INFORMATION
Refugees and migrants have a variety of different physical and mental health needs, shaped by experiences in their country of origin, their migration journey, their host country’s entry and integration policies, and living and working conditions. These experiences can increase the vulnerability of refugees and migrants to chronic and infectious diseases.
The COVID-19 pandemic has disrupted health services, putting people already in vulnerable situations at heightened risk and hampering the ability of health systems to respond to their needs.
The term refugee is defined in Article 1 of the 1951 Convention Relating to the Status of Refugees. There is no universally accepted definition of the term migrant. However, the United Nations Department of Economic and Social Affairs defines an international migrant as “any person who changes his or her country of usual residence”, and this definition includes people who are moving or have moved across an international border, regardless of legal status, duration of the stay abroad and causes for migration.
Migrants may be given a migration status that limits their entitlement and access to health care. However, international law guarantees universal access in line with the 2030 Agenda for Sustainable Development, in particular with Sustainable Development Goal 3 (ensure healthy lives and promote well-being for all at all ages).
Although governed by separate legal frameworks, refugees and migrants are entitled to the same universal human rights and fundamental freedoms as other people.
In 2021, countries with the highest number of refugees fleeing were 1. Syrian Arab Republic, 2. Venezuela, 3. Afghanistan, 4. South Sudan and 5. Myanmar while countries hosting the highest number of refugees were 1. Turkey, 2. Colombia, 3. Uganda, 4. Pakistan, 5. Germany.
Refugees and migrants are a diverse group and have a variety of health needs, which may differ from those of the host populations.
Refugees and migrants often come from communities affected by war, conflict, natural disasters, environmental degradation or economic crisis. They undertake long, exhausting journeys with inadequate access to food and water, sanitation and other basic services, which increases their risk of communicable diseases, particularly measles, and food- and waterborne diseases. They may also be at risk of accidental injuries, hypothermia, burns, unwanted pregnancy and delivery-related complications, and various noncommunicable diseases due to the migration experience, restrictive entry and integration policies and exclusion.
Refugees and migrants may arrive in the country of destination with poorly controlled non-communicable diseases, as they did not have care on the journey. Maternity care is usually a first point of contact with health systems for female refugees and migrants.
Refugees and migrants may also be at risk of poor mental health because of traumatic or stressful experiences Many of them experience feelings of anxiety and sadness, hopelessness, difficulty sleeping, fatigue, irritability, anger or aches and pains but for most people these symptoms of distress improve over time They may be at more risk of such as depression, anxiety and post-traumatic stress disorder (PTSD) than the host populations.
Refugee and migrant health is also strongly related to the social determinants of health, such as employment, income, education and housing.
Barriers to access to health services
Refugees and migrants remain among the most vulnerable members of society and are often faced with xenophobia; discrimination; substandard living, housing and working conditions; and inadequate or restricted access to mainstream health services.
Migrants, particularly in an irregular situation, are often excluded from national programs for health promotion, disease prevention, treatment and care, as well as from financial protection in health. They can also face high user fees, low levels of health literacy, poor cultural competency among health providers, stigma and inadequate interpreting services.
Barriers are even greater for people with disabilities. Women and girls may find difficulty in accessing sexual and gender-based violence protection and response services. Refugee and migrant children, especially unaccompanied minors, are more likely to experience traumatic events and stressful situations, such as exploitation and abuse, and may struggle to access health care.
The ability to access health services in humanitarian settings is usually compromised and complicated by shortages of medicines and lack of healthcare facilities.
