhaskar (lead author), Dr.
Stephanie Tache, Dr. Henna Riemenschneider, Maureen McGowan, Indre
Karciauskaite, Dr Joost Butenop, Dr. Veronica I. Dodero, Ruth Kopelke, Dr. Jinan
Abi Jumaa, Antonia Ekerdt, Dr. Sonia Diaz-Monsalve, Dr. Michael Wirsching, Dr.
Elham Khatamzas, Dr. Mohamed Moussif, Vicky Pros Abenakyo, Oxana Abovskaya,
Dr. Sevil Hakimi, Dr. Naqibullah Hamdard, Khullat Munir, Nadina Stadler.
Policy Challenges
Challenge 1: Contextualising migra-
tion within the global health and One
Health discourses
It is imperative to confront the
challenge of embedding migration
within the broader context of global
health and the One Health discourse.
One Health, as delineated by the
World Health Organization (WHO),
represents an integrated and unifying
approach aimed at balancing and
optimizing the health of people,
animals, and the environment. One in
every 30 people worldwide is broadly
classified as a migrant (IOM, 2022) [1].
As of 2021, a report by the
International Organization for
Migration (IOM) reveals a threefold
increase in the global migrant labour
force over the past decade [2].
According to the International Labour
Organization (ILO), migrant workers
constituted 1 in 20 of the world's
workforce in 2019, playing vital roles in
sectors like healthcare, transportation,
and food processing [3]. However, as
of January 2022, a Grattan Institute
report highlighted a decrease in
Australia's temporary migrant
population from nearly 2 million in
2019 to 1.5 million [4]. This decline is
primarily attributed to the absence of
approximately 500,000 'missing
migrants,' mainly comprising
international students and working
holidaymakers. The ever-intensifying
interconnectedness on a global scale is
anticipated to drive migration, both
from the Global North to the Global
South and vice versa. There also exists
a disconnect between global policy
and individual responses, as embodied
by the 2022 Global Compact for
Migration ratified by the United
Nations General Assembly [5].
Moreover, the compounding impacts
of climate change have exacerbated
this situation, leading to increased
instances of internal displacements
and South-South migrations [6]. The
vulnerabilities, exposure to health
disparities, and struggles with
healthcare access form a compelling
rationale for immediate attention.
Solutions: Migration should be central to the global and national health discourse.
There is an emerging understanding in Germany to contextualise migration within
the broader canvas of One Health and global health [7]. The ethical dimension of
the integration of migrants and refugees into global health also needs to be
emphasised, spotlighting the intricate nexus connecting migration push and pull
factors, One Health, geopolitics, and global health security. These health concerns
are closely intertwined with broader domains such as women's health, mental
health, and urban health. While examples from other nations (such as Australia) or
good practices may not directly transpose to Germany, there are lessons and
practices that can provide insights and potential solutions. Tailoring these
examples and recommendations to the German context while considering cultural
and institutional differences can play a pivotal role in elevating migration's
centrality in the global health discourse. Prioritizing collaboration, inclusivity, and
evidence-based approaches is crucial to safeguarding the health and well-being of
migrant populations in Germany. Here are some examples and
recommendations:
Example 1: Health Screening and Access
• Australia: Currently, the Australian migration system incorporates health
screenings for migrants, involving comprehensive health assessments for visa
applicants to verify their compliance with health requirements. Moreover,
specific programs have been implemented to cater to the health needs of
refugees and asylum seekers.
• Recommendation for Germany: Implement comprehensive health
screenings for migrants entering the country. Ensure that the screening
process is not a barrier to entry but rather a means to identify health needs
and provide appropriate support.
Example 2: Community Health Programs
• Australia: Australia has community-based health programs that target
migrant populations. These programs focus on health education, access to
healthcare services, and cultural sensitivity in healthcare delivery.
• Recommendation for Germany: Develop and expand community health
programs tailored to the diverse needs of migrant populations. Collaborate
with community organizations to bridge language and cultural gaps in health
communication.
Example 3: Partnerships with NGOs and International Organizations
• Australia: Australia collaborates with non-governmental organizations
(NGOs) and international health organizations to address the health needs of
migrants. These partnerships facilitate the provision of healthcare services
and support systems.
