World: Health system strengthening interventions to improve the health of displaced and migrant populations in the context of climate change

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Country: World Source: World Health Organization Please refer to the attached file. Executive summaryThe health of refugees and migrants is directly related to their access to quality, effective and appropriate health care along all their routes of travel. Refugees and migrants face challenges in accessing health care, including financial, legal and cultural barriers, that are well documented.These challenges vary according to national and regional legislation and services. Additionally, their global context is increasingly affected by the changing climate, which not only directly affects individual health but also impacts upon health systems and exacerbates health inequities. Climate change continues to drive increasing migration and population displacement and to directly and indirectly affect the health and well-being of those displaced. Health systems must increasingly and urgently consider the additional challenges presented by climate change in order to effectively respond to health needs and work towards universal health coverage and health equity.From the literature considered within this review, a total of 95 health system interventions were identified, spanning the six health system building blocks. The majority (53%) focused on service delivery, particularly in the context of climate-related emergencies. These included the provision of health and immunization services, mental health interventions and access to safe water, sanitation and hygiene services. Interventions pertaining to governance and the health workforce constituted 37% of total interventions. These primarily focused on the inclusion of climate-affected migrants in policies and plans for governance, as well as on enhancing the capacity of the health workforce to address the health needs of displaced and migrant populations. The least represented interventions related to health financing, medicines and supplies, and the health information system, accounting for approximately 10% of all interventions identified. These included efforts to expand health coverage, ensure the availability of medical supplies and monitor climate-sensitive health risks within each respective building block.Additionally, only six health system interventions explicitly included climate mitigation strategies; the remainder focused on climate adaptation, primarily in response to extreme weather events.This evidence review found that innovative interventions are emerging but also that many existing interventions can be adapted to meet population needs. The examples identified demonstrate that cross-sectoral and interdisciplinary collaboration is vital, as is engagement with the migrant community. The review also highlighted possible evidence gaps for future research and action. There is an increasing need for evidence to be amassed concerning longer-term sustainable interventions. These should include interventions covering climate mitigation; evaluating the effectiveness and impact of interventions and population outcomes; addressing less-documented building blocks of health systems (such as health financing, medicines and supplies, and health information systems) and that cut across multiple building blocks (health system-wide approaches); and more evidence from less-represented regions, such as the WHO European, South-East Asia and Western Pacific Regions, particularly those particularly vulnerable to climate change impacts.Moving forward, to build migrant-inclusive and climate-resilient health systems, evidence gaps identified in this review must be filled through cross-sectoral and interdisciplinary research and action. To ensure coherence across policies, programmes and frameworks, applying a migration lens to the climate-resilient health system agenda and a climate lens to migration health efforts is crucial. It is also important to move beyond short-term reactive responses and consider the longer-term health needs of climate-affected displaced and migrant populations.