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Migration, Health Inequity and ICT: A reflection from Latin American and the Caribbean

Migration, Health Inequity and ICT: A reflection from Latin American and the Caribbean

The economic globalization of the world has resulted in significant changes in the flow and composition of migratory movements, particularly in the Latin America and the Caribbean (LAC) region. While historically, the LAC region attracted  immigrants from different continents of the world - from the economic recovery in Europe and the establishment of close political, economic and trade relations with the United States - some changes have been observed in migration flows, transforming the LAC region to a place of emigration. In 2005, the LAC population represented 13% of the world's migrant population. 

In the last decade, the change in the movement of migrants also impacted on gender composition; there is a notably higher proportion of women who decide to seek new employment options outside their place of origin. According to a 2003 study of the Economic Commission for Latin America (ECLA), the participation of Latin American women in international migration increased from 44.7% (1960) to 50.5%  (2000). Regardless of these changes related to the dimension of economic globalization, a phenomenon that remains constant are the conditions of economic and social vulnerability of a large proportion of the population who decide to leave the LAC region. Factors influencing this vulnerability are poor health and lack of social protection (national policies and programs designed to manage situations that negatively affect the well being of people).

In response to this phenomenon the eSAC Project convened a group of professionals interested in this subject to participate in an Open Virtual Panel to reflect on the following questions:

a) What are the conditions that make migrants vulnerable group?

b) What health-related situations can be addressed effectively by the use of information and communication technologies (ICT)?

c) What benefits have the use of ICT in the healthcare  brought to this population group?

d) What is the potential of ICTs to improve the health of migrants?

Speakers and audience at this panel helped clarify some important points regarding these questions:

Health conditions of migrants

Living conditions characterized by transience and instability are risk factors in the health of migrants. Precarious hygiene and housing conditions create problems of infectious diseases. Problems of obesity, hypertension and cardiovascular diseases are common, not necessarily derived from migrant status. Mental health is also noted as a recurring condition, closely linked to the conditions of social and economic instability of migrants.

The vulnerability in migrants’ health conditions is due to a lack of or limited access to regular health services and the absence of social protection by institutions in the destination countries. The fact that both chronic diseases and mental health problems require regular and stable care exacerbates the problems.

Other major health problems of Latin American and Caribbean migrants are violence, addictions and accidents, which represent health problems closely linked to the social conditions of instability evident in places where migrants reside.

A determining factor in the vulnerability of the health conditions of migrants is related to the absence of legislation to provide social protection to this population, as a large proportion of migrants enter destination countries illegally.

The potential of ICT in contributing to equity in health of migrants 

The goal of equity is to eliminate unfair circumstances that deprive people of their human rights (health, education and other opportunities).  The focus is on reaching the poor and most marginalized.

ICT has both negative and positive potential to impact the health of migrants. In conditions of inequity, ICT can compromise the security of message transmission, provide ineffective data storage and security, and create avenues to increase stigma and discrimination against certain groups. However, in an equitable environment, ICT can improve services such as health call centers, emergency toll free services and mobile telemedicine.  ICT can also improve interventions such as health surveys, surveillance, health promotion and awareness raising and decision support systems.

The relation between ICT and migration is under-researched. There is still a serious absence of empirical data and rigorous methods to track the current interactions between ICT and migration processes. However, an interesting study on this issue, is Caribbean Migrations, a project based at the University of the West Indies Mona that focuses on returned migrants to Jamaica. The project explores exposures to and opportunities with ICTs, with other social determinants of health for migrants such as general educational background and health literacy. 

The project “Active Search, Screening and Intervention for Trauma in Displaced Women” (Proyecto Búsqueda Activa, Tamizaje e Intervenciones en Mujeres Desplazadas), based in Bogotá, Colombia  uses ICT to promote mental health, improve health education practices in mental health, facilitate community screening for the identification of mental disorders and for systematization of information. 

Conclusion

According to the researchers who participated in the Open Panel, there are some windows of opportunity for using ICT for migrant health. It is important to use research on migrants to inform an effective strategy for health promotion and prevention. 

Although health problems are not the main cause of migration, once the migrants travel from their home, health becomes a critical resource. However, there is a self-perception of being "healthy". Recognition of the risks of all health problems in migrants should also be an important part of any health promotion strategy targeting this population.

Improving migrant health equity must be done through evidence-based ICT systems and initiatives. While on one hand it is important to use innovative strategies, on the other hand, there is no need to ‘re-invent the wheel’. Collaborations and partnerships with organizations, stakeholders, projects etc. with aligned interest can create positive results and impact in the targeted populations.

eSAC is a project that aims at supporting and nurturing an ongoing dialogue and reflection on the ways that ICTs can be used in public health in Latin America and the Caribbean, beyond clinical and individual care, focused on equity and the social determinants of health. eSAC is jointly developed by the Pan American Health Organization and the University of Toronto, with funding by the International Development Research Centre (IDRC). Visit www.esacproject.net for more information.

Presenters from the eSAC Open Panel (April, 29, 2014)

 Dr. Rubén Silván, international researcher on migration. México/Honduras
• Dr. Ishtar Govia, Ph.D., Lecturer in Psychology, UWI Mona, Jamaica
• Dr. Luis Hernández, Director of Public Health studies at University of Andes. Colombia

Links

  • PowerPoint Presentations available: http://en.esacproject.net/esac_database/table/publication 
  • YouTube videos of Webinar Series https://www.youtube.com/user/esacproject