https://www.who.int/publications/i/item/9789240054462

Положение дел в области миграции - одна из ключевых детерминант здоровья и благополучия, в то время как беженцы и мигранты остаются одними из самых уязвимых и забытых членов общества во многих странах.

Во Всемирном докладе по охране здоровья и миграции за 2022 г. Всемирная организация здравоохранения (ВОЗ) объединила основные фактические данные о тех многочисленных проблемах в области здравоохранения, с которыми сталкиваются беженцы и мигранты в ходе своих перемещений, и выявила серьезные пробелы в системе глобальных данных и знаний. В докладе представлена информация о передовом опыте и тематических исследованиях ответных мер, предпринимаемых правительствами и другими глобальными заинтересованными сторонами, включая беженцев и мигрантов, а также возможных коллективных ответных мер. Такие ответные меры направлены на обеспечение внедрения эффективных многосекторальных исследований, политики и действий для улучшения здоровья беженцев и мигрантов. Помимо представления текущих глобальных данных и свидетельств об охране здоровья и миграции, в докладе также озвучены нынешние и будущие возможности и проблемы. Двумя основными выводами доклада являются фактическое отсутствие данных о здоровье беженцев и мигрантов, которые были бы сопоставимы между странами и во времени, а также отсутствие разбивки по миграционному статусу в глобальных наборах данных.

Фактологическая база доклада включает более 82000 документов из научной и "серой" литературы, изданной на основных языках, в том числе на всех официальных языках ВОЗ, и результаты всех соответствующих доступных обследований домохозяйств наряду с аналитическими работами и обзорами глобальных и региональных экспертов. Сфера охвата настоящего доклада ограничивается беженцами и международными мигрантами.

Contents

Foreword
Preface
Acknowledgements
Abbreviations and acronyms

1. Population movement and health: an overview

1.1 Introduction
1.2 Definitions and terms
1.2.1 Key definitions
1.2.2 Populations not included in this Report
1.3 Global displacement and migration patterns
1.4 Migratory patterns in WHO regions
1.5 Age and gender
1.6 Displacement
1.7 Health and the dynamics of global displacement and migration
1.7.1 Urbanization
1.7.2 Brain circulation: brain drain versus brain gain
1.7.3 Sending money home
1.7.4 Left-behind families
1.7.5 Discrimination and xenophobia
1.7.6 People smuggling and human trafficking
1.7.7 Climate change
1.8 Health and migration policies
1.8.1 Key international frameworks
1.8.2 WHO resolutions and action plans
References

2. Determinants of refugee and migrant health

2.1 Introduction
2.2 Sex and gender
2.2.1 Health of women and girls
2.2.2 Health of men and boys
2.2.3 LGBTQI+ populations and sexual minorities
2.2.4 Menstrual hygiene management
2.3 Age
2.3.1 Unaccompanied or separated children
2.4 Education
2.4.1 Health outcomes
2.4.2 Access to education for refugee and migrant children
2.4.3 Employment challenges associated with level of education
2.5 Health literacy
2.5.1 Influence on health outcomes
2.5.2 Strategies to improve health literacy and communication
2.6 Income
2.6.1 Health outcomes
2.6.2 Remittances and left-behind families
2.7 Migratory status
2.8 Social support
2.8.1 Acculturation
2.8.2 Parenting
2.8.3 Substance use
2.9 Air quality
2.10 Water, sanitation and hygiene
2.10.1 Access to safe drinking-water
2.10.2 Access to safe sanitation
2.10.3 Hygiene
2.11 Housing and living environments
2.11.1 Housing
2.11.2 Immigration detention
2.11.3 Housing barriers and solutions
2.12 Food and nutrition
2.12.1 Food assistance
2.13 Summary
References