• Recommendation for Germany: Establish strong partnerships with NGOs and
international organizations to leverage resources and expertise in addressing
the health challenges of migrant populations. Engage in knowledge-sharing
and collaborative initiatives.
Example 4: Inclusive Health Policies
• Australia: Australia has inclusive health policies that prioritize equitable
access to healthcare services for all residents, regardless of their migration
status.
• Recommendation for Germany: Adopt and strengthen inclusive health
policies that ensure migrants, including refugees and asylum seekers, have
equal access to healthcare services. Promote policies that do not discriminate
based on immigration status.
Example 5: Research and Data Collection
• Australia: Australia conducts research on the health status of migrant
populations, contributing to evidence-based policies and programs.
• Recommendation for Germany: Invest in research and data collection on the
health status of migrants. Use the findings to tailor health interventions and
policies to meet the specific needs of different migrant groups.
Example 6: Cross-Sectoral Collaboration
• Australia: Australia encourages collaboration between the health sector and
other sectors, such as education and employment, to address the broader
determinants of health for migrants.
• Recommendation for Germany: Foster cross-sectoral collaboration to
address social determinants of health for migrants. Engage multiple sectors
in creating comprehensive strategies that go beyond healthcare services.
Challenge 2: Unique health risks and
challenges faced by migrants and
refugees
Healthcare challenges for refugees
and migrants include heightened
vulnerability to poverty-related
illnesses, hygiene-related diseases,
poor mental health, and inadequate
access to basic healthcare services [8].
Addressing the health needs of
migrant populations is not only a
humanitarian imperative but also a
matter of public health concern.
Neglecting the health of migrants may
accrue public health risks, which can
have far-reaching implications for both
migrant and host populations in
Germany and the European Union. The
triggers and effects of migration are
deeply intertwined with historical
legacies and economic policies.
From the perspective of the migrants'
country of origin and journey, the
exposure risks, conditions of
migration, whether voluntary or
forced, and frequently insufficient
access to basic healthcare services all
increase the health risks. Screening for
hygiene- and poverty-related diseases,
or certain infectious diseases that are
highly prevalent in certain origin
countries or refugee camps but less
known in Germany, is critical. From a
host country perspective, tuberculosis
[9], COVID, lice, infestations of pests
like rats, and cockroaches may warrant
attention. For example, migrants and
health workers, especially migrant
health workers, are at an increased risk
of COVID-19 infection [10]. Moreover,
depending on countries of origin and
transit, specific conditions such as
Malaria, HIV due to sexualized
violence, and scabies may be more
prevalent in refugees emanating from
specific countries or refugee camps. In
addition, hygiene-related diseases
(e.g., diphtheria and cholera) and some
less-known poverty-related diseases
(e.g., Chikungunya) may also pose a
significant threat to migrants,
particularly those from economically
disadvantaged backgrounds. Migrants,
especially those living in temporary or
informal settlements, are at greater
risk of exposure. Inadequate access to
healthcare further complicates the
timely diagnosis and treatment of such
conditions among migrants.
In summary, addressing the health
needs of migrants and refugees is not
only a matter of humanitarian concern
but is also essential for promoting
global health security, preventing the
spread of diseases, fostering social
harmony, and harnessing the full
potential of diverse populations for
the betterment of global society.
Solutions: The challenges faced by refugees and migrants, specifically in Germany
and the European Union, have been outlined in Appendix Table 1, emphasizing the
need for comprehensive solutions. Addressing health-related challenges requires
a holistic approach integrating humanitarian, economic, and public health
considerations. Vulnerable populations, particularly those at risk of infectious
diseases and lacking robust healthcare infrastructure, must be prioritized. The
complexities of migration's triggers and effects necessitate holistic and effective
approaches. It is crucial to understand the root causes of migration and create
conditions that allow individuals to thrive in their places of origin, respecting the
universal right to seek a better life. A comprehensive healthcare strategy,
including cultural competency training, tailored screenings, collaboration with
NGOs, mental health services, education campaigns, and inclusive policies, is
crucial. This approach ensures the well-being of migrants and fosters social
cohesion in a diverse and resilient Europe.
