Blockchain technology in migrant and refugee health: A scoping review

Abstract

BackgroundThe increase of forcibly displaced people worldwide is a challenge for health systems and their ability to provide access and equity in Health as a universal right. In the case of migrants and refugees, their journey exacerbates this challenge, as they go through diverse countries, camps, and humanitarian teams. Hence, the collection and analysis of health data are essential in providing quality care. The scientific community has been studying health digital technologies to answer health data consolidation, transparency, and global surveillance efficiency issues. Observing some empirical experiments with Blockchain in migrants and refugee health, we assessed the state-of-the-art by conducting a literature review.Methods Blockchain applications are still emerging, which means that peer-reviewed literature may still be scarce in life science databases. Therefore, to gather the most appropriate available evidence, we used a diverse and balanced set of databases that compile articles and journals from different fields. We used a multi-step scoping review to refine search keywords and analyse the literature. We included studies between 2008 and 2021 that reported value, utility, or use cases of Blockchain in support of migrant and refugee health. ResultsWe identified a total of 69 articles, with 22 retained for full-text analysis and 8 of those being relevant. We employed Rayyan application to manage and evaluate the references by two researchers working independently. We identified two main uses of Blockchain technology to support migrant and refugee health: mitigate the lack of personal identification and make health records available. Blockchain also promotes data reliability in humanitarian aid, academic certificates, legal contracts, and financial transactions. ConclusionsThe availability of reliable information about individuals facilitates universal health coverage, improves cooperation between diaspora-related countries, and supports global health efficiency in line with the third goal of the Sustainable Development Goals 2030 agenda. Given its characteristics of decentralization, resilience, transparency, and auditability, Blockchain remains a promising avenue for future research in migrant and refugee health.Since the World Health Organization (WHO) constitution in 1946, the right to health has been increasingly recognized and has gained preponderance in the international agenda [1]. On the other hand, according to a 2010 report from the International Organization for Migration (IOM), international migrants worldwide may be as many as 405 million by 2050 [2]. This trend stems from a-significant increase in people's mobility, fostered by globalization, low transportation costs, economic pressures, demographic trends, environmental degradation, violence, and human rights abuse [2].

Decentralization, Blockchains, and the Development of Smart Communities in Economically Challenging Environments

“…Such an identity would be influenced more heavily by platform governance, rather than by geopolitical factors. 45 Other work on blockchain implementations for identity management includes a survey of blockchain applications for government-issued identification around the world including UAE, Finland, Estonia, Luxembourg, and Switzerland, 46 and blockchain applications for migrant and refugee health, 47 government issued identification, 48 and refugee identity solutions.…”

Addressing Planetary Health through the Blockchain—Hype or Hope? A Scoping Review

“…All studies were published between 2017 and 2022. Their authors were from institutions based in the USA (n = 11) [23][24][25][26][27][28][29][30][31][32][33], Canada (n = 2) [34,35], China (n = 2) [36,37], India (n = 2) [34,38], Iran (n = 1) [39], Iraq (n = 1) [39], Korea (n = 1) [40], Kyrgyzstan (n = 1) [40], Malaysia (n = 1) [39], the Netherlands (n = 1) [28], Pakistan (n = 1) [40], Portugal (n = 1) [41], Taiwan (n = 1) [42], and Saudi Arabia (n = 1) [43]. The papers were literature or narrative reviews (n = 10) [26,28,29,35,[37][38][39][40]43,44], conceptual frameworks (n = 10) [23][24][25]27,30,31,34,36,45] (of which one included expert interviews) [32], a scopi...…”

“…The health focus of the articles encompassed: pandemics and outbreaks (n = 8), specifically with regards to COVID-19 [39,44], vaccination [42], public health surveillance [27,34,35], and pandemic preparedness [40]; and the use of blockchain to support vulnerable groups health (n = 3), including for homelessness [23], refugees and migrants [41], and tackling the misuse of opioids [32], alongside specific disease groups (n = 1; HIV [30]). Five articles discussed blockchain use in population health, including to study the social determinants of health and health equity [24], and for population-level health interventions explored across all the WHO health building blocks [26,31,43,45].…”

“…All articles included the use of blockchain technology (BCT), either in isolation (n = 16) [23,[27][28][29][30][31][32]34,35,[37][38][39]41,[43][44][45] or with reference to the use of smart contracts (n = 6) [24][25][26]36,40,42], the impacts of mining (n = 1) [33], or other technologies, including the Internet of (Medical) Things (IoT/IoMT) (n = 5) [35,[38][39][40]43], artificial intelligence [38], and machine learning [40]. Climate change and/or environment was explicitly mentioned in four papers [33][34][35]38].…”

“…Values-based considerations that emerged in the data include equity, decentralisation, transparency and trust, and managing complexity. [26,40], the reduction of siloed health services [35,38,41], and the challenges of data sharing and interoperability issues [35,38]. Patients having access to past records, and interconnected records owned by patients instead of centralised health providers, increases…”