Migrant Health: Advancing from the local ambit to the national
OBMICA (Observatory Caribbean Migrants) Centro para la Observación Migratoria y el Desarrollo Social en el Caribe
(
Non-governmental organization (NGO)
)
#SDGAction54796
Description
The core mission of the partnership contributes to the role of law and compliance with human rights in the Dominican Republic by increasing nondiscriminatory inclusion in the Dominican public health system of vulnerable Haitian labour migrants and their families. Directly benefitting will be 1,200 community members and 80 users reporting positive change will evidence progress. Thus, the right to health by community led vigilance will assist with the production of new knowledge with which to reinforce the capacity of users to advocate for their rights, notably on sexual and reproductive health, and sensitise duty bearers on the findings.
The dissemination of the information originated by Community Led Monitoring is done first in the communities – to identify possible solutions and points of action, subsequently with networks and like-minded civil society organizations. Then it is carried out with duty bearers such as the Directors of health centres and public functionaries with a view to having more transparency from public health providers. Thus, policy advocacy is bottom up, following on from evidence generated on the ground. Documents, tables, and materials are drawn up using the principal challenges found with these populations in situations of vulnerability based on the national and international normative as well as the different commitments engaged in by the Dominican state as to universal access to health (ODS 3). Testing occurs to ensure that the data is useful and appropriate for the different fora and meetings with the authorities. In this phase it is opportune to collaborate with national and international human rights organizations, with preliminary reporting feeding into alternative reports generated by the Universal Periodic Review (UPR) process, for example. Collaboration is emphasized with those organisations which have experience in generating feasible solutions, the formulation of recommendations and the implementation of identified needs. The alternative reports generated permit the establishing of policy dialogue, which may be behind closed doors, depending on the political context, both with local authorities as well as central government entities such as the Ministries of Public Health and Women, the National Migration Institute and the Ombudsman among others. The implementing organizations as well as the community leaders present clearly the findings and analyse in a practical way the findings of the monitoring of health access and quality, reporting on human rights violations where these occur with the objective of pointing out he difficulties but also offering solutions. The chosen advocates present their arguments, the context and perspectives for improvements and are armed with the data to back up their positions. The advocacy strategy includes proposing solutions and seeking the backing of health service providers as well as third parties implicated. The project works alongside the authorities to implement the changes at the appropriate level and agree the indicators for analyzing impact. Mechanisms are established at the local and national levels to ensure that, notwithstanding a change in the incumbent government, the local authorities hold to the agreements even if there are such changes.
A 20–30-minute video on learnings generated on the difficulties of migrants and their family’s access to adequate quality health services. This is part and parcel of the advocacy strategy and is intended to be a tool to continue the action beyond the lifetime of the project. There is a communications campaign throughout the action characterized by the publication and diffusion of relevant messages (including social networks, radio broadcasts, podcasts, blogs, press articles), exhorting migrants to be less reticent in their use of the services and explaining to a broader public the barriers faced by this population, including their fragile documentation status. Subsequently, based on the data collected, messaging is extended to state authorities, as well as civil society with special emphasis on reaching social communicators. Outreach likewise occurs in public seminars with key champions of an improved health system for all, eliminating discrimination. Particular attention is placed on sexual and reproductive rights for migrant in a situation where there has been both racial profiling and misogyny generated against them in country. A final national meeting will be held where the video will be a centre piece and there will be a reiteration of commitments agreed and requiring sustained follow up beyond the life of the project. By means of the project, monitors will have been trained in an innovative methodology which had earlier been implemented in the DR, but exclusively with the HIV/AIDS sector. In parallel, community promotors will have their knowledge reinforced from a rights perspective, as regards access to health. Health providers will be sensitized to the issues as faced by migrants and enabled to engage in better intercultural practice than hitherto. Social communicators will be provided with new data and lived experiences material by which to make their reporting more rights based and with an enhanced gender perspective. The four project associates, ASCALA, CEDESO, MUDHA and OBMICA, through joined up planning and actions, will be better briefed for collective engagement on health matters and encouraging potential replication elsewhere in the country through relevant networks of which they are members and, hence, with the possibility of scaling up in the future. The installed capacities in the communities (engaged in the VDC) may be used for other projects (beyond health monitoring) to evaluate the quality of any service being received and increase the level of accountability from service providers.
