Final Report Summary - COHEMI (Coordinating resources to assess and improve health status of migrants from Latin America)
Executive Summary:
1.1 Executive summary
European health systems are committed to meeting the challenge of understanding the needs of migrant populations and adapting their services to meet these needs. Limited knowledge of the priority health problems affecting Latin American migrants and a lack of data on the multiple determinants of health service utilization (accessibility, appropriateness of the care provided and client satisfaction) negatively influence the possibility of providing good quality care for migrants.
COHEMI (COordinating resources to assess and improve HEalth status of MIgrants from Latin America) is a three-year European project launched in 2011 and coordinated by the IRCCS- Istituto di Ricerche Farmacologiche Mario Negri of Milan, Italy. The consortium brings together 10 partners, including 6 from 4 European Member States, and 4 from 3 Latin American countries. The project is supported by the European Commission under the Health Cooperation Work Programme of the 7th Framework Programme.
COHEMI aimed to provide a clear picture of the full migration cycle in relation with the health systems in Europe and Latin America and to suggest specific (disease-driven) policies to address the priority aspects of ill-health in the migrant population.
The COHEMI network collected information and data through reviews, organization of/participation at national and international meetings, congresses, workshops, symposiums, use of questionnaires and interviews. The activities done produced a global picture of the health and needs of LA migrants, with a focus on health systems, legislation and policies in the different European countries, gaps in prevention, screening, diagnosis, and care of selected infectious and non-infectious diseases and social and cultural factors related to health seeking, health-care, and access to health systems. Final documents addressed. The COHEMI project and activities has been diffused through the website, periodical newsletters, scientific publications, participation to national and international events, press releases etc, and a COHEMI video-spot has been realised.
Final COHEMI Policy Briefs documents and COHEMI recommendations have been produced, reporting the current situation, the gaps to be solved, and the priorities to be addressed in order to suggest/promote specific strategies/initiatives/methods/policies-guidelines/legislative measures to be promoted at the European Union and Latin American levels, both on general aspects and on specific diseases.
Project Context and Objectives:
1.2 Project context and objectives
European health systems are committed to meeting the challenge of understanding the needs of migrant populations and adapting their services to meet these needs. The difficulties inextricably linked to this challenge are caused by the complexity of migration patterns and the differences between migrant population across European Union (EU) countries.
Health through the provision of accessible healthcare services is a right for permanent and temporary residents of the EU. Furthermore, ensuring that migrants (temporary or new permanent residents) are healthy would provide both social and economic benefits to EU states: able to contribute to economic growth, healthy migrants are also less likely to be socially marginalized. The diversity of migrant populations in European Countries - labour and educational migrants, and vulnerable groups such as asylum seekers and refugees, all from a variety of nationalities - poses challenges for national health systems to ensure the accessibility of healthcare.
Limited knowledge of the priority health problems affecting Latin American migrants and a lack of data on the multiple determinants of health service utilization (accessibility, appropriateness of the care provided and client satisfaction) negatively influence the possibility of providing good quality care for migrants. The inequality of access to and outcomes from healthcare services between migrants and the autochthonous population is therefore an issue of concern to both healthcare providers and policymakers in Europe.
COHEMI’s general objective is to coordinate referral centres (both in Europe and Latin American countries) dealing with selected diseases in Latin American (LA) countries (Chagas disease, strongyloidiasis, cysticercosis), as well as other infectious and non-infectious diseases affecting LA migrants, and centers investigating migrant health in general (health systems, reproductive and child health, anthropological and psycho-social problems). Through coordinating these groups, COHEMI aims to provide a clear picture of the full migration cycle in relation with the health systems in Europe and Latin America and to suggest general and specific (disease-driven) policies to address the priority aspects of ill-health of the migrant population.
