¶ … Migrant Health Problems Understanding the Migrant Health Problem

Currently access to health and social services for the majority of migrants is based on their legal status. Needless to say undocumented migrants have little or no access to health care services. One's legal status is one of the prerequisite conditions for one to receive sufficient care. Additionally, accessibility, availability, acceptability and quality of such services depends on various factors such as financial, gender, structural, linguistic, social, cultural and geographical factors. Furthermore, various beliefs and myths or knowledge about ill health and one's health status prevent migrants from engaging or getting into national health systems.

Causes of the Migrant health problem/Impact on communities

Low health literacy levels within migrant communities are a huge barrier and deter many migrants from wanting to engage health care professionals (Becker, 2003). This situation is the same within many migrant communities regardless of a migrant's socio-economic status or legal status. Also, the nature of migrant workers not to work for long in a single workplace makes it somewhat difficult for healthcare providers to adequately document their needs. Seasonal and temporary workers often favor delaying their need to engage health care services regardless of the urgency or criticalness of their need for treatment (Okie, 2007). Migrants' long working hours also deters them from having enough time to get sufficient care even during occasions when there are free and open public health services. The nature of mobility of migrants also affects follow-up treatment and long-term care, for example, this phenomenon has been directly observed in the treatment of tuberculosis (TB). Traveling causes a lack of access to care which makes it difficult for one to complete TB treatment; not completing the treatment of diseases can lead to the emergence of drug resistant viruses or bacteria and individuals not completing TB treatment leads to the emergence of multi-drug resistant tuberculosis (Huang, Yu, & Ledsky, 2006). According to CDC (Center for Disease Control) (2013), the high prevalence of tuberculosis among certain communities in the population is a known health disparity. The difference in prevalence levels may be due to several reasons such as geographic location, race, gender, ethnicity, socio-economic status or co-morbidity of health conditions.

Behavioral, reproductive, sexual, cultural and ethnic health practices are among some of the key health concerns for migrant communities, particularly the lack of adequate use of contraception and the practice of female genital mutilation among some of these communities. Some of these migrant health practices challenge or conflict the knowledge or beliefs of host populations. Recognition and management of reproductive and sexual health practices requires cultural competence among health care service providers, however, cultural competence is not currently part of medical education training in most parts of the globe.

Formal and informal power bases

Migrant communities are highly vulnerable in terms of health care and the manner in which such vulnerabilities continue to exist and increase present further challenges to national health care systems (Stanhope & Lancaster, 2013b). Despite the current dynamics of immigrants, host nations are better placed to intervene. Combinations of events and circumstances also present several difficulties for national healthcare systems.

The basic principles of public health approaches determine the formation of migrant priorities. A fundamental public health objective is to avoid or prevent disparities in terms of access to health care services and in the health status between host populations and migrant communities. Besides, this fundamental objective is closely linked to making sure that the health rights of migrants are taken care of. This involves removal of impediments that prevent migrants' access to preventive and curative in healthcare interventions as well as prevention of discrimination or stigmatization (Stanhope & Lancaster, 2013a). Other healthcare public healthcare principles associated with migrations from places of conflict and/or disaster involves the establishment of life-saving initiatives and other interventions to cut excess mortality and morbidity. Other fundamental principles encompass the minimization of adverse migration impacts that affect the health status of immigrants. These are just some of the principles that help define public health plans and health policy frameworks for migrants.

The majority of migrants these days living in foreign nations do not have any significant legal statuses. Such people are often living in conditions of abject poverty making the prospects of getting employed and their access to proper healthcare very difficult (Carrasquillo, Carrasquillo, & Shea, 2000). Undocumented migrants are often considered a burden in many host countries' populations. These types of migrants are also usually very poor. Undocumented migrants are also often not quite literate and do not have health care insurance bringing about a serious burden to national health services of host nations resulting...

Present health information systems are engaged in disaggregating data in such a manner that allows the investigation of major health concerns among migrants. Comparative epidemiological surveys and studies reveal that migrants have higher frequencies of adverse or negative health outcomes compared to host communities (Becker, 2003). Qualitative studies and surveys concentrate on various health seeking behavior approaches and health perceptions. This shows that qualitative studies complement quantitative health studies in several ways in spite of the existing limitations in relevant data.
Legal immigrants, often have similar socio-economic statuses to those of minorities who live in poverty in host countries. These migrants have also been reported to delay or forego curative and preventive healthcare interventions, waiting until the situations become dire or dangerous. Furthermore, there is also the significant challenge of securing a space for migrants' equitable access to healthcare services. Making sure that migrants have equitable access to healthcare services involves different approaches that are of importance to the institutions and organizations that are funding health systems (Okie, 2007). The objective of these organizations is to bring about financial protection mechanisms and to prevent excessive expenditures existing among groups that are economically vulnerable. Weight has to be given to sustained health insurance coverage provision in various countries of origin, transit, return and destination especially for temporary migrants and irregular migrants (Stanhope & Lancaster, 2013a). Different nations insist on an immigrant having a legal status as a prerequisite for access to health services. Some nations especially on the eastern fringes of Europe have, of late faced a rapid influx of transit migrants in very short periods of time resulting in challenges to national health systems.

Public policy

There are several approaches that can be pursued to improve the health statuses of migrants. First, it is crucial to come up with mechanisms of advocacy and policy. The support and promotion of pro-migrant health policies will permit proper adherence to principles of public health. This widens migrants' health elements while at the same time advocating for their health rights. It also promotes access and protection of equitable health services provision, in addition to care for immigrants. The formulation of mechanisms in terms of healthcare services improves social protection for immigrants and also promotes international cooperation (Stanhope & Lancaster, 2013b). For the approaches and efforts that revolve around migrants' health to be effective such mechanisms must be implemented in the countries of origin, destination, transit and return.

Stakeholders

The participation of all concerned parties promotes cooperation in the formulation of health policies among civil society representatives, national and local governments. Executive branches of governments should take the lead in encouraging cooperation between foreign affairs and health departments and other concerned healthcare departments (Stanhope & Lancaster, 2013a). It is possible to strengthen international, regional, and interagency collaboration for migrants' health while at the same time accommodating the promotion of partnerships with other relevant alternative institutions and organizations such as UNCHR and IOM (International organization for Migration).

Other approaches include research, assessments and information dissemination Carrasquillo, Carrasquillo, & Shea, 2000). An evaluation of migrants' health and related trends enables the identification of service delivery gaps and the filling of those gaps. The objective of such an evaluation or assessment would be to determine the health needs of migrants and disaggregate health information by age, gender and origin and also by socio-economic and migratory status. The promotion of the production of migrants' health information surveys and studies triggers the revelation and reporting of best practices and lessons. Such studies and surveys are crucial to identifying and meeting migrants' health needs in transit, destination and return countries (Huang, Yu, & Ledsky, 2006). Dissemination of best practices enhances the promotion of pro-migrant health care services in many places around the globe.

Another addition to aforementioned approach would be to increase capacity-building efforts. Programs to increase awareness and to train the relevant health policymakers and stakeholders who are involved in migrants' healthcare in destination and transit countries result in increased gender, cultural, religious and linguistic sensitivity.

This is related to the migrants' health for the health service providers in addition to training health experts who tackle certain health factors like population movements (Stanhope & Lancaster, 2013b). The establishment of networks meant for the…