Challenge 3: Challenges faced by mi-
grants and refugees in accessing
health systems
Migrants often encounter intersecting
challenges that hinder their ability to
access healthcare and maintain
optimal health [11]. Limited access to
essential healthcare services for
migrants represents a significant
public health concern, particularly in
the domains of chronic conditions,
infectious diseases, HIV testing, and
reproductive healthcare [12]. Migrants
living in host countries may lack
awareness, familiarity, and
understanding of the health systems in
those countries, particularly when
these systems differ significantly from
those in their countries of origin [13,
14]. In Germany, migrants face
language barriers in accessing care,
which nonetheless end up being a
serious obstacle, as translation and
interpretation services are not
consistently offered by the German
public health system [15]. The onus
falls on the patients to secure these
services, creating obstacles in terms of
navigating the system and managing
associated financial responsibilities.
The impediments faced by migrants
and refugees extend beyond
healthcare and are often tangled with
political dynamics and economic
factors.
Solution: To address challenges faced by migrants accessing healthcare in host
countries (e.g., in Germany), a best-case solution involves integrating multilingual
support and cultural competence. Establishing a program would include training
multilingual healthcare navigators, providing cultural competence training for
healthcare professionals, and disseminating informational materials in multiple
languages. Consistent translation services within healthcare facilities and
community engagement initiatives would bridge language gaps, fostering
understanding. Policy advocacy is crucial for mandating translation services in the
public health system. This comprehensive approach enhances accessibility for
migrants, addressing language barriers, cultural sensitivities, and healthcare
navigation challenges. Aligned with the principles of One Health, it recognizes the
interconnectedness of human health and social factors, contributing to the well-
being of both migrants and the broader community.
Comprehensive solutions, encompassing legal frameworks and strategic funding
considerations, are essential for addressing services, communication, and
systemic barriers to access and funding. These measures, outlined in Appendix
Table 2, play a vital role in bridging healthcare disparities and ensuring the well-
being of migrants and host communities alike.
Challenge 4: Complexities at the In-
tersections of One Health and Mi-
grant Health
The intricate landscape in the Global
South, especially concerning
“undocumented” migrants, introduces
added complexities [15]. Medinet is a
non-government organisation that
provides anonymous treatment to
undocumented migrants or special
populations in Germany. This places
significant strain on the healthcare
budgets of host nations, which are
already stretched to accommodate the
healthcare needs of undocumented
migrants. The combination of
undocumented migration and strained
healthcare resources creates a volatile
dynamic that not only contributes to
societal tensions but also raises the
risk of potential unrest. The issue of
biodiversity, a crucial component of
“One Health," intersects with
migration patterns in complex ways.
Climate change, driven by various
factors including environmental
degradation and natural disasters,
disproportionately impacts vulnerable
groups such as forced migrants and
refugees [6]. The adverse
consequences of climate change, such
as extreme weather events and
resource scarcity, often act as push
factors for migration, exacerbating the
existing challenges associated with
this phenomenon. Forced migration
caused by environmental factors adds
another layer of complexity to the
already-strained systems of host
nations [8]. It places additional
pressure on healthcare resources,
public services, and infrastructure. In
particular, regions prone to climate-
related challenges may experience
surges in migration flows, testing the
resilience of healthcare and social
support systems.
In essence, the confluence of
undocumented migration, strained
healthcare budgets, and the impact of
climate change on vulnerable
populations intensifies the
multifaceted challenges associated
with migration.
Solution: To navigate challenges at the nexus of One Health and migrant health,
a proactive approach, exemplified by the "Integrative Resilience Framework",
offers a best-case scenario. For instance, host nations adopting this model could
reduce healthcare budget strain, enhance societal harmony, and bolster climate
resilience. Scaling up anonymous healthcare services, inspired by organizations
like Medinet, can effectively address the health needs of undocumented migrants
without overwhelming the system. This proactive approach not only tackles
immediate healthcare concerns but also fosters long-term sustainability by
addressing root causes, especially those related to climate change. Embracing an
integrative and resilient approach enables nations to navigate complexities,
fostering a more sustainable and equitable future. Additionally, a comprehensive
approach is crucial, recognizing the broader implications for public health, societal
stability, and the environment. Promoting legal pathways for migration,
bolstering healthcare infrastructure, and addressing climate change-related
displacement are pivotal efforts in mitigating these challenges.