COHEMI’s specific objectives are: to assess/compare health systems in EU and LA countries with specific reference to legislation and policies affecting migrant categories, related ethical issues and multiple determinants of the utilizations of health service; to identify specific bottle-necks affecting priority health needs of the migrants population and potential repercussions on the EU host countries’ population; to provide a reliable estimate of the burden of selected Neglected Tropical Diseases (NTDs), selected infectious diseases and selected chronic, non-infectious diseases in countries of origin and in different groups of migrants and of the access to appropriate care; to promote greater coordination in an effort to understand the social and cultural factors that influence health-seeking behaviours of Latin American migrants residing in Europe; to suggest/promote, based on the main results, specific strategies/initiatives/methods/policies-guidelines/legislative measures to be promoted at the EU and LA levels, both on general aspects and on specific diseases.
Project Results:
1.3 Work performed and main results
During the three years of the COHEMI project the activities planned in the different WPs have been achieved with relatively minor deviations.
A collection of information concerning legal and social aspects of migrants’ access to health systems and health care in three European countries (Italy, Spain and UK) has been analyzed and documents produced.
Reviews on NTDs (Chagas diseases, strongyloidiasis and cysticercosis), infectious diseases (tuberculosis) and non-infectious diseases (hypertension / cardiovascular diseases) have been finalized and some of them published, and some study designs carried out.
Six Policy Brief documents addressed to stakeholders and policy makers on: Latin American Migrants in Europe: health and policy, NTDs (Chagas diseases, strongyloidiasis and cysticercosis), infectious diseases (tuberculosis) and non communicable chronic disorders (hypertension / cardiovascular diseases), have been finalized.
Five COHEMI recommendations on NTDs (Chagas diseases, strongyloidiasis and cysticercosis), infectious diseases (tuberculosis) and non communicable chronic disorders (hypertension / cardiovascular diseases) have been produced.
A collection of information concerning anthropological and cultural contexts related to migrants’ health has been gathered and a trans-disciplinary and trans-national research agenda on health status and determinants of Latin-Americans in Europe has been finalised.
The dissemination of the COHEMI project and activities, through website, periodical newsletters, scientific publications, participation to national and international congresses and events with oral and poster presentations, participation and/or organization of meetings, workshops, international symposiums, press releases etc, has been carried out and a COHEMI video-spot has been realised.
Potential Impact:
1.4 Final results, potential impact and use
The exhaustive research done on the different aspects related to LA migrants’ health (legal, social and anthropological and disease related) represented the first step necessary to obtaining information on the current situation, in order to (specific objectives): identify specific bottle-necks affecting the priority health needs of the migrant population and potential repercussions on the EU host countries' population; promote greater coordination in efforts to understand the social and cultural factors that influence health-seeking behaviours of LA migrants resident in Europe; suggest/promote specific strategies/initiatives/methods/policies- guidelines/legislative measures to be promoted at the EU and LA levels, both on general aspects and on specific diseases.
The activities of the COHEMI network produced a global picture of the health and needs of LA migrants, with a focus on health systems, legislation and policies in the different European countries, gaps in prevention, screening, diagnosis, and care of selected infectious and non-infectious diseases and social and cultural factors related to health seeking, health-care, and access to health systems. Reviews carried out on Chagas disease, strongyloidiasis, cysticercosis, tuberculosis, hypertension and cardiovascular diseases, and socio-cultural aspects have been essential to improve the knowledge of the current gaps in the health care and needs of LA migrants in Europe, as well as the condition of health and diseases in their countries of origin. The organization of workshops, meetings and symposiums gave the opportunity to share within the COHEMI network and with international experts the current situation and the key issues to be addressed to improve access to healthcare and LA migrants’ health. Much of the work done has been already published and COHEMI partners participated in many national and international meetings/congresses to raise awareness of the COHEMI project and LA migrant health and to diffuse, through oral and poster presentations, the work done and the results achieved.
The work carried out by COHEMI network allowed to produce final Policy Brief documents and COHEMI recommendations for stakeholders, policy makers and health operators, with the indication of the crucial points and the main needs of migrants to be addressed and to work, the host country together with the country of origin, to prevent and treat diseases and to improve migrants’ healthcare.
The common efforts of European and Latin American countries will build a collaboration in migrant health with improvement of health care, prevention, and treatment of diseases, also in their countries of origin. The work done and the publications, presentations, events organised, and documents produced strengthen the collaboration among European and Latin American countries, improve the knowledge on LA migrant health, and contribute to plan interventions and policies focused on the most crucial and urgent gaps to be solved and needs to be addressed.
