A Meta-Synthesis of Policy Recommendations Regarding Human Mobility in the Context of Climate Change

Abstract

Changing mobility patterns combined with changes in the climate present challenges and opportunities for global health, requiring effective, relevant, and humane policy responses. This study used data from a systematic literature review that examined the intersection between climate change, migration, and health. The study aimed to synthesize policy recommendations in the peer-reviewed literature, regarding this type of environmental migration with respect to health, to strengthen the evidence-base. Systematic searches were conducted in four academic databases (PubMed, Ovid Medline, Global Health and Scopus) and Google Scholar for empirical studies published between 1990–2020 that used any study design to investigate migration and health in the context of climate change. Studies underwent a two-stage protocol-based screening process and eligible studies were appraised for quality using a standardized mixed-methods tool. From the initial 2425 hits, 68 articles were appraised for quality and included in the synthesis. Among the policy recommendations, six themes were discernible: (1) avoid the universal promotion of migration as an adaptive response to climate risk; (2) preserve cultural and social ties of mobile populations; (3) enable the participation of migrants in decision-making in sites of relocation and resettlement; (4) strengthen health systems and reduce barriers for migrant access to health care; (5) support and promote optimization of social determinants of migrant health; (6) integrate health into loss and damage assessments related to climate change, and consider immobile and trapped populations. The results call for transformative policies that support the health and wellbeing of people engaging in or affected by mobility responses, including those whose migration decisions and experiences are influenced by climate change, and to establish and develop inclusive migrant healthcare.

Family Physician Perceptions of Climate Change, Migration, Health, and Healthcare in Sub-Saharan Africa: An Exploratory Study

“…As PHC providers such as CHWs, midwives, nurses, and FPs are highly trusted by local communities, they can sensitize national governments, private sector actors, and civil society on their responsibilities and raise public awareness on environmental issues [18]. This aligns with Schwerdtle et al (2020), who suggest adding communications and advocacy as additional elements in the WHO operational framework [4]. PHC teams, in collaboration with NGOs, can support communities in moments of despair and coordinate climate change adaptation activities such as re-forestation, provision of clean sources of water, food security, and shelter [32,33].…”

“…The climate change, migration, and health nexus has been extensively explored in and beyond the Sub-Saharan Africa (SSA) region [ 1 , 2 , 3 , 4 ]. Explanatory frameworks highlighting the linkages together with the feedforward and feedback relationships are useful to inform and guide the formulation of research agendas and policy responses [ 1 , 2 , 3 , 5 ].…”

“…Austerity measures imposed by some international donors, and reduced public health expenditure in many SSA countries, have led to underfinancing, under-resourcing, and donor dependency, compromising the health sectors’ ability to provide effective and equitable healthcare [ 13 , 14 ]. A shift to strengthened, climate-resilient, migration-inclusive health systems may better anticipate, prevent, prepare for, monitor, and manage changing health needs [ 4 , 9 ]. To achieve this, international bodies suggest an “intersectoral capacity-building approach”.…”

Decision‐making factor interactions influencing climate migration: A systems‐based systematic review

“…We specifically recommend policy makers to reference these causal connections when determining development strategies in climate-affected areas so that down-stream effects on migration and other key areas can be better understood. In this way, we compliment meta-syntheses, such as Nayna Schwerdtle et al (2020), in helping to better understand ensuing effects and possibly prioritize policy recommendations for aiding health in human mobility. In our analysis of the top feedback loops within the climate migration system CLD, we highlight that particular emphasis for policy and practice needs to be made on "Economic" factors, such as financial capital and livelihood to assist climate-affected communities.…”

Climate change, migration, and health(care) in primary care training

“…The World Health Organization (WHO) Operational Framework for climate-resilient health systems, with its integrated development strategies and governance for local, national and international governments and agencies, can be used as an advocacy tool in training but with more emphasis on communications and advocacy and the connection with migration and related health risks should also be made more explicit. 9 Such actions will strengthen the overall health service delivery, as emphasised in the Astana Declaration on primary health care (PHC) and the Global Sustainable Development Goals.…”