Building Partnership to Improve Migrants’ Access to Healthcare in Mumbai

Abstract

ObjectivesAn intervention to improve migrants’ access to healthcare was piloted in Mumbai with purpose of informing health policy and planning. This paper aims to describe the process of building partnership for improving migrants’ access to healthcare of the pilot intervention, including the role played by different stakeholders and the contextual factors affecting the intervention.MethodsThe process evaluation was based on Baranowski and Stables’ framework. Observations in community and conversations with stakeholders as recorded in daily diaries, minutes of pre-intervention workshops, and stakeholder meetings served as data sources. Data were coded using the framework and descriptive summaries of evaluation components were prepared.ResultsRecruitment of stakeholders was easier than sustaining their interest. Community representatives led the intervention assisted by government officials. They planned community-level interventions to improve access to healthcare that involved predominantly information, education, and communication activities for which pre-existing formal and informal social networks and community events were used. Although the intervention reached migrants living with families, single male migrants neither participated nor did the intervention reach them consistently. Contextual factors such as culture differences between migrants and native population and illegality in the nature of the settlement, resulting in the exclusion from services, were the barriers.ConclusionInclusive multi-stakeholder partnership, including migrants themselves and using both formal and informal networks in community is a feasible strategy for health education and has potential to improve the migrants’ access to healthcare. However, there are challenges to the partnership process and new strategies to overcome these challenges need to be tested such as peer-led models for involvement of single male migrants. For sustaining such efforts and mainstreaming migrants, addressing contextual factors and having formal mechanisms for their inclusion are equally important.

Community-Based Healthcare for Migrants and Refugees: A Scoping Literature Review of Best Practices

“…Publications in this category are studies focusing on health promotion and access to care, mainly implemented in the USA (19/36), Europe (12/36), and Canada (2/36), and in Australia (2/36) and Asia (1/36), mostly in between 2007–2018 [ 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 97 , 98 , 99 ]. The populations addressed included racial and ethnic minorities; migrants (further specified as elderly, farm workers, or irregular); refugees (Syrian, apartment-dwelling, youth, older adult, and more); immigrants (elderly or recent); and minority children.…”

“…Prevalent aspects of interventions were: supervision and responsibility of stakeholders to provide equity, cultural, and linguistic competence in healthcare access and delivery [86,87]; creating a sense of community and commitment; obligation of stakeholders [68,[86][87][88]; community-based leadership that is transferring the operational supervision of the intervention to the local level to facilitate sustainability [79,89]; social networking viewed as a necessary skill along with good communication to improve the efficiency of the intervention [89,90]; and evidence-based guidelines [91,92].…”

“…Finally, building trust between migrants and service providers [77,81,84], educating service providers on the health needs of the community [77,79,81,85,90], warranting the availability of resources [85,97] and sustainability of the programs [79,91], surveillance, and the evaluation of interventions [79,88,92].…”

Maternal Health and Access to Healthcare among Migrant Workers Engaged in Informal Construction Work, Ahmedabad, India

“…Workers vulnerabilities are further compounded by the lack basic social, legal and health protection (4,6). Studies have also found that migrants are rarely able to access urban health services despite increased proximity to these services in the city (7,8). They are also excluded from government health programs in the destination region merely on account of being migrants (9).…”

Practices of Engagement in Innovation Platforms: Sustainably Overcoming Complex Societal Challenge Landscapes

“…Champions are motivated by their eagerness to see the platform operate successfully and to see the platform objectives realised (24,70,71,26,50,52,55,57,58,61,62)…”