1.5 Dissemination
COHEMI projects has a crucial role in the dissemination of knowledge on LA migrants health. During these three years many activities has been carried out to diffuse the information on this theme, addressing both a scientific as well as a general public.
- The website (http://www.cohemi-project.eu/(si apre in una nuova finestra)) with a public and a private section (the last one for COHEMI partners only) has been realized in the first period of the project and has been online since December 2011 (English version) and May 2012 (Spanish version). The website has been regularly updated with news on event on migrant health and with collection of the work done to be shared step by step within COHEMI partners.
- Six Newsletters (with a public and a private version) have been published since the beginning of the project and are available in the COHEMI website.
- The COHEMI project produced 32 publications since the beginning (January 2011).
- The COHEMI activities and results have been presented (oral presentation and posters) in some international and national congresses, symposiums, workshops, meetings.
- Press releases have been produced on the occasion of international meetings/symposiums, with publication of articles in the popular press/web.
- A COHEMI video spot has been produced and presented during the COHEMI Final Symposium in Milan, Italy, December, 2nd – 3rd, 2013 (see http://www.cohemi-project.eu/(si apre in una nuova finestra)).
List of Websites:
http://www.cohemi-project.eu(si apre in una nuova finestra)
1.5.1 COHEMI logo: relevant documents attached in Final Report pdf
1.5.2 COHEMI Website: relevant documents attached in Final Report pdf
1.5.3 COHEMI Video: relevant documents attached in Final Report pdf
1.5.4 COHEMI Poster: relevant documents attached in Final Report pdf
1.5.5 COHEMI Brochure: relevant documents attached in Final Report pdf
1.5.6 COHEMI Newsletter (Public): relevant documents attached in Final Report pdf
1.6 COHEMI Network
Coordinator
Dr Maurizio Bonati
IRCCS - Istituto di Ricerche Farmacologiche Mario Negri (IRFMN)
Via Giuseppe La Masa 19, 20156 Milan, Italy
mother_child@marionegri.it
Partners
• Fundació Clínic per a la Recerca Biomèdica (FCRB)
Carrer Roselló 132, 4º, 08036, Barcelona
ocigener@clinic.ub.es
• University of Amsterdam (UvA)
Kloveniersburgwal 48, 1012 CX Amsterdam, The Netherlands
aissr@uva.nl
• Centre for Tropical Diseases (CTD)
Sacro Cuore – Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar (Verona)
www.tropicalmed.eu
• University College London Hospitals NHS Foundation Trust (UCLH)
Department of Clinical Parasitology, Hospital for Tropical Diseases, Mortimer Market, Capper Street, London WC1E 6JB UK
peter.chiodini@uclh.nhs.uk
• Dipartimento di Area Critica Medico Chirurgica, Clinica Malattie Infettive, Università di Firenze, Florence (UNIFI)
Clinica Malattie Infettive, Piastra dei Servizi, AOU Careggi, Largo Brambilla 3, 50134 Firenze
bartoloni@unifi.it
• Fundación Salud Ambiente y Desarrollo – Centro de Epidemiologia comunitaria y Medicina Tropical (FUNSAD/CECOMET)
Calle Vicente Ramón Roca E6-06 y Juan León Mera, Edif. El Castillo – ofic. 702, EC170133 Quito, Ecuador
• Colectivo de Estudios Aplicados y Desarrollo Social Juan XXIII (CEADES JUAN XXIII)
Calle Rico Toro # 1054 casi Melchor Urquidi, Zona Queru Queru, Cochabamba - Bolivia
• Universidad Peruana Cayetano Heredia, Lima (UPCH)
Honorio Delgado 430 San Martin de Porres (Lima 31), Lima, Perú
eduardo.gotuzzo@upch.pe
• Taller de Education y Comunication TEKO-GUARANÌ (TEKO)
Calle Sargento Maceda S/N, entre calle Santa Cruz y Av. Bolívar, Zona central, Camiri - Bolivia
guarani@cidis.ws
1.1 Executive summary
European health systems are committed to meeting the challenge of understanding the needs of migrant populations and adapting their services to meet these needs. Limited knowledge of the priority health problems affecting Latin American migrants and a lack of data on the multiple determinants of health service utilization (accessibility, appropriateness of the care provided and client satisfaction) negatively influence the possibility of providing good quality care for migrants.
