Returnee migrant woman taking health assistance at a local health complex.This health initiative is being implemented under UHC in Bangladesh. Source: Ovibashi Karmi Unnayan Program (OKUP)
For the migrants worker’s community, the urgency to achieve Universal Health Coverage is even more pronounced because less migrants are able to access to quality healthcare and even fewer have health insurance. This reflects that good health always becomes an option for migrant workers. This is because migrants are primarily considered as sources of remittances rather than human beings but in reality, these remittance warriors are playing the most vital role in accelerating the economic growth but they are encountering various adversity and challenges in return.
Evidently, in 2021, Bangladesh has received a total of 3,652 deceased migrant worker’s bodies and major causes of the deaths were because of heart attack, stroke, road accidents and suicide. If migrant workers had access to healthcare in the receiving countries nations where they were working, being received, these causes and related health issues might be prevented or managed on time rather than losing lives. Undocumented migrant workers cannot access health care due to the fear of arrest, detention and deportation as they have to show legal work permit (passports) before getting any medical attention.
While, in Pakistan, there has not been budget allocated for the health needs of Pakistani labour emigrants but funding has been set aside for health needs of registered Afghan refugees. Even worst, migrant workers are among the most vulnerable groups in terms of gaining access to health care, but HIV & AIDS policies in migrant worker's sending nations in South Asia do not prioritise them as at risk critical populations which leads to a significant neglect of their health risks. Because of this, achieving Universal Health Coverage is the only realistic solution to all the adversities faced by migrants in migration cycle at pre-departure, post-arrival and re-integration stages.
At post arrival stage, when migrants are in receiving countries they experience stigma, discrimination and they are being largely criminalized in many countries based on their HIV positive status. Mandatory health testing including tests for HIV is a requirement for migrant workers to obtain job abroad. For example, in Jordan, Residence and Foreign Affairs Law of 1973 has been used to deport many migrants who were living with HIV as part of Jordanian strict policy to deport any non-national who is living with HIV. Majority of governments in receiving countries have strict policies which state that all migrants must undergo a series of medical examinations before coming and upon arrival in the country and migrants have to undergo mandatory medical tests again as a requirement for renewal of work permit. As a result, if they are found with HIV infection and any other health conditions, they immediately get arrested, detained, deported back to their sending countries without any provision of health services.
What and Why Universal Health Coverage (UHC)?
According to the World Health Organization (WHO), Universal Health Coverage (UHC) means that "all individuals and communities have access to the health services they need, when and where they need and, without suffering any financial hardship". It includes the full spectrum of essential and quality health services from health promotion to prevention, treatment, rehabilitation and palliative care across the life course. Additionally, UHC is a holistic approach not only directed towards the provision of comprehensive health services but also their funding, management and administration. Hence, robust health financing structures are key to achieve UHC.
World Health Organizations (WHO) uses 16 essential health services in 4 categories as indicators of the level and equity of coverage in countries. The delivery of these services requires adequate and competent health care workers with optimal skills mix at facility, outreach, and community level, and who are equitably distributed, adequately supported, and enjoy decent work. UHC strategies enable everyone to access the services that address the most significant causes of disease and death and ensure that the quality of those services is good enough to improve the health of the people who receive them.
Therefore, UHC is crucial for all because it is a fundamental right to have access to healthcare anywhere in the world without discrimination. It is important to access these services for the health and well being of people irrespective of their status and recognition. Not forgetting, practicing strong UHC in nations promotes a healthy population and a healthy workforce that supports a healthy economy.
Progress Towards Universal Health Coverage (UHC)
Achieving UHC is one of the targets the nations of the world set when adopting the Sustainable Development Goals in 2015. Countries reaffirmed this commitment at the United Nations General Assembly High Level Meeting on UHC in 2019. Countries that progress towards UHC will make progress towards the other health-related targets, and towards the other goals. Good health allows children to learn and adults to earn, helps people escape from poverty, and provides the basis for long-term economic development.
Launch of CARAM Asia Pre-Recorded Research Report on Universal Health Coverage Project
CARAM Asia carried out a Research Project on Universal Health Coverage (UHC) for Migrants in Four South Asian Countries which are Bangladesh, Sri Lanka, Pakistan and Nepal to bring light to the implementation progress of Universal Health Coverage in the respective countries.The research findings are presented by CARAM Asia partners in the videos given below:
Presenting the Research Findings from Pakistan by CARAM Asia's Partner Organization, SPEAK TRUST
Presenting the Research Findings from Sri Lanka by CARAM Asia's Partner Organization, Community Development Services (CDS)
Presenting the Research Findings from Nepal by CARAM Asia's Partner Organization, POURAKHI
Presenting the Research Findings from Bangladesh by CARAM Asia's Partner Organization, Ovibashi Karmi Unnayan Program (OKUP)
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