The kernel of the action is an adaptation of the methodology of “Vigilance conducted by the community” (VDC) which is connected to the cycle of applied research spearheaded by OBMICA (Observatory Caribbean Migrants) to amplify the impact of the intervention. The field-based partners (CEDESO, ASCALA and MUDHA) have excellent relations with the communities of migrants and their descendants, in three strategic locations in the Dominican Republic. ASCALA (the Scalabrinian Catholic mission working with migrants), works in the east of the country in sugarcane communities, CEDESO (the Centre for Sustainable Development) in the extreme southern border also with sugarcane communities, while MUDHA (the movement for Dominico-Haitian Women) works with ex sugarcane communities which now constitute peri-urban locations around Santo Domingo. The monitors come from the selfsame communities and carry out their vigilance with the agreement of the local public health authorities. OBMICA accompanies, researches the issues and sistematises the data and lived experiences for scaling up purposes and possibilities of replication in other communities. Parallel work with social communicators encourages a more favourable public opinion towards the respect of the rights of migrants and their families in a context which has often been hostile towards them. There is a steering committee (with representation from each of the four partner organizations) which meets on a regular basis to engage in planning and evaluating the previous period. In addition to a baseline-reference study there will be an external evaluation at the end of the project. Representatives of the Delegation of the European Union regularly accompany the activities of the action. Reporting from the community monitoring is systematized, by an external consultant, for use in policy advocacy. The three project partners in the field report to OBMICA every three months and there is a project blog which serves to make visible important landmarks during the action. http://migrasalud.obmica.org/ and the OBMICA three monthly news bulletin also features the action. Adaptation occurs when that project activities may have to be adjusted to cope with unexpected natural disasters, such as tropical storms or circumstances derived from arbitrary detentions or deportations of migrants suspected of having irregular status. Moreover, the action has started delivering information to UN treaty bodies and the inter-american human rights system as regards the discrimination faced by migrants and their families in access to health, including mistreatment at times of arbitrary detention and possible deportation to neighbouring Haiti, even for pregnant or lactating women.
SDGS & Targets
Goal 3
Ensure healthy lives and promote well-being for all at all ages
3.1
3.1.1
Maternal mortality ratio
3.1.2
Proportion of births attended by skilled health personnel
3.2
3.2.1
Under-five mortality rate
3.2.2
Neonatal mortality rate
3.3
By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases
3.3.1
Number of new HIV infections per 1,000 uninfected population, by sex, age and key populations
3.3.2
Tuberculosis incidence per 100,000 population
3.3.3
Malaria incidence per 1,000 population
3.3.4
Hepatitis B incidence per 100,000 population
3.3.5
Number of people requiring interventions against neglected tropical diseases
3.4
3.4.1
Mortality rate attributed to cardiovascular disease, cancer, diabetes or chronic respiratory disease
3.4.2
Suicide mortality rate
3.5
Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol
3.5.1
Coverage of treatment interventions (pharmacological, psychosocial and rehabilitation and aftercare services) for substance use disorders
3.5.2
Alcohol per capita consumption (aged 15 years and older) within a calendar year in litres of pure alcohol
3.6
3.6.1
Death rate due to road traffic injuries
3.7
By 2030, ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes
3.7.1
Proportion of women of reproductive age (aged 15-49 years) who have their need for family planning satisfied with modern methods
3.7.2
Adolescent birth rate (aged 10-14 years; aged 15-19 years) per 1,000 women in that age group
3.8
Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all
3.8.1
Coverage of essential health services
3.8.2
Proportion of population with large household expenditures on health as a share of total household expenditure or income
3.9
3.9.1
Mortality rate attributed to household and ambient air pollution
3.9.2
Mortality rate attributed to unsafe water, unsafe sanitation and lack of hygiene (exposure to unsafe Water, Sanitation and Hygiene for All (WASH) services)
3.9.3
Mortality rate attributed to unintentional poisoning
3.a
3.a.1
Age-standardized prevalence of current tobacco use among persons aged 15 years and older
3.b
Support the research and development of vaccines and medicines for the communicable and non-communicable diseases that primarily affect developing countries, provide access to affordable essential medicines and vaccines, in accordance with the Doha Declaration on the TRIPS Agreement and Public Health, which affirms the right of developing countries to use to the full the provisions in the Agreement on Trade-Related Aspects of Intellectual Property Rights regarding flexibilities to protect public health, and, in particular, provide access to medicines for all
