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Building Responsive Health Systems to Help Communities Affected by Migration: An International Delphi Consensus

Departments of Family Medicine & Epidemiology and Community Medicine, University of Ottawa, 1 Stewart Street, Ottawa, ON K1N 6N5, Canada
Bruyère Research Institute, 85 Primrose Ave, Annex E-208, Ottawa, ON K1R 6M1, Canada
Department of Pediatrics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
Centre for Social Science and Global Health, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands
Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut 11-0236, Lebanon
School of Primary Health Care, Monash University, Notting Hill Campus, Bldg 1, 270 Ferntree Gully Road, Notting Hill VIC 3168, Australia
Center for Migrant Health Policy, San Yat-sen University School of Public Health, No.74 Zhongshan Er Road, Guangzhou 510000, China
Migration Health Division, International Organization for Migration, 17, Route des Morillons, CH-1211 Geneva, Switzerland
Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, 3333 California Street, Suite 265, San Francisco, CA 94118, USA
Author to whom correspondence should be addressed.
Academic Editors: Jimmy T. Efird and Pollie Bith-Melander
Int. J. Environ. Res. Public Health 2017, 14(2), 144;
Received: 17 November 2016 / Revised: 14 January 2017 / Accepted: 19 January 2017 / Published: 3 February 2017
(This article belongs to the Special Issue Refugee Health)
PDF [1237 KB, uploaded 3 February 2017]


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. Materials and Methods: 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. Results: 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. Discussion: 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. View Full-Text
Keywords: public health; health systems; refugees; other migrants; Delphi consensus public health; health systems; refugees; other migrants; Delphi consensus

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Pottie, K.; Hui, C.; Rahman, P.; Ingleby, D.; Akl, E.A.; Russell, G.; Ling, L.; Wickramage, K.; Mosca, D.; Brindis, C.D. Building Responsive Health Systems to Help Communities Affected by Migration: An International Delphi Consensus. Int. J. Environ. Res. Public Health 2017, 14, 144.

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