Challenge 5: The demographic
pressures and migrants as an
opportunity to address labor
shortages
The demographic landscape is
undergoing a significant trans-
formation characterized by a rapidly
ageing population in European
countries. Germany, in particular, faces
a demographic challenge where a
substantial proportion of its citizens
are reaching retirement age, leading
to a decline in the working-age
population. This presents a dual
challenge and opportunity. The
challenge lies in the strain it places on
the labour market and social welfare
systems, while the opportunity lies in
the potential of migration to provide a
solution.
Solution: Migration cannot only address labour shortages in Germany but also
contribute to economic growth and the sustainability of social services in the face
of demographic change [16]. Germany has recognized the value of migration as a
solution to address the growing demand for labour. It's important to recognize
that the successful integration of migrants into the labour market is a complex
process that requires appropriate policies, infrastructure, and cultural
considerations. Germany needs to continue investing more in language training,
vocational education, and programs that facilitate the cultural integration of
migrants. In the context of the healthcare workforce, there are opportunities to
integrate skilled migrants into existing health systems or community-based public
health interventions [16]. This is to emphasise that this should follow the WHO
code for ethical migration of the healthcare workforce [17]. Finally, ensuring
access to healthcare for these populations enhances economic productivity, as
healthy migrants and refugees are better equipped to contribute economically to
their host countries, leading to overall improvements in global economic
wellbeing.
Recommendations
An overview of the policy recommendations to address the healthcare challenges faced by migrants and refugees is summarised
in Table 1 [further details on specific health risks and challenges faced by refugees and migrants as well as the health systems are
presented in Appendix Tables 1 and 2].
Table 1. Summary of policy recommendations to address specific healthcare challenges experienced by
migrants and refugees.
Policy area
Recommendations
Reality check
(5-year perspective)
Policy & strategic
conside-
rations
Integration of
migration into
global health
discourse
- Advocate for the inclusion of migration in global and One Health discussions.
Raise awareness about the ethical imperative to incorporate migrants and refu-
gees into global health agendas
Platforms such as the Global
Health and Migration Hub Commu-
nity contribute to ongoing discus-
sions.
Need for additional efforts to opti-
mize its functionality and effec-
tiveness both at the local and
global levels.
Climate Change
Mitigation and
Adaptation
- Formulate strategies to address the underlying causes of environmental dis-
placement.
Enhance disaster preparedness and response mechanisms for more robust crisis
management.
Struggling with the intricacies of
the federal system, particularly ev-
ident in the challenges posed by
the COVID-19 pandemic.
Operational Re-
search / Evidence
Comprehensive
Assessment of
Health Con-
cerns
- Conduct comprehensive health assessments addressing a spectrum of concerns
among migrant populations, encompassing both physical and mental well-being,
with specific attention to women's health and the unique dynamics of urban
health.
High potential identified in vari-
ous initiatives in Germany funded
by BMG.
- Foster collaboration with international organizations, governments, and re-
search institutions to collect comprehensive data on the specific health chal-
lenges confronted by migrants.
- Advocate for the promotion of health equity through robust assessment and re-
search initiatives, raising awareness on the diverse health needs of migrant popu-
lations.
Limited capacity to participate at
the operational level due to time
constraints.
Despite activities taking place,
there is currently no discernible
impact on policy or operational
levels.
Research efforts are underway,
but their influence on policy devel-
opment remains minimal.
Research and
Policy Develop-
ment
- Support research initiatives to inform evidence-based policies and strategies.
- Engage policymakers to develop policies considering the health concerns of mi-
grants
Initiatives are currently being im-
plemented; however, there is an
opportunity for expanded assis-
tance and more active engage-
ment.
Data Collection
and Research
- Gather comprehensive data on health challenges faced by migrants.
- Promote international cooperation for financial and technical support.
- Promote research initiatives that focus on understanding the specific healthcare
challenges faced by migrants and refugees and evaluate the effectiveness of in-
terventions.
Significant potential for operation-
alization exists, but currently, the
process lacks a centralized system
for information gathering
(knowledge management prac-
tices).
- Use research findings to inform evidence-based policies and strategies that en-
hance healthcare access and services for migrants.
Currently happening, though en-
countering difficulties within the
federal framework.
