Access to healthcare for undocumented migrants: Analysis of avoidable hospital admissions in Sicily from 2003 to 2013

Access to healthcare services for undocumented migrants is one of the main public health issues currently being debated among European countries. Exclusion from primary healthcare services may lead to serious consequences for migrants' health. We analyzed the risk among undocumented migrants, in comparison with regular migrants, of being hospitalized for preventable conditions in the Region of Sicily (Italy). We performed a hospital-based cross-sectional study of the foreign population hospitalized in the Sicily region between 1 January 2003 and 31 December 2013. The first outcome was the proportion of avoidable hospitalization (AHs) among regular and irregular migrants. Second outcomes were the subcategories of AHs for chronic, acute and vaccine preventable diseases. 85 309 hospital admissions were analyzed. In the hospitalized population, in comparison to regular migrants, undocumented migrants show a higher proportion of hospitalization for diseases preventable through primary and preventive care (AOR1·48, 95%CI 1·37-1·59). The proportion of avoidable hospitalizations associated with the lack of legal status is higher for vaccine preventable conditions (AOR 2·06, 95%CI 1·66-2·56) than for chronic conditions (AOR 1·47, 95%CI 1·42-1·63) and acute conditions (AOR 1·37; 95%CI 1·23-1·53). Between 2003 and 2013, the proportion of avoidable hospitalizations decreased both in regular and undocumented migrants but decreased faster for regular than for undocumented migrants. Undocumented migrants experience higher proportion of hospitalization for preventable conditions in comparison with regular migrants probably due to a lack of access to the national healthcare service. Policies and strategies to involve them in primary healthcare and preventive services should be developed to tackle this inequality

A desk review on institutional and non-institutional organizations active in the field of migrant’s health in the WHO European Region

Background Migrants have problematic access to health-care; non-institutional organizations (NGOs), as well as institutional bodies may play a role facilitating their access to mainstream health care. Aim Our research reviews actions that address migrant’s need to understand how, where, and who participates to this effort. Method Data were from desk or web research, declaration from organisations and their websites, information from WHO Country offices.  Results 154 NGO were identified in the WHO EURO region. 58% were direct health care providers while the remaining provided either mediation services or belong to umbrella organization. 173 National Institutes (GOVs) were found; less than the 20% were directly or indirectly involved in health care, whereas the majority was involved in research, policy development, international relations and human rights. Conclusion and recommendation Some gaps and duplications were identified. WHO can play an overarching role in the exchange of expertise and harmonisation of the efforts in this field

Strengthening Country Readiness for Pandemic-Related Mass Movement: Policy Lessons Learned

The COVID-19 pandemic has thus far restricted the large movement of people; nonetheless, we cannot exclude the disruptive power of a virus with similar characteristics to COVID-19 affecting both high- and low-income countries, as a factor for future mass migrations. Indeed, the top 15 countries affected by COVID-19 host about 9 million refugees, and it is, therefore, important to investigate and strengthen the readiness of countries’ health policies to ensure they are well equipped to deal with potential large influxes of ‘epidemic-related refugees and migrants.’ Using the Bardach Policy Framework as a tool for analysis, this article investigates the readiness of countries for a potential public health event (mass migration generated by future pandemics), therefore, aiming at a health response forecasting exercise. The article reviews the policies put in place by countries who faced large influxes of migrants between 2011 and 2015 (the policy-prolific years between the Arab Spring migration and the introduction of stringent measures in Europe) and new evidence generated in response to the COVID-19 pandemic (including the ‘ECDC Guidance on infection prevention and control of COVID-19 in migrant and refugee reception and detention centres in the EU/EEA and the UK’ and the ‘WHO Lancet priority for dealing with migration and COVID-19′) to formulate a policy option able to strengthen national system capacities for responding to influxes of epidemic-related migrants and the management of highly infectious diseases.</jats:p

Strengthening Country Readiness for Pandemic-Related Mass Movement: Policy Lessons Learned

The COVID-19 pandemic has thus far restricted the large movement of people; nonetheless, we cannot exclude the disruptive power of a virus with similar characteristics to COVID-19 affecting both high- and low-income countries, as a factor for future mass migrations. Indeed, the top 15 countries affected by COVID-19 host about 9 million refugees, and it is, therefore, important to investigate and strengthen the readiness of countries’ health policies to ensure they are well equipped to deal with potential large influxes of ‘epidemic-related refugees and migrants.’ Using the Bardach Policy Framework as a tool for analysis, this article investigates the readiness of countries for a potential public health event (mass migration generated by future pandemics), therefore, aiming at a health response forecasting exercise. The article reviews the policies put in place by countries who faced large influxes of migrants between 2011 and 2015 (the policy-prolific years between the Arab Spring migration and the introduction of stringent measures in Europe) and new evidence generated in response to the COVID-19 pandemic (including the ‘ECDC Guidance on infection prevention and control of COVID-19 in migrant and refugee reception and detention centres in the EU/EEA and the UK’ and the ‘WHO Lancet priority for dealing with migration and COVID-19′) to formulate a policy option able to strengthen national system capacities for responding to influxes of epidemic-related migrants and the management of highly infectious diseases

A desk review on institutional and non-institutional organizations active in the field of migrant's health in the WHO European Region

BACKGROUND: Migrants have problematic access to health-care; non-institutional organizations (NGOs), as well as institutional bodies may play a role in facilitating their access to mainstream health care. AIM: Our research reviews actions that address the need of migrants in terms of health care in order to understand how, where, and who participates in this effort. METHOD: Data were from desk or web research, declaration from organisations and their websites, information from WHO Country Offices. RESULTS: 154 NGOs were identified in the WHO European Region. 58% were direct health care providers while the remaining provided either mediation services or were part of a network organization. 173 national institutes (GOVs) were found; less than the 20% were directly or indirectly involved in health care, whereas the majority were involved in research, policy development, international relations and human rights. CONCLUSION AND RECOMMENDATION: Some gaps, a certain fragmentation and lack of coordination were identified. WHO can play an overarching role in the exchange of expertise and harmonisation of the efforts in this field