Migration and health: a review of policies and initiatives in low and middle income countries

Abstract Background The migration of people within national borders is nearly four times higher than international migration. Internal labour migration is an important livelihood strategy for many poor groups worldwide, but this population faces exclusion from existing mainstream health programmes. We aimed to conduct a literature review to understand factors in low and middle income countries affecting the health of migrants, and policies and initiatives to address health issues. Methods Pubmed, The Lancet , Google Scholar, Advanced Google, Popline by K4 Health, reports of international agencies, country official websites, government publications and conference proceedings (restricted to the English language) were searched. Keywords were “low- and middle-income countries”, “urbanization”, “internal labour migration”, “rural-urban”, “migration”, “migrant workers”, “internal migrants”, “health problems/issues” “health”, “migrant women/children”, “social determinant”, “health services”, “social inclusion”, “health policies”. Empirical, non-empirical papers, reports from agencies, regional forums, and international conferences from 1970 to 2015 were retrieved. A narrative synthesis of literature was undertaken. Findings 209 articles were retrieved; after screening for duplication and relevance, 136 were included in the review. Factors affecting migrants' health included political and social marginalisation, lack of socioeconomic and societal resources, inadequate nutrition, poor housing, hazardous occupational conditions, lack of access to health-care services, discrimination, and financial burden. Access to health and social benefits were usually linked to identity, and migrant families often did not have location-specific identity documents. Migrant women had less antenatal care than non-migrant women. Migrant women were more likely to experience violence, and their children were six times more at a risk of physical abuse. Policies related to migration included security, labour, trade, enforcement, and international aid laws; they rarely included health policy for migrants which was traditionally viewed in terms of a threat to public health resulting in screening, monitoring, quarantine, and communicable disease control. Interpretation Lessons drawn from our review suggest three key strategies to improve the health of internal migrants—namely, formation of a nodal agency for the welfare of internal migrants, formation of a database on internal migrants and