Health system considerations related to voluntary and forced displacement in the Eastern Mediterranean Region: a critical analysis of the available literature/Considerations des systemes de sante relatives aux deplacements volontaires et forces dans la Region de la Mediterranee orientale: analyse critique de la litterature disponible/[phrase omitted]

Background: The WHO Region for the Eastern Mediterranean has had a history of complex migration patterns, with high levels of migration to, from and within the Region, overlaid by massive recent forced displacement. Relatively little is known about the health system response to this large-scale mobility. Aims: To review the literature on the Region critically, identify gaps and suggest areas needing research and policy attention. Method: A search of the published literature using MEDLINE and POPLINE was conducted on health and migration focusing on the WHO health system building blocks with no date or language limitations. Results: Out of 4679 retrieved articles published between 1964 and January 2019, 140 met our inclusion criteria; 45 additional articles were included in a December 2020 update. Most publications focused on refugees and on the delivery of services. Conclusions: Few studies explored the responsiveness of health system to refugees and migrants compared with those for host communities, or assessed the quality of services or refugees'/migrants' perceptions of available health services. Few suggested new approaches to financing health care access for these populations or new governance arrangements. Keywords: refugees, migrants, health systems, Eastern Mediterranean Region Contexte: La Region OMS de la Mediterranee orientale presente depuis longtemps des schemas migratoires complexes, avec des niveaux eleves de migration vers la Region, en provenance et a l'interieur de celle-ci, auxquels viennent s'ajouter les recents deplacements forces en masse. Tres peu d'informations sont disponibles sur la reponse des systemes de sante a cette mobilite a grande echelle. Objectifs: Effectuer une analyse critique de la litterature sur la Region, identifier les lacunes et suggerer les domaines necessitant une attention particuliere de la part des chercheurs et des responsables politiques. Methodes: Une recherche de la litterature publiee dans Medline et Popline a ete effectuee dans le domaine de la sante et des migrations. Celle-ci se concentrait principalement sur les elements constitutifs des systemes de sante de l'OMS, sans limitation de date ni de langue. Resultats: Sur 4679 articles recuperes, publies entre 1964 et janvier 2019, 140 repondaient a nos criteres d'inclusion; 45 articles supplementaires ont ete inclus lors d'une mise a jour en decembre 2020. La plupart des publications portaient sur les refugies et la prestation de services. Conclusion: Pe