The annual migration of millions of people from one corner of the planet to another is no longer a strange phenomenon for most people today. This is true even for those who might be living in the most remote parts of the world. Perhaps they too have come across an émigré in their communities as they went about their daily business.
One phenomenon that has been observed in the 21st century with multifactorial-driven migration is the stress on the health systems of the host countries. This is driven by factors like increased ethnic diversity within such populations resulting in linguistic and cultural barriers. This leads to a gradual attenuation of the quality of healthcare services that can be provided to the population within such countries. We cannot assume that all health professionals in these societies are culturally competent enough to handle this enormous diversity.
While these problems stare at us in the face, in Europe for example, the Committee of Ministers of the Council of Europe have long recommended that “the governments of the member states promote the involvement and participation of all parties concerned (researchers, policy makers, local health authorities, health professionals, representatives of ethnic minority groups and non-governmental organisations) in the planning, implementation and monitoring of health policies for multicultural populations”.
Since this recommendation in 2006, it is evident that great strides have been made in bridging the gap of cultural and linguistic barriers on all fronts especially in the ethnically diverse Europe of this century. These changes have taken place at the individual, organisational and political levels of the society. On the one hand, these are all worth celebrating. However, on the other hand, if the health systems must remain robust, they must apply the learnings of all these last decades of immigration and emigration. There is a need to train more health-aware interpreters, train more culture-intelligent medical practitioners and health workers, and re-organize several health centres such as hospitals and disease screening centres to become more migrant-friendly. Furthermore, politicians and policymakers need to continue bouncing the ball by providing support that will ensure the fortification the health system from this perspective.
One simple path that could be explored to reduce these ethnic inequities is to encourage health professionals to transform their attitudes to become more culturally competent. Health workers need more training in cultural sensitivity. Hospitals, for example, should be adapted to meet the needs of the nouveaux arrivés by having more interpreters in healthcare centres, and communities should offer more affordable language courses to migrants. Moreover, all and sundry need to undergo training on the two-way cultural differences that are very likely to occur in the health system.
In the coming decades, global health systems will be even more urgently influenced by migration. We have to consider that migrants are usually a very diverse population with varying health needs ranging from infectious diseases like sexually transmitted infections, and influenza to non-communicable diseases like cardiovascular diseases, mental health conditions as well and obesity to name a few. These are further influenced by various social determinants of health like trauma, violence, exclusionary migration policies, inadequate shelter, racism, discrimination, and barriers to healthcare services. Health and migration policies should focus on removing barriers and providing culturally competent care that allows individuals and communities to enjoy the best state of health possible. This is easier said than done due to various barriers.
Therefore, additional efforts should be made to improve health literacy and awareness among migrant communities so that they can also be co-stewards of their health rather than mere victims of the system. Finally, to enrich the health systems and improve the quality of life of citizens and migrants in communities across the globe, there is a need for thorough research on migration and health. By understanding the specific health needs of different migrant groups, evaluating interventions, and identifying best practices that are essential for evidence-based policymaking, we can restore health to various communities in a globally-orchestrated and adapted fashion.
