Institute of Global Health Innovation, Imperial College London, South Kensington, London SW7 2AZ, UK.
Global Health Centre, Graduate Institute of International and Development Studies, 1202 Geneva, Switzerland.
Int J Environ Res Public Health. 2021 Nov 30;18(23):12639. doi: 10.3390/ijerph182312639.
The health of migrants and refugees, which has long been a cause for concern, has come under greatly increased pressure in the last decade. Against a background where the world has witnessed the largest numbers of migrants in history, the advent of the COVID-19 pandemic has stretched the capacities of countries and of aid, health and relief organizations, from global to local levels, to meet the human rights and pressing needs of migrants and refugees for access to health care and to public health measures needed to protect them from the pandemic. The overview in this article of the situation in examples of middle-income countries that have hosted mass migration in recent years has drawn on information from summaries presented in an M8 Alliance Expert Meeting, from peer-reviewed literature and from reports from international agencies concerned with the status and health of migrants and refugees. The multi-factor approach developed here draws on perspectives from structural factors (including rights, governance, policies and practices), health determinants (including economic, environmental, social and political, as well as migration itself as a determinant) and the human security framework (defined as "freedom from want and fear and freedom to live in dignity" and incorporating the interactive dimensions of health, food, environmental, economic, personal, community and political security). These integrate as a multi-component 'ecological perspective' to examine the legal status, health rights and access to health care and other services of migrants and refugees, to mark gap areas and to consider the implications for improving health security both for them and for the communities in countries in which they reside or through which they transit.
移民和难民的健康问题一直以来都是一个令人关注的问题，在过去十年中，这一问题面临的压力越来越大。在全球见证历史上最大规模移民潮的背景下，COVID-19 大流行使各国以及援助、卫生和救济组织的能力受到了极大的压力，从全球到地方各级，都难以满足移民和难民获得医疗保健以及采取公共卫生措施以保护他们免受疫情影响的人权和迫切需求。本文对近年来接纳大量移民的中等收入国家的情况进行了概述，所依据的信息来自 M8 联盟专家会议上的总结、同行评议文献以及关注移民和难民地位和健康的国际机构的报告。这里提出的多因素方法借鉴了结构性因素（包括权利、治理、政策和做法）、健康决定因素（包括经济、环境、社会和政治因素，以及移民本身作为一个决定因素）以及人类安全框架（定义为“免于匮乏和恐惧以及自由尊严地生活”，并纳入健康、粮食、环境、经济、个人、社区和政治安全的互动层面）的观点。这些因素整合为一个多组件的“生态视角”，以审查移民和难民的法律地位、健康权利以及获得医疗保健和其他服务的情况，指出差距领域，并考虑改善他们和他们所在国家或过境国家社区的健康安全的影响。
