The inclusion of migrants in universal health coverage (UHC) national plans is essential to achieving Sustainable Development Goal (SDG) 3.8 on UHC (see The importance of addressing migration health). At the national level, priority areas should be defined jointly by all relevant stakeholders involved in the development and implementation of the UHC plan. This provides a foundation to develop strong migration-sensitive health systems and policies that are responsive to increasingly diverse population health profiles and needs, and to “leave no one behind”.

The migration health plan should align with key guiding frameworks, including the World Health Assembly (WHA) resolutions, the World Health Organization (WHO) global action plan (GAP), the SDGs and the Global Compact for Migration, as well the international human rights frameworks, previously discussed in this chapter (Read more on international law and principles in International instruments, initiatives and dialogues).

Outlined below are recommended steps and actions for working with the ministry of health to develop a national migration health plan at the country level. These steps are meant to serve as suggestions to guide this process and be applied when and how appropriate. They can happen in sequence or they may overlap, depending on the needs identified in the national context and how the process unfolds.

Partnering to understand migration health issues and challenges

To address the economic, political, environmental and social determinants affecting the health of migrants as well as the migration process, intersectoral actions are needed that target causes at societal level as well as their health consequences. Therefore, it is important to develop and strengthen multisectoral partnerships. Such partnerships help to identify key challenges to migration health, and to promote and implement migration health initiatives.

Policy Approaches
National stakeholder consultation workshop
  • Identify existing services, relevant policies, experiences and actors in the migration health arena in advance of the workshop.
  • Bring together ministries that are fundamental to migration health – health, foreign affairs, labour, immigration, social welfare and so forth – with representative(s) from the migrant community, the United Nations (including the World Health Organization [WHO] and IOM), and partner non-governmental organizations (NGOs), as well as academics working with migrant issues.
  • Draw on key guiding frameworks to inform the workshop (such as the WHO global action plan Promoting the health of refugees and migrants).
  • Include among possible topics of discussion:
    • Challenges in including migrants in health systems and services;
    • Challenges with managing the migration of health professionals;
    • Existing health inequalities and health service accessibility challenges faced by international migrants, national migrants abroad, the families left behind, and internally displaced persons (IDPs).
  • Identify health-care priorities to include in the plan.
Developing a migration health research plan

The national stakeholder consultation workshop will identify priorities and needs in the area of migration health. These priorities and needs can be used to develop a migration health research plan that will improve evidence-based policy and programme development and will enable informed decision-making and guide the direction of future programming. Ministries of health – ideally in collaboration with other ministries – can then use the outcomes of national consultations to formulate the key research areas, research questions and mechanisms to drive policy-related research.

Policy Approaches
Informing policies with a strong evidence base
  • Develop a research plan to best identify areas for action on migration health by first identifying key research areas, research questions and mechanisms for driving the research.
  • Collect data on different aspects of migrants’ health, including migrants’ health-seeking behaviours, access to and utilization of health services, and migrants’ health status. It might be helpful to start with a situation assessment and gap analysis to generate information and include participatory approaches.
  • Ensure comparability of migration and health data by using key indicators that are acceptable and useable across countries (that is, use standardized variables).
  • Disaggregate data, so as to understand the diversity of the population (such as by sex, age, migration status).
  • Integrate migration and health-related variables (as relevant) in national and international data collection mechanisms such as census, national statistics, targeted health surveys and routine health information systems.
  • Disseminate information on the status of migrants’ health to promote good practices in addressing the health of migrants.

Further details on strengthening the evidence base are in Stage 2: Data, research and analysis for policymaking.

To Go Further
Establishing a dedicated migration health unit or focal point to develop a national migration health plan

Establishing a dedicated migration health unit or focal point within the ministry of health (MOH) is one mechanism to support development and implementation of an evidence-based, comprehensive migration health plan. Such a coordination mechanism would:

  • Bolster MOH capacity for knowledge transfer on migration health issues;
  • Develop a repository for all relevant technical papers and planning documents;
  • Facilitate essential interministerial coordination;
  • Address the migration health issues identified;
  • Ensure future sustainability and continuity of the action.

The type of coordination mechanism will depend on the structure and available resources of the MOH. The coordination mechanism would ideally move the rest of the process forward, thereby promoting ownership.

Adopting the national migration health plan

Once the government and other stakeholders have agreed on a national migration health plan, aligned with key frameworks (see the framework and global action plan on promoting the health of refugees and migrants in Initiatives and commitments in this chapter for suggested components of the plan), there are many ways that adoption could be formalized. One example is the development of an action plan or national policy or strategic plan. It is important to note that a multi-stakeholder consultation is crucial to identify the intersectoral priorities that need to be considered. The ultimate goal of this process is for the ministry of health (MOH) to transform initial actions and experiences into:

  • A comprehensive migration health policy;
  • Sustainable migrant-sensitive programmes;
  • The inclusion of migrants in existing national health policies (as well as in other relevant policies and strategies);
  • The inclusion of health issues in migration strategies.

Coherent and consistent policies that address the various types and phases of migration will help to harmonize a country’s overall migration management system.

Implementing, monitoring and evaluating the migration health plan

Implementing the migration health plan will involve many actors, and will likely occur in many different phases, over time. Robust strategies to implement this plan should be established early in the process. Such strategies will need to articulate the priorities, resource needs, institutional and organizational roles and frameworks to manage and implement priority interventions. These interventions will vary based on the health system and government structures and other contexts specific to the country or region, and will need to be flexible so as to address changing migration dynamics. The strategies will also need to outline the outcomes and outputs for which the various stakeholders are to be accountable, along with monitoring indicators and risk mitigation measures.

Monitoring and evaluation are critical to measure the effectiveness of the migration health plan and its implementation. The approach needed for monitoring should be decided upon early, before implementation, and linked to the objectives. To ensure accountability, a governance structure could be used to monitor progress, ideally associated with the migration health coordination mechanisms described above.

To Go Further
  • IOM et al., Integrating Migration into Health Interventions: A Toolkit for International Cooperation and Developments, 2022. Provides guidance for integrating migration into development cooperation programmes and projects in the health sector. It provides activities and tools for development cooperation experts working in the field of health to capitalize on opportunities offered by migration, to address or mitigate challenges that migration may pose, and to strengthen the protection of the rights of migrants and their families.
Key messages
  • Migration health issues cannot be solved by the health sector alone. Migration and health are inextricably linked to other policies on development, foreign policy, security, foreign employment and the environment. Solutions require the broader engagement of a multisector constituency, as well as coherent and coordinated policies.
  • To achieve the goal to “leave no one behind”, the best practice is to develop a migration health plan at the national level, as well as migration-sensitive and migration-inclusive health systems, and to develop policies that are effective, sustainable and coordinated with other policy sectors.
  • To develop and enhance evidence-based policies and interventions, it is essential to collect data on migrants’ health in a way that is comparable and differentiates between genders. Developing a research health plan facilitates the best understanding of realities and needs to inform policymaking.
  • Migration health is a matter of shared responsibility and interest that extends beyond national boundaries. Regional and global stewardship is required, as well as interventions that focus specifically on migrant and mobile populations to help to improve the health of both migrants and the receiving community, while achieving safe and orderly migration.
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