The response of health systems to the needs of migrants and refugees in the COVID-19 pandemic: a comparative case study between Mexico, Colombia and Peru

IF 7 Q1 HEALTH CARE SCIENCES & SERVICES Lancet Regional Health-Americas Pub Date : 2024-12-01 Epub Date: 2024-05-14 DOI:10.1016/j.lana.2024.100763
Ietza Bojorquez , Andres Cubillos-Novella , Juan Arroyo-Laguna , Luis Alberto Martinez-Juarez , Ana Cristina Sedas , Oscar Franco-Suarez , Zuly Suárez-Morales , Edith Adame-Avilés , Marcela Barragán-León , Angela Suarez , Miriam Orcutt , Paul Spiegel
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Abstract

Background

Protecting the health of migrants and refugees during the pandemic was a significant challenge in the Latin American region. We aimed to describe and contrast the response of the health systems of Mexico, Colombia and Perú to migrants' and refugees’ health needs during the COVID-19 pandemic, and to situate the response in the context of the migration and health policies of each country.

Methods

We conducted case studies of the three countries. The data collected for each case included: 1) policy documents; 2) peer-reviewed and grey literature; 3) qualitative interviews with key informants.

Findings

The three countries issued policies to detect COVID-19 cases among migrants and refugees, and granted them access to COVID-19 care regardless of their migration status or facilitated regularization as a way to improve access to care. However, other health care needs were not considered, some groups of migrants remained invisible in the policies, and policies rarely considered the increased social and economic vulnerability of migrants and refugees during this period. Pre-existing barriers to care were made worse during the pandemic. All three countries’ response to migrants was reliant on non-governmental organizations, with international cooperation being especially active in Colombia, and local civil society organizations in Mexico.

Interpretation

The response of each country was a continuation of their previous approach to migration and health. Developing plans for pandemic response that consider migrants and refugees’ particular needs will be important to improve response capacities in the future.

Funding

Funding was provided by USA for the International Organization for Migration (IOM) under an agreement with the Johns Hopkins Center for Humanitarian Health.
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在 COVID-19 大流行中卫生系统对移民和难民需求的回应:墨西哥、哥伦比亚和秘鲁之间的比较案例研究
背景:在大流行期间保护移民和难民的健康是拉丁美洲区域面临的一项重大挑战。我们的目的是描述和对比墨西哥、哥伦比亚和Perú的卫生系统在COVID-19大流行期间对移民和难民卫生需求的反应,并将这些反应置于每个国家的移民和卫生政策的背景下。方法对这三个国家进行个案研究。每个案例收集的数据包括:1)政策文件;2)同行评议和灰色文献;3)对关键线人进行定性访谈。这三个国家发布了在移民和难民中发现COVID-19病例的政策,并允许他们获得COVID-19治疗,无论其移民身份如何,或促进正规化,以此作为改善获得治疗的一种方式。然而,没有考虑到其他保健需要,一些移民群体在政策中仍然被忽视,政策很少考虑到这一时期移民和难民的社会和经济脆弱性增加。在大流行期间,原有的保健障碍变得更加严重。所有三个国家对移徙者的反应都依赖于非政府组织,哥伦比亚的国际合作特别积极,墨西哥的当地民间社会组织。解释:每个国家的反应都是它们以前处理移徙和健康问题的办法的延续。制定考虑到移民和难民特殊需求的大流行病应对计划,对于今后提高应对能力将非常重要。供资美国根据与约翰·霍普金斯人道主义卫生中心达成的协议向国际移民组织(移徙组织)提供资金。
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期刊介绍: The Lancet Regional Health – Americas, an open-access journal, contributes to The Lancet's global initiative by focusing on health-care quality and access in the Americas. It aims to advance clinical practice and health policy in the region, promoting better health outcomes. The journal publishes high-quality original research advocating change or shedding light on clinical practice and health policy. It welcomes submissions on various regional health topics, including infectious diseases, non-communicable diseases, child and adolescent health, maternal and reproductive health, emergency care, health policy, and health equity.
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