COHEMI (COordinating resources to assess and improve HEalth status of MIgrants from Latin America) is a three-year European project launched in 2011 and coordinated by the IRCCS- Istituto di Ricerche Farmacologiche Mario Negri of Milan, Italy. The consortium brings together 10 partners, including 6 from 4 European Member States, and 4 from 3 Latin American countries. The project is supported by the European Commission under the Health Cooperation Work Programme of the 7th Framework Programme.
COHEMI aimed to provide a clear picture of the full migration cycle in relation with the health systems in Europe and Latin America and to suggest specific (disease-driven) policies to address the priority aspects of ill-health in the migrant population.
The COHEMI network collected information and data through reviews, organization of/participation at national and international meetings, congresses, workshops, symposiums, use of questionnaires and interviews. The activities done produced a global picture of the health and needs of LA migrants, with a focus on health systems, legislation and policies in the different European countries, gaps in prevention, screening, diagnosis, and care of selected infectious and non-infectious diseases and social and cultural factors related to health seeking, health-care, and access to health systems. Final documents addressed. The COHEMI project and activities has been diffused through the website, periodical newsletters, scientific publications, participation to national and international events, press releases etc, and a COHEMI video-spot has been realised.
Final COHEMI Policy Briefs documents and COHEMI recommendations have been produced, reporting the current situation, the gaps to be solved, and the priorities to be addressed in order to suggest/promote specific strategies/initiatives/methods/policies-guidelines/legislative measures to be promoted at the European Union and Latin American levels, both on general aspects and on specific diseases.
Project Context and Objectives:
1.2 Project context and objectives
European health systems are committed to meeting the challenge of understanding the needs of migrant populations and adapting their services to meet these needs. The difficulties inextricably linked to this challenge are caused by the complexity of migration patterns and the differences between migrant population across European Union (EU) countries.
Health through the provision of accessible healthcare services is a right for permanent and temporary residents of the EU. Furthermore, ensuring that migrants (temporary or new permanent residents) are healthy would provide both social and economic benefits to EU states: able to contribute to economic growth, healthy migrants are also less likely to be socially marginalized. The diversity of migrant populations in European Countries - labour and educational migrants, and vulnerable groups such as asylum seekers and refugees, all from a variety of nationalities - poses challenges for national health systems to ensure the accessibility of healthcare.
Limited knowledge of the priority health problems affecting Latin American migrants and a lack of data on the multiple determinants of health service utilization (accessibility, appropriateness of the care provided and client satisfaction) negatively influence the possibility of providing good quality care for migrants. The inequality of access to and outcomes from healthcare services between migrants and the autochthonous population is therefore an issue of concern to both healthcare providers and policymakers in Europe.
COHEMI’s general objective is to coordinate referral centres (both in Europe and Latin American countries) dealing with selected diseases in Latin American (LA) countries (Chagas disease, strongyloidiasis, cysticercosis), as well as other infectious and non-infectious diseases affecting LA migrants, and centers investigating migrant health in general (health systems, reproductive and child health, anthropological and psycho-social problems). Through coordinating these groups, COHEMI aims to provide a clear picture of the full migration cycle in relation with the health systems in Europe and Latin America and to suggest general and specific (disease-driven) policies to address the priority aspects of ill-health of the migrant population.
COHEMI’s specific objectives are: to assess/compare health systems in EU and LA countries with specific reference to legislation and policies affecting migrant categories, related ethical issues and multiple determinants of the utilizations of health service; to identify specific bottle-necks affecting priority health needs of the migrants population and potential repercussions on the EU host countries’ population; to provide a reliable estimate of the burden of selected Neglected Tropical Diseases (NTDs), selected infectious diseases and selected chronic, non-infectious diseases in countries of origin and in different groups of migrants and of the access to appropriate care; to promote greater coordination in an effort to understand the social and cultural factors that influence health-seeking behaviours of Latin American migrants residing in Europe; to suggest/promote, based on the main results, specific strategies/initiatives/methods/policies-guidelines/legislative measures to be promoted at the EU and LA levels, both on general aspects and on specific diseases.
