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OMS | L’Europe doit assurer un meilleur accès aux soins pour les personnes migrantes et réfugiées

Dans le rapport « Report on the health of refugees and migrants in the WHO European Region. No public health without refugee and migrant health« , l’Organisation mondiale pour la santé (OMS) alerte l’Europe sur la santé des personnes migrantes et réfugiées. C’est la première fois que l’organisation se penche sur cette question. Son analyse met en lumière de nombreuses inégalités selon le pays d’accueil et le statut de la personne, ainsi que de nombreuses déficiences dans la prise en charge.

Ce rapport cherche à souligner les causes, les conséquences et les réponses aux besoins et défis en matière de santé des réfugiés et des migrants dans la région, tout en donnant un aperçu des progrès réalisés. En outre, le rapport cherche à identifier les lacunes qui nécessitent des actions supplémentaires par le biais de la collaboration, à améliorer la collecte et la disponibilité de données et à stimuler les initiatives politiques.

La principale conclusion: les migrants et les réfugiés sont de manière générale en bonne santé, mais ils risquent de tomber malades lors de leur parcours, dans les pays de transit, ou pendant leur séjour dans les pays d’accueil en raison de mauvaises conditions de vie ou de l’ajustement de leur mode de vie. De plus, de nombreuses idées reçues sont contredites par les recherches. Par exemple, il n’y a qu’un très faible risque que les réfugiés et les migrants transmettent des maladies transmissibles à la population hôte. Concernant le cancer, la population migrante a moins de chance d’en souffrir, mais les cas sont diagnostiqués plus tard, à des stades plus avancés.

Le rapport publié par le Bureau régional de l’OMS pour l’Europe en janvier 2019 est disponible en ligne sur le site internet de l’OMS, uniquement en anglais. Le résumé ci-dessous a été publié en ligne par l’OMS, plus de détails sont également disponibles ici.

Summary

Almost one in 10 people in the WHO European Region is currently an international migrant. Finding work is a major reason why people migrate internationally, although violence, conflict, natural disasters and human rights abuses are also contributors. Migration and displacement are social determinants of health affecting the health of refugees and migrants. The WHO Regional Office for Europe has taken the lead in assisting Member States in promoting refugee and migrant health and addressing the public health aspects of their health. The Regional Office established the Migration and Health programme specifically for this purpose. Gaining an overview of the health status of refugees and migrants and health system response is paramount in achieving the Sustainable Development Goals and in ensuring universal health coverage, and is in line with the Health 2020 framework.

This report, the first of its kind, creates an evidence base with the aim of catalysing progress towards developing and promoting migrant-sensitive health systems in the 53 Member States of the WHO European Region and beyond. This report seeks to illuminate the causes, consequences and responses to the health needs and challenges faced by refugees and migrants in the Region, while also providing a snapshot of the progress being made across the Region. Additionally, the report seeks to identify gaps that require further action through collaboration, to improve the collection and availability of high-quality data and to stimulate policy initiatives. The report is a much-needed boost for Member States and other stakeholders to ensure high-quality health care for all.

Key findings and myths exposed

  • International migrants make up only 10% (90.7 million) of the total population in the WHO European Region. Less than 7.4% of these are refugees. In some European countries, citizens estimate that there are 3 or 4 times more migrants than there really are.
  • While communicable diseases are commonly linked with displacement and migration, there is a growing awareness that a range of acute and chronic conditions also require attention.
  • Refugees and migrants are at lower risk for all forms of cancer, except cervical cancer. However, cancer in refugees and migrants is more likely to be diagnosed at an advanced stage, which can lead to considerably worse health outcomes than those of the host population.
  • Depression and anxiety tend to affect refugees and migrants more than host populations. However, variation by migrant group and in the methods used to assess prevalence make it hard to draw firm conclusions.
  • In general, refugees and migrants have a higher incidence, prevalence and mortality rate for diabetes than the host population, with higher rates in women.
  • Refugees and migrants are potentially at greater risk of developing infectious diseases because of their exposure to infections, lack of access to health care, interrupted care and poor living conditions during the migration process. It is therefore necessary to protect them and to ensure that health-care workers on the front line understand the risks.
  • While refugees and migrants may arrive in Europe with incomplete or interrupted immunization, vaccination uptake is likely to increase with the duration of their stay. The immediate response to new arrivals is to ensure that they receive basic vaccines based on the schedule of the host country.
  • *Access to social and health services varies across the WHO European Region, with legal status, language barriers and discrimination generally being influential factors.
  • *Unaccompanied minors are vulnerable to sexual exploitation and experience higher rates of depression and symptoms of post-traumatic stress disorder.
  • *Male migrants experience significantly more work-related injuries than non-migrant workers.