Interdisciplinary
collaboration
Cross-Sectoral
Collaboration
- Encourage cross-sectoral collaboration between health, environmental, and mi-
gration experts.
- Foster dialogue and cooperation between governments, NGOs, and academia
for a multidisciplinary approach.
Opportunities for growth and de-
velopment not systematically pur-
sued.
Health Infrastruc-
ture and Services
Health Infra-
structure
Strengthening
- Invest in health infrastructure to ensure equitable access to healthcare services,
with focus on
- increasing the availability of translation services.
- provider training
- Develop and implement community-based healthcare services that cater to the
specific needs of migrant populations. These services should include culturally
sensitive care and language support.
Historical data indicates that the
likelihood of this occurrence is
low, based on experiences dating
back to 2014.
- Collaborate with local and international NGOs for community-based healthcare
services
Unlikely in Germany, parallel struc-
tures are neither desired nor sus-
tainable.
- Enhance disaster preparedness.
Unlikely due to a lack of financial
resources and political willingness.
Comprehensive
Healthcare Ser-
vices including
Information, Ed-
ucation and
Communication
(IEC)
Access: Ensure migrants have access to comprehensive healthcare services.
Limited options within the initial
18 months due to national law
(AsylbLG).
Currently constrained by legal
provisions, hindering any signifi-
cant changes or adjustments.
Information, Education, Communication (IEC):
- Multilingual materials: Develop educational materials in multiple languages to
ensure that information is accessible and comprehensible to diverse populations.
High Potential Evaluation. Evalu-
ate the quality of materials from
BZgA, assess their reach within
the target group, and identify op-
portunities for optimization. Con-
sider refining content, outreach
strategies, and exploring innova-
tive approaches to unleash the full
potential of available resources.
- Develop and launch health education campaigns and awareness programs, sani-
tation and hygiene improvement initiatives, and economic empowerment pro-
grams, targeting both migrant and host communities to raise awareness about
the importance of inclusive healthcare access.
The current initiative is not mak-
ing a substantial impact, prompt-
ing concerns about its relevance
and effectiveness. An evaluation
conducted by a COVID-19 expert
group has highlighted shortcom-
ings in terms of the initiative's rel-
evance, effectiveness, and impact.
The initiative may be facing chal-
lenges related to funding, affect-
ing its ability to execute strategies
and achieve meaningful out-
comes.
Training / Education:
- Provide training for healthcare providers in cultural sensitivity and effective
communication to create an inclusive healthcare environment.
- Peer-to-peer education and guidance model with host citizens to migrants
Demonstrates moderate potential
for effectiveness.
Need to be administered via col-
laboration with NGOs or medical
professional associations.
Few instances of success have
been observed, with SoulTalk and
IPSO Care standing out as a nota-
ble example.
Legal Pathways
for Migration
(for health care
workforce)
- Promote and facilitate legal pathways for safe migration.
- Enhance healthcare infrastructure and disaster preparedness.
Unlikely scenario: Federal states
are not expected to delegate re-
sponsibilities to the national level,
and vice versa.
Funding Alloca-
tion and Sup-
port
- Allocate sufficient funding to sustain healthcare initiatives.
- Seek international support for healthcare funding.
Unlikely due to the federal struc-
ture.
Published by: Global Health Hub Germany
c/o Deutsche Gesellschaft für Internationale
Zusammenarbeit (GIZ) GmbH
Köthener Str. 2-3, 10963 Berlin, Deutschland
Phone: +49 30 59 00 20 210
info@globalhealthhub.de
www.globalhealthhub.de
Version: 02/2024
About the Global Health Hub Germany
The Global Health Hub Germany offers all individuals and institutions active in the
field of global health the opportunity to connect in an independent network across
eight different stakeholder groups: International organisations, youth, politics,
foundations, think tanks, business, science and civil society. The members of the
Hub work together on current issues of global health. The interdisciplinary
exchange generates themes, issues and solutions that the Hub brings to
policymakers to support informed policy-making and advance global health.