3. Health status of refugees and migrants: a global perspective

3.1 Introduction
3.2 Occupational health
3.2.1 High-risk and physically demanding sectors of industry
3.2.2 Data challenges
3.3 Sexual and reproductive health
3.3.1 Contraception and family planning
3.3.2 Sexually transmitted infections
3.3.3 Sexual and gender-based violence
3.3.4 Female genital mutilation
3.4 Maternal and child health
3.4.1 Access to antenatal care
3.4.2 Obstetric, postpartum and postnatal health and access to care
3.4.3 Malnutrition and anaemia
3.4.4 Other child health issues
3.5 Noncommunicable diseases and major risk factors
3.5.1 Cardiovascular diseases
3.5.2 Cancer
3.5.3 Hypertension
3.5.4 Diabetes mellitus
3.5.5 Substance use
3.5.6 Obesity
3.6 Mental health
3.6.1 Depression and anxiety
3.6.2 Post-traumatic stress disorder
3.6.3 Suicide and self-harm
3.6.4 Schizophrenia and other psychotic disorders
3.6.5 Child mental health
3.7 Communicable diseases
3.7.1 HIV/AIDS
3.7.2 Tuberculosis
3.7.3 Malaria
3.7.4 Other communicable diseases
3.8 COVID-19
3.8.1 Burden of disease
3.8.2 Health and other impacts
3.8.3 Policy responses
3.8.4 Testing, treatment and vaccination
3.9 Summary
References

4. Refugee- and migrant-sensitive health systems

4.1 Introduction
4.2 Service delivery
4.2.1 Common barriers
4.2.2 Service models to meet refugee and migrant health needs
4.3 Health workforce
4.3.1 Sufficient staffing levels, training and resources
4.3.2 Supporting refugee and migrant health workers
4.3.3 Impact of migration
4.3.4 Better use of health professionals
4.3.5 Countries with a large migrant health workforce
4.4 Access to medical products, vaccines and technologies
4.4.1 Access to good-quality and affordable medicines
4.4.2 Access to vaccines
4.5 Health information systems
4.5.1 Data collection on refugee and migrant health
4.5.2 Dissemination and use of refugee and migrant health data
4.6 Financing
4.6.1 Refugee and migrant expenditure
4.6.2 Public health coverage
4.6.3 Mixed or private health insurance coverage
4.7 Leadership and governance
4.7.1 Legal access and entitlement: national policies
4.7.2 Refugee-hosting contexts
4.7.3 Regional leadership and strategies
4.8 Summary
References

5. Mapping progress towards global health goals: an exploratory review

5.1 Introduction
5.2 The challenge to meet
5.2.1 Making the health of refugees and migrants visible in major data sets
5.2.2 The SDGs and population movement
5.2.3 Moving forward on disaggregation
5.3 Review methodology
5.3.1 Criteria for inclusion
5.3.2 Data limitations
5.3.3 Definitions
5.4 Review results
5.4.1 Housing
5.4.2 Health insurance
5.4.3 Health and access to health care services
5.4.4 Health services and protective interventions
5.4.5 Mental health
5.4.6 Drinking-water, sanitation and hygiene as a health determinant
5.5 Summary
References

6. Health and migration: the way forward

6.1 The current state of affairs
6.1.1 Population movement and health: an overview
6.1.2 Determinants of refugee and migrant health
6.1.3 Health status of refugees and migrants
6.1.4 Gaps and good practices in health systems
6.1.5 Refugees and migrants are not visible in global data sets: Sustainable Development Goal targets will be missed
6.2 The way forward: health for a world in motion
6.2.1 Health and migration: a global health priority
6.2.2 Towards concerted efforts: a paradigm shift
6.2.3 Effectively integrating refugees and migrants into universal health coverage and primary health care
6.2.4 Global action plan
6.3 Policy and practice
6.3.1 Develop short- and long-term public health action plans that include refugees and migrants, and support their implementation
6.3.2 Strengthen the capacity and increase the sensitivity of health systems to meet the specific health needs of refugees and migrants
6.3.3 Enhance understanding of the health promotion and health needs of refugees and migrants
6.3.4 Actively include refugees and migrants within financial and social protection systems
6.3.5 Strengthen accountability and indicators framework
6.3.6 Promote global research, strengthen knowledge production and build research capacity in health and migration
References

Annex
Methodology