Project Results:
1.3 Work performed and main results
During the three years of the COHEMI project the activities planned in the different WPs have been achieved with relatively minor deviations.
A collection of information concerning legal and social aspects of migrants’ access to health systems and health care in three European countries (Italy, Spain and UK) has been analyzed and documents produced.
Reviews on NTDs (Chagas diseases, strongyloidiasis and cysticercosis), infectious diseases (tuberculosis) and non-infectious diseases (hypertension / cardiovascular diseases) have been finalized and some of them published, and some study designs carried out.
Six Policy Brief documents addressed to stakeholders and policy makers on: Latin American Migrants in Europe: health and policy, NTDs (Chagas diseases, strongyloidiasis and cysticercosis), infectious diseases (tuberculosis) and non communicable chronic disorders (hypertension / cardiovascular diseases), have been finalized.
Five COHEMI recommendations on NTDs (Chagas diseases, strongyloidiasis and cysticercosis), infectious diseases (tuberculosis) and non communicable chronic disorders (hypertension / cardiovascular diseases) have been produced.
A collection of information concerning anthropological and cultural contexts related to migrants’ health has been gathered and a trans-disciplinary and trans-national research agenda on health status and determinants of Latin-Americans in Europe has been finalised.
The dissemination of the COHEMI project and activities, through website, periodical newsletters, scientific publications, participation to national and international congresses and events with oral and poster presentations, participation and/or organization of meetings, workshops, international symposiums, press releases etc, has been carried out and a COHEMI video-spot has been realised.
Potential Impact:
1.4 Final results, potential impact and use
The exhaustive research done on the different aspects related to LA migrants’ health (legal, social and anthropological and disease related) represented the first step necessary to obtaining information on the current situation, in order to (specific objectives): identify specific bottle-necks affecting the priority health needs of the migrant population and potential repercussions on the EU host countries' population; promote greater coordination in efforts to understand the social and cultural factors that influence health-seeking behaviours of LA migrants resident in Europe; suggest/promote specific strategies/initiatives/methods/policies- guidelines/legislative measures to be promoted at the EU and LA levels, both on general aspects and on specific diseases.
The activities of the COHEMI network produced a global picture of the health and needs of LA migrants, with a focus on health systems, legislation and policies in the different European countries, gaps in prevention, screening, diagnosis, and care of selected infectious and non-infectious diseases and social and cultural factors related to health seeking, health-care, and access to health systems. Reviews carried out on Chagas disease, strongyloidiasis, cysticercosis, tuberculosis, hypertension and cardiovascular diseases, and socio-cultural aspects have been essential to improve the knowledge of the current gaps in the health care and needs of LA migrants in Europe, as well as the condition of health and diseases in their countries of origin. The organization of workshops, meetings and symposiums gave the opportunity to share within the COHEMI network and with international experts the current situation and the key issues to be addressed to improve access to healthcare and LA migrants’ health. Much of the work done has been already published and COHEMI partners participated in many national and international meetings/congresses to raise awareness of the COHEMI project and LA migrant health and to diffuse, through oral and poster presentations, the work done and the results achieved.
The work carried out by COHEMI network allowed to produce final Policy Brief documents and COHEMI recommendations for stakeholders, policy makers and health operators, with the indication of the crucial points and the main needs of migrants to be addressed and to work, the host country together with the country of origin, to prevent and treat diseases and to improve migrants’ healthcare.
The common efforts of European and Latin American countries will build a collaboration in migrant health with improvement of health care, prevention, and treatment of diseases, also in their countries of origin. The work done and the publications, presentations, events organised, and documents produced strengthen the collaboration among European and Latin American countries, improve the knowledge on LA migrant health, and contribute to plan interventions and policies focused on the most crucial and urgent gaps to be solved and needs to be addressed.
