Building Responsive Health Systems to Help Communities Affected by Migration: An International Delphi Consensus.
Persons affected by migration require health systems that are responsive and adaptable to the needs of both disadvantaged migrants and non-migrant populations. The objective of this study is to support health systems for populations affected by migration.



An international Delphi consensus process was used to identify policy approaches to improve health systems for populations affected by migration. Participants were leading migrant health experts from Americas, Europe, Middle East, Asia, and Australasia. We calculated average ranking scores and qualitatively analyzed open-ended questions.



Participants identified the following key areas as priorities for policy development: health inequities, system discrimination, migrant related health data, disadvantaged migrant sub-groups, and considerations for disadvantaged non-migrant populations. Highly ranked items to improve health systems were: Health Equity Impact Assessment, evidence based guidelines, and the International Organization for Migration annual reports.



Policy makers need tools, data and resources to address health systems challenges. Policies need to avoid preventable deaths of migrants and barriers to basic health services.
Departments of Family Medicine & Epidemiology and Community Medicine, University of Ottawa, 1 Stewart Street, Ottawa, ON K1N 6N5, Canada. kpottie@uottawa.ca.|Bruyère Research Institute, 85 Primrose Ave, Annex E-208, Ottawa, ON K1R 6M1, Canada. kpottie@uottawa.ca.
Kevin
K
Pottie
Department of Pediatrics, University of Ottawa, Ottawa, ON K1N 6N5, Canada. chui@cheo.on.ca.
Charles
C
Hui
Bruyère Research Institute, 85 Primrose Ave, Annex E-208, Ottawa, ON K1R 6M1, Canada. Prinon.Rahman@dal.ca.
Prinon
P
Rahman
Centre for Social Science and Global Health, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands. j.d.Ingleby@uu.nl.
David
D
Ingleby
Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 11-0236, Lebanon. ea32@aub.edu.lb.
Elie A
EA
Akl
School of Primary Health Care, Monash University, Notting Hill Campus, Bldg 1, 270 Ferntree Gully Road, Notting Hill VIC 3168, Australia. grant.russell@monash.edu.
Grant
G
Russell
Center for Migrant Health Policy, San Yat-sen University School of Public Health, No.74 Zhongshan Er Road, Guangzhou 510000, China. lingli@mail.sysu.edu.cn.
Li
L
Ling
Migration Health Division, International Organization for Migration, 17, Route des Morillons, CH-1211 Geneva, Switzerland. kwickramage@iom.int.
Kolitha
K
Wickramage
Migration Health Division, International Organization for Migration, 17, Route des Morillons, CH-1211 Geneva, Switzerland. dmosca@iom.int.
Davide
D
Mosca
Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94118, USA. claire.brindis@ucsf.edu.
Claire D
CD
Brindis
D003695:Delivery of Health Care / Q000458:organization & administration*; D003697:Delphi Technique; D004641:Emigration and Immigration; D006078:Government Programs / Q000458:organization & administration*; D054624:Health Status Disparities; D006801:Humans; D011050:Policy Making; D011287:Prejudice; D011787:Quality of Health Care; D035862:Vulnerable Populations
Delphi consensus; health systems; other migrants; public health; refugees