Founded in 2019, the Hub now has around 1,500 members. For more information:
www.globalhealthhub.de
About the Hub Communities
The Hub Communities are working groups led by the members of the Global Health
Hub Germany themselves. They meet regularly to exchange ideas, share expertise
and work together on global health issues. If you would like to join a Hub
Community or learn more about their work, contact Merle Wangerin, Head of
Community Management: merle.wangerin@globalhealthhub.de
Suggested Citation
Bhaskar S et al. (2024). Prioritising Migrants and Refugees in the Global Health
Discourse: A Policy Brief of the Global Health Hub Germany Community on Global
Health and Migration. DOI: 10.13140/RG.2.2.19053.77284 Published 20.02.2024
Retrieved from Berlin, Germany: https://www.globalhealthhub.de/de/news/detail/
policy-brief-global-health-and-migration
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Syrian refugees in the early years of asylum in Germany: a cross-sectional pilot
study. BMC Public Health 22, 2217 (2022). https://doi.org/10.1186/s12889-022-
14684-7
15. A Kaleidoscope of Migrant Experiences within the German Healthcare System.
Global Health Hub Germany. September 4, 2023.
[https://www.globalhealthhub.de/en/news/detail/a-kaleidoscope-of-migrant-
experiences-within-the-german-healthcare-system]
16. Statement on Workforce and Migration in the Health Sector to the
Subcommittee on Global Health of the German Bundestag. Global Health and
Migration Hub Community, Global Health Hub Germany. 30 June 2023.
[https://globalhealthhub.de/fileadmin/Statement_GHHG_Community_on_Glob
al_Health_and_Migration_Health_workforce_Final__1_.pdf]
17. World Health Organization (WHO) Global Code of Practice on the International
Recruitment of Health Personnel:
[https://www.who.int/publications/i/item/wha68.32]
Appendix
Methodology:
The policy brief on Global Health and Migration embodies a collaborative and
inclusive approach, mirroring the diverse perspectives within the Hub Community
[4]. It emerges from the collective efforts of professionals from varied fields,
organisations, and civil society, all committed to improving the health and well-
being of migrant populations and the healthcare systems of their host societies.
The policy brief stems from vibrant discussions within the Global Health Hub
Germany's Hub Community on Migration and Global Health. Comprising diverse
professionals, the community's core emphasis is addressing intricate challenges
and opportunities pertaining to migrants and refugees in the global health context.
Various elements and stages involved in policy development have been
summarised below:
1. The policy brief's foundation lies in the virtual roundtable held during the
Annual Symposium of the Global Health and Migration Hub Community on
April 19, 2023. Ahead of this symposium, a draft agenda with five focused
sessions was shared. Specific queries from the policy brief were distributed
prior to the event, prompting concise statements on Global Health and
Migration. The symposium featured dedicated sessions, allowing members to
express viewpoints through in-person and written interactions.
2. Data collection drew from the virtual Global Health and Migration Hub
Community Annual Symposium, the in-person Global Health Hub Germany's
Annual Community Day (June 12-13, Berlin), and subsequent regular HC
meetings. Active member participation and input enriched this process,
fostering an exchange of insights on Global Health and Migration challenges. A
working draft was compiled to collate suggestions, embracing a collaborative
and iterative approach to document creation.
3. The policy brief draws inspiration from the groundwork laid by previous
projects undertaken within the Hub Community. The “Migrant Kaleidoscope”
shared healthcare experiences of migrants/refugees. Seven individuals,
migrants/refugees in Germany (Ukraine, Syria, Ghana, Nigeria,
Palestine/Lebanon, Iran/Afghanistan), were interviewed from August to
December 2022 [12]. Insights shaped recommendations on language barriers,
training, healthcare navigation, and combating discrimination. Also, our
submission to Bundestag's Sub-Committee on Global Health highlighted our
active role, with constructive feedback enhancing policy discussions,
underscoring collaborative importance [13].
4. An inclusive call for collaboration was extended to all Hub Community
members, fostering a sense of shared ownership and participation in the policy
brief. The real-time working document of the brief was openly shared, actively
encouraging input and contributions. The creation of a dedicated working
committee and regular meetings facilitated the participation of interested
members, enabling collaboration, discussions, and the refining of the
document.
5. The methodology prioritises openness and inclusivity. All members were
notified in advance about project discussions, ensuring fair and inclusive
participation opportunities. Specialised committee-led meetings enabled in-
depth deliberations on specific tasks. Platforms like Google Docs streamlined
consultation, review, and member contributions, fostering collective ownership
and transparency.
