Increasing Access to Health Services for those living in Border Areas in the GMS

Transcription

1 International Organization for Migration (IOM) Increasing Access to Health Services for those living in Border Areas in the GMS WHO Bi-regional Meeting on Healthy Borders in the Greater Mekong Sub-region 5-7 August 2013 Bangkok, Thailand 1

2 Presentation Overview Health inequalities and barriers to health care access in the GMS Border Areas Bridging health gaps towards health equity in the border areas Way forward within the context of the 2010 Global Operational Framework on the health of migrants

3 Session 5. Increasing access to health services for those living in border areas in the Greater Mekong Subregion HEALTH INEQUALITIES AND BARRIERS TO HEALTH CARE ACCESS IN THE GMS BORDER AREAS

4 Health Inequalities in the Greater Mekong Sub-region Health Variables (World Bank Data) Myanmar Thailand Cambodia Laos Viet Nam China Life Expectancy at Birth (2011) Maternal Mortality Ratio (per 100,000 live births, est) (2010) Infant Mortality Rate (per 1,000 live births) (2011) Births attended by skilled health staff Health Expenditure (Total %) (2011) Health Expenditure per Capita (sum of public and private health expenditures as a ratio of total population) Physicians (per 1,000 people) (2010) (2010) 100 (2009) 71 (2010) 37 (2010) 93 (2011) 100 (2010)

5 Number per 100,000 pop Communicable Diseases in the Border Areas HIV Prevalence per 100,000 population in Countries of the GMS in 2009 No Data Thailand Myanmar Cambodia Viet Nam Lao PDR China Reference: World Health Statistics WHO Accessed online at

6 Number per 100,000 pop Communicable Diseases in the Border Areas 700 TB Prevalence and Incidence per 100,000 population in Countries of the GMS in No Data Thailand Myanmar Cambodia Viet Nam Lao PDR China Prevalence Incidence Reference: World Health Statistics WHO Accessed online at

7 Number per 100,000 pop Communicable Diseases in the Border Areas Malaria Incidence per 100,000 population in Countries of the GMS in Thailand Myanmar Cambodia Viet Nam Lao PDR China Reference: World Health Statistics WHO Accessed online at

8 Barriers to Improving Access to Health in Border Areas Thailand Myanmar Cambodia Laos PDR Viet Nam Poor migrant monitoring systems Complex migration practices Limited surveillance systems? Under resourced health system especially in border areas No cross border referral system Limited migration sensitive health system Migration Policies/frameworks ineffective for border areas Medicine shortages Key areas and hard to reach pop Disease specific multi country partnerships Ineffective border collaborations

9 Session 5. Increasing access to health services for those living in border areas in the Greater Mekong Subregion BRIDGING HEALTH GAPS TO ACHIEVE HEALTH EQUITY IN THE BORDER AREAS

10 Thailand: Strengthening Health Service Provision and Policy Development Registration of migrant workers; health assessment and enrolment to health insurance scheme Establishment of networks of paid, full-time migrant community health workers (CHWs) and volunteers (CHVs) Introduction of the concept of migrant-friendly or migrant-sensitive health services delivery to improve accessibility of service Investing on health promotion and awareness raising interventions to improve knowledge of migrants on health Promoting multi-sectoral collaboration including non-health stakeholders Research on Health Financing Schemes Border Health Development Master Plan and Health Policy Development

11 Other GMS Countries Multi-funded Community base Malaria, HIV & TB Projects for migrants and members of migration affected communities in the border provinces of Myanmar TB Reach funded projects in Cambodia that increase active case detection for Returned Irregular Migrants at Poi Pet border in 2012 Vietnam: Project on Community Action for Preventing HIV/AIDS Myanmar s National Health Plan highlights the development of a stronger health information system as a priority of the Government GMS Strategic Framework and Action Plan for Human Resource Development in the GMS

