Transcript Session 1 - WHA Resolution

International Organization for Migration (IOM)
High Level Multi Stakeholder Dialogue on Migrant
Worker’s Health and Access to HIV services in the
ASEAN Region
Jacqueline Weekers, MHD/IOM
Bangkok, November 2011
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Objectives
•WHA Resolution & Global Consultation on Migrant Health
•Observations on the place of health in global platforms on
migration and development
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World Health Assembly Resolution
& Global Consultation on Migrant Health
2008 :61st WHA Resolution on "the health of migrants"
Migrant-sensitive health policies and equitable access to services;
Capacity building of health service providers and professionals;
Bi- and multi-lateral cooperation, intersectoral action [...]
2010 : Global Consultation on Migrant Health to:
Take stock of actions by MS & Stakeholders
Reach consensus on priority areas and strategies
Initiate an operational framework to assist MS and stakeholders
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Global Consultation on Migrant Health
Madrid, Spain 3-5 March 2010
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Operational Framework: Priorities
Monitoring Migrant Health
Policy- legal frameworks
To identify key indicators useable across countries
To implement international standards that protect
migrants' right to health
To develop and implement policies that promote
equal access to health services for all migrants
To ensure the standardization and comparability of
data on migrant health
To map good practices in monitoring migrant
health, policy models, health system models[…]
To extend social protection in health and improve
social security for all migrants and family members[…]
Migrant sensitive health systems
Partnerships, multi country framework
To ensure continuity and quality of care in all
settings
To establish and support migration/ health dialogues
and cooperation across sectors and countries of
origin, transit and destination
To enhance the capacity of the health workforce to
address the health issues associated with
migration
To ensure health services are culturally,
linguistically and epidemiologically appropriate[..]
To address migrant health in global and regional
processes (e.g. GMG, GFMD)
To develop an information clearing house of good
practices […]
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Risk factors for migrant health
Migrant health risk factors:
Poverty, social exclusion, discrimination,
barriers to access health services, out of
pocket payments etc
Uneven distribution of
MDGs, marginalization,
reduced productivity
Negative impact on
migrants' health &
public health
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Working towards a paradigm shift
Traditional approach
of exclusion:
Multi-dimensional approach
of inclusion:
Security
Reduction of inequities
Disease control,
quarantine,
IHR '51
Social protection
in health, health
determinants, NCDs
National focus
Multi country &
inter-sectoral
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Health as part of the Global Migration and
Development debates, 2010
 Global Migration Group: Inter agency
group to promote the development and
application of international and regional
instruments related to migration and
encourage better coordinated
approaches to international migration
 Global Forum on Migration and
Development: Intergovernmental -, non
binding, government-lead process
handling global migration and
development questions and trends.
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Observations from the global dialogues
 Migrants tend to be perceived as 'workers' who contribute to
economic development. Much less mention about the health
dimensions of internationally agreed development goals
 Migration is “good” for health and “bad” for health
 The discussion is about costs: the only health related GFMD
outcome was : "finding cost effective ways to address the
health of migrants"
Role of remittance
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Remittance flows to developing countries 2011: 347 USD bn (Worldbank)
Top remittance recipients in East Asia and Pacific, 2010
 Philippines USD 21,3 bn
11.7 % of GDP (fourth biggest in the world)
 Vietnam
USD 7.2 bn
7 % of GDP
 Indonesia
USD 7.1 bn
1.3 % of GDP
 Thailand
USD 1.8 bn
 Malaysia
USD 1.6 bn
 Cambodia
USD 04 bn
 Myanmar
USD 0.2 bn
3 % of GDP
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"Transnational" family life, how healthy is it?
Contemporary labour migration flows and long term separation
affect family life:
•Family members living apart
•Psychological impact on left behind children and heavy burden
on elderly grandparents and older siblings
•Gender roles, identities & inter generational relations change
•'Global Care Chain‘: special issue for women migrants
•Family disintegration, high divorce rates
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Models to enhance migrant health
• Countries of origin (remittances-dependent countries):
pre departure orientation; overseas health insurance or
insurance for family back home; reintegration assistance. BUT
many limitations
• Destination countries: wide spectrum from barring access to
universal access; portability of benefits is rare
• Multi lateral arrangements : they are rare. Example "Ibero
american multi lateral agreement on social security"
• Role of remittances?: much to be explored
Today and tomorrow
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 Good time to take stock since the WHA Resolution, Global
Consultation and regional commitments that promote the
health of migrants
 Ensure accomplishments, plans and commitments will be
reported in future relevant platforms (HDL 2013; WHA…)