In summary, the policy brief on Global Health and Migration is a testament to the
Hub Community's enduring dedication to collaboration, inclusivity, and informed
decision-making. This iterative approach combines symposium discussions, member
input, and insights from previous initiatives to craft a comprehensive and
actionable framework for addressing migrant health challenges. The aim is to
contribute meaningfully to the development of equitable and sustainable
healthcare systems.
Appendix Table 1. Various healthcare challenges, and
solutions aimed to address them, faced by refugees and
migrants.
Healthcare
Challenge
Solutions
Improved
Healthcare
Coverage
- Establish healthcare centers or mobile clinics in areas with
high migrant populations.
- Collaborate with NGOs to provide culturally sensitive care.
- Digital tools (mHealth, eHealth, and telehealth) to enable
access to information, services and lifelong engagement,
e.g., use of interactive digital interventions towards
advancing HIV knowledge and prevention behaviours
- Address maternal and child health in the context of
humanitarian camps.
Health Education
- Launch health education campaigns in multiple languages
to increase awareness about hygiene practices and disease
prevention.
- Develop educational materials accessible to diverse
migrant groups.
Sanitation and
Hygiene
Infrastructure
- Improve sanitation facilities in migrant settlements to
reduce hygiene-related disease risks.
- Ensure access to clean water sources and promote hygiene
practices like handwashing.
Poverty
Alleviation
- Implement programs addressing economic disparities
among migrants, including job training and income
generation.
- Collaborate with local businesses to provide employment
opportunities.
Preventive
Measures for
Vector Borne
Diseases (VBD)
- Distribute insecticide-treated bed nets to reduce malaria
transmission risk.
- Establish mobile testing and treatment centers for timely
diagnosis and management of VBD such as malaria, Zika,
and Chikungunya cases.
Collaboration and
Funding
- Foster collaboration between governments, international
organizations, NGOs, and local communities.
- Allocate sufficient funding to sustain healthcare initiatives
and ensure equitable access to services.
Legal and Social
Support
- Provide legal assistance to help migrants navigate
healthcare and immigration systems.
- Offer social support services, including counseling and
mental health care.
Integration and
Inclusivity
- Promote the integration of migrants into local
communities to reduce vulnerability and improve access to
healthcare.
- Encourage local cultural understanding and acceptance.
Appendix Table 2. Table outlining healthcare challenges
faced by host countries regarding migrants, potential
solutions, and funding considerations.
Healthcare
Challenge
Solutions
Funding Considerations
Limited Access to
Infectious
Disease/HIV
Testing
- Awareness campaigns
- Allocate funds for
community-based testing
- Culturally sensitive
healthcare services
- Support healthcare
infrastructure in high
migrant areas
- Community-based testing
initiatives
- Training healthcare
providers in cultural
sensitivity
Reproductive
Healthcare
Disparities
- Prenatal care and
childbirth facilities
- Investment in healthcare
infrastructure in areas with
high migrant populations
- Educational programs
about healthcare rights
- Training healthcare
providers for cultural
sensitivity
- Inclusive and respectful
care practices
Comprehensive
Healthcare
Approach
- Collaboration between
government agencies,
NGOs, and international
bodies
- Develop and implement
policies ensuring equitable
healthcare access
- Addressing the entire
healthcare spectrum, from
prevention to treatment
- Allocate necessary funds to
sustain healthcare initiatives
for migrants
Declarations: The photos/graphics presented in this policy brief were generated using
DALL-E by Ruth Kopelke.
Data Collection,
Monitoring
evaluation, and
Implementation
Research
- Gather comprehensive health data on migrant populations
to tailor healthcare interventions.
- Conduct research on the health status of migrants to
inform evidence-based policies.
- Formulate clear definitions for key outcome and impact
indicators to effectively evaluate the current situation,
identify improvements, and facilitate comparisons across
diverse regions.
Suggested Citation
Bhaskar S et al. (2024). Prioritising Migrants and Refugees in the Global Health
Discourse: A Policy Brief of the Global Health Hub Germany Community on Global
Health and Migration. DOI: 10.13140/RG.2.2.19053.77284 Published 20.02.2024
Retrieved from Berlin, Germany: https://www.globalhealthhub.de/de/news/detail/
policy-brief-global-health-and-migration