12 Partnerships and networks Network Mekong Basin Disease Surveillance (MBDS) Joint United Nations Initiative on Mobility and HIV/AIDS (JUNIMA) WHO Mekong Malaria Programme Members Cambodia, Lao PDR, Myanmar, Viet Nam, Thailand, Yunnan & Guang Xi Provinces of China + WHO & Dev Partners Brunei Darussalam, Cambodia, Indonesia, Lao PDR, Malaysia, Myanmar, Philippines, Singapore, Thailand, Viet Nam and the southern provinces of China (Guangxi and Yunnan) + UN, ASEAN, IOM & CSOs Cambodia, Lao PDR, Myanmar, Viet Nam, Thailand, Yunnan & Guang Xi Provinces of China + WHO Thailand & Core Partners Others

13 Regional Frameworks - 1

14 Regional Frameworks - 2 MOU to reduce HIV vulnerability in the GMS Regional Framework for Action - Malaria Drafting of the Regional Framework on TB and Migration

15 st World Health Assembly Resolution on the Health of Migrants Key Global Instruments with Relevance to Migration and Health 2010 Global Consultation on the Health of Migrants: the Way Forward 2011 World Conference on Social Determinants of Health 2005 International Health Regulations

16 Session 5. Increasing access to health services for those living in border areas in the Greater Mekong Subregion WAY FORWARD IN THE CONTEXT OF THE 2010 GLOBAL OPERATIONAL FRAMEWORK ON THE HEALTH OF MIGRANTS

17 Global Operational Framework Research and Information system Advocacy for policy development Monitoring Migrants Health Policy and Legal Frameworks Strengthening inter-country coordination and partnership Partnership, Networks and Multicountry Frameworks Migrant sensitive health systems Health service delivery and capacity building 17

18 Pillar 1: Monitoring of Migrant Health Priority Areas: - Data standardization across GMS - Disaggregated data for migrant health in border areas - Monitor migrants health seeking behaviour especially those in transborder movements - Analyses of data to assist in policy formulation Moving Forward: - Identify key indicators that can be used across the GMS - Include migrants in national data collection systems - Promote data collection and analysis of key populations across border areas - Formulate border area specific progress reports 18

19 Pillar 2 : Promote conducive policies and legal frameworks on the health of migrants Priority Areas: - Adopt international standards on right to migrants health. - Health in all policies approach particularly with a focus on migrants in border areas - Monitor implementation of relevant policies - Extend social protection and health and improve social security for all migrants Moving Forward: - Develop and monitor frameworks and policies already in place - Promote resources for programme implementation in the border areas based on sound policy and best practice - Community and stakeholder awareness in border area on key migrant health instruments - Develop best practice based on model programmes - Promote extending social protection based on good migrant health programming 19

20 Pillar 3: Migrant Sensitive Health Systems Priority Areas: - Migrant appropriate health services - Improve service quality for migrant focused programming - Improve continuity of care provision from NGOS and private providers alike - Advocate multi-stakeholder approach towards health and migration Moving Forward: - Focal points in government for migrant health - Develop core standards of health care delivery - Develop frameworks for monitoring migrant sensitive health service performance - Cost benefit study on addressing migrant health - Integrate migrant health into education systems - Include diaspora migrant health workers in programme development and delivery 20

21 Pillar 4: partnerships, networks and multicountry frameworks in migrant health Priority Areas: - Multi-sector migration health dialogue - Promote migrant health in multi country networks - Address Migrant health in global and regional processes Moving Forward: - Create multi-stakeholder working groups and develop resource mobilization plan for increasing programmes in border areas - Develop best practices and sharing of migrant health monitoring, policy development and service delivery targeting key pops in border areas - Multi stakeholder engagement and approach to assist policy and programme development with governments for populations in border regions - Promote inclusion of migrant health needs in key border areas in existing regional and global funding mechanisms 21

22 THANK YOU VERY MUCH! 22