Medecins du Monde - France

The route to healthier and more inclusive migration

Lead Organization

Medecins du Monde - France

Paris, Île-de-France, France

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To learn more about – or provide significant funding to – this project, please contact Lever for Change.

Project Summary

Millions of migrants and refugees travel along migration routes from the Sahel and North Africa to Europe, and in Central America, towards the US. Throughout the journey, their access to health care is severely curtailed, contributing to a vicious circle of physical and mental health issues and rejection. We propose a dramatic expansion and adaptation of health services to redress the resulting loss of human capital and promote long-term inclusion. Drawing on evidence regarding the power of removing barriers to healthcare to promote uptake, the effectiveness of community health workers in improving health access, the importance of social contact in promoting collaboration, and the importance of mental health and psychosocial support interventions, we aim to empower migrants, improve their health, and promote acceptance. Concretely, we will provide urgent healthcare, help transit and destination countries create more resilient health systems, and support for civil society to promote acceptance of migrants’ rights.

Problem Statement

The number of international migrants globally now totals 258 million. Many have left behind unstable conditions, frequently endure long and perilous journeys, marred by violence, and face social exclusion for long periods on arrival in countries of settlement. Throughout the journey, men, women, and children face mental health difficulties, the risk of repeated violence (in particular sexual and gender-based), and very limited or disrupted access to medical care. They are also spending longer periods of time on uncertain journeys: they often live in urban areas, outside camp settings, and spend years in transit, in legal limbo.Despite public commitments to common goals elaborated in the Sustainable Development Goals and the Global Compact for Migration, many countries have erected (de jure or de facto) barriers to health access for migrants out of fear of attracting others, leaving migrants without recourse to fundamental rights. Many health systems are set up with few clear points of entry to services or reception, meaning they fail to uphold the principle of universal health coverage. Poor health access worsens migrants’ health issues, creating a further barrier to their productive integration in society, and a source of misunderstanding and fear. We believe the solution lies in a combination of empowering migrants with basic information on their rights and available services, as well as in strengthening the ability of local health workers and system to receive them, but also to treat the host population. This promotes acceptance through collaboration towards a shared objective of an inclusive, healthy population.

Solution Overview

Our objective is to produce healthier and more inclusive migration routes by strengthening local health systems throughout the journey, and by empowering migrants with tools and information to access their rights to healthcare. We focus on two major migration routes—across Central America to the US border and from the Sahel to Europe—but the goal is to produce and scale evidence-based interventions for adaptation and replication anywhere.To do this, MdM will triple the number of its target beneficiaries (from about 100,000 direct beneficiaries) across the two routes, providing direct primary health care and support to health care systems in Niger, Algeria, Egypt, Morocco, Tunisia, Italy, France, Belgium, Spain, Nicaragua, Guatemala, Honduras, El Salvador, Mexico, and explore expansion in Libya and the US. We will deliver a holistic approach centered on five major components:•Training for local medical professionals in the technical knowledge and cultural awareness required to respond to migrants’ physical and mental health needs.•Community mobilization and health mediation services targeted at connecting migrants to health systems and strengthening their ability to access care.•Safe havens for integrated healthcare and service referrals, open to all vulnerable groups (migrants and hosts), in an effort to promote acceptance of migrants and to create broader access points into local health systems. •New tools for promoting health, including a digital health passport.•Strengthening civil society networks to promote acceptance of migrants’ rights through advocacy strategies informed by experience and rigorous evidence (created in an Innovation Lab).

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