1.5 Dissemination
COHEMI projects has a crucial role in the dissemination of knowledge on LA migrants health. During these three years many activities has been carried out to diffuse the information on this theme, addressing both a scientific as well as a general public.
- The website (http://www.cohemi-project.eu/(si apre in una nuova finestra)) with a public and a private section (the last one for COHEMI partners only) has been realized in the first period of the project and has been online since December 2011 (English version) and May 2012 (Spanish version). The website has been regularly updated with news on event on migrant health and with collection of the work done to be shared step by step within COHEMI partners.
- Six Newsletters (with a public and a private version) have been published since the beginning of the project and are available in the COHEMI website.
- The COHEMI project produced 32 publications since the beginning (January 2011).
- The COHEMI activities and results have been presented (oral presentation and posters) in some international and national congresses, symposiums, workshops, meetings.
- Press releases have been produced on the occasion of international meetings/symposiums, with publication of articles in the popular press/web.
- A COHEMI video spot has been produced and presented during the COHEMI Final Symposium in Milan, Italy, December, 2nd – 3rd, 2013 (see http://www.cohemi-project.eu/(si apre in una nuova finestra)).
List of Websites:
http://www.cohemi-project.eu(si apre in una nuova finestra)
1.5.1 COHEMI logo: relevant documents attached in Final Report pdf
1.5.2 COHEMI Website: relevant documents attached in Final Report pdf
1.5.3 COHEMI Video: relevant documents attached in Final Report pdf
1.5.4 COHEMI Poster: relevant documents attached in Final Report pdf
1.5.5 COHEMI Brochure: relevant documents attached in Final Report pdf
1.5.6 COHEMI Newsletter (Public): relevant documents attached in Final Report pdf
1.6 COHEMI Network
Coordinator
Dr Maurizio Bonati
IRCCS - Istituto di Ricerche Farmacologiche Mario Negri (IRFMN)
Via Giuseppe La Masa 19, 20156 Milan, Italy
mother_child@marionegri.it
Partners
• Fundació Clínic per a la Recerca Biomèdica (FCRB)
Carrer Roselló 132, 4º, 08036, Barcelona
ocigener@clinic.ub.es
• University of Amsterdam (UvA)
Kloveniersburgwal 48, 1012 CX Amsterdam, The Netherlands
aissr@uva.nl
• Centre for Tropical Diseases (CTD)
Sacro Cuore – Don Calabria Hospital, Via Sempreboni 5, 37024 Negrar (Verona)
www.tropicalmed.eu
• University College London Hospitals NHS Foundation Trust (UCLH)
Department of Clinical Parasitology, Hospital for Tropical Diseases, Mortimer Market, Capper Street, London WC1E 6JB UK
peter.chiodini@uclh.nhs.uk
• Dipartimento di Area Critica Medico Chirurgica, Clinica Malattie Infettive, Università di Firenze, Florence (UNIFI)
Clinica Malattie Infettive, Piastra dei Servizi, AOU Careggi, Largo Brambilla 3, 50134 Firenze
bartoloni@unifi.it
• Fundación Salud Ambiente y Desarrollo – Centro de Epidemiologia comunitaria y Medicina Tropical (FUNSAD/CECOMET)
Calle Vicente Ramón Roca E6-06 y Juan León Mera, Edif. El Castillo – ofic. 702, EC170133 Quito, Ecuador
• Colectivo de Estudios Aplicados y Desarrollo Social Juan XXIII (CEADES JUAN XXIII)
Calle Rico Toro # 1054 casi Melchor Urquidi, Zona Queru Queru, Cochabamba - Bolivia
• Universidad Peruana Cayetano Heredia, Lima (UPCH)
Honorio Delgado 430 San Martin de Porres (Lima 31), Lima, Perú
eduardo.gotuzzo@upch.pe
• Taller de Education y Comunication TEKO-GUARANÌ (TEKO)
Calle Sargento Maceda S/N, entre calle Santa Cruz y Av. Bolívar, Zona central, Camiri - Bolivia
guarani@cidis.ws