3.b.1
Proportion of the target population covered by all vaccines included in their national programme
3.b.2
3.b.3
Proportion of health facilities that have a core set of relevant essential medicines available and affordable on a sustainable basis
3.c
3.c.1
Health worker density and distribution
3.d
Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks
3.d.1
International Health Regulations (IHR) capacity and health emergency preparedness
3.d.2
Percentage of bloodstream infections due to selected antimicrobial-resistant organisms
Goal 5
Achieve gender equality and empower all women and girls
5.1
End all forms of discrimination against all women and girls everywhere
5.1.1
Whether or not legal frameworks are in place to promote, enforce and monitor equality and non‑discrimination on the basis of sex
5.2
5.2.1
Proportion of ever-partnered women and girls aged 15 years and older subjected to physical, sexual or psychological violence by a current or former intimate partner in the previous 12 months, by form of violence and by age
5.2.2
Proportion of women and girls aged 15 years and older subjected to sexual violence by persons other than an intimate partner in the previous 12 months, by age and place of occurrence
5.3
5.3.1
Proportion of women aged 20-24 years who were married or in a union before age 15 and before age 18
5.3.2
Proportion of girls and women aged 15-49 years who have undergone female genital mutilation/cutting, by age
5.4
Recognize and value unpaid care and domestic work through the provision of public services, infrastructure and social protection policies and the promotion of shared responsibility within the household and the family as nationally appropriate
5.4.1
Proportion of time spent on unpaid domestic and care work, by sex, age and location
5.5
Ensure women’s full and effective participation and equal opportunities for leadership at all levels of decision-making in political, economic and public life
5.5.1
Proportion of seats held by women in (a) national parliaments and (b) local governments
5.5.2
Proportion of women in managerial positions
5.6
Ensure universal access to sexual and reproductive health and reproductive rights as agreed in accordance with the Programme of Action of the International Conference on Population and Development and the Beijing Platform for Action and the outcome documents of their review conferences
5.6.1
Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care
5.6.2
Number of countries with laws and regulations that guarantee full and equal access to women and men aged 15 years and older to sexual and reproductive health care, information and education
5.a
Undertake reforms to give women equal rights to economic resources, as well as access to ownership and control over land and other forms of property, financial services, inheritance and natural resources, in accordance with national laws
5.a.1
(a) Proportion of total agricultural population with ownership or secure rights over agricultural land, by sex; and (b) share of women among owners or rights-bearers of agricultural land, by type of tenure
5.a.2
Proportion of countries where the legal framework (including customary law) guarantees women’s equal rights to land ownership and/or control
5.b
5.b.1
Proportion of individuals who own a mobile telephone, by sex
5.c
Adopt and strengthen sound policies and enforceable legislation for the promotion of gender equality and the empowerment of all women and girls at all levels
5.c.1
Proportion of countries with systems to track and make public allocations for gender equality and women’s empowerment
Goal 10
Reduce inequality within and among countries
10.1
By 2030, progressively achieve and sustain income growth of the bottom 40 per cent of the population at a rate higher than the national average
10.1.1
Growth rates of household expenditure or income per capita among the bottom 40 per cent of the population and the total population
10.2
By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status
10.2.1
Proportion of people living below 50 per cent of median income, by sex, age and persons with disabilities
10.3
Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard
10.3.1
Proportion of population reporting having personally felt discriminated against or harassed within the previous 12 months on the basis of a ground of discrimination prohibited under international human rights law
10.4
Adopt policies, especially fiscal, wage and social protection policies, and progressively achieve greater equality
10.4.1
Labour share of GDP
10.4.2
Redistributive impact of fiscal policy
10.5
Improve the regulation and monitoring of global financial markets and institutions and strengthen the implementation of such regulations
10.5.1
Financial Soundness Indicators
10.6
10.6.1
Proportion of members and voting rights of developing countries in international organizations
10.7
Facilitate orderly, safe, regular and responsible migration and mobility of people, including through the implementation of planned and well-managed migration policies
10.7.1
Recruitment cost borne by employee as a proportion of montlhy income earned in country of destination
10.7.2
Number of countries with migration policies that facilitate orderly, safe, regular and responsible migration and mobility of people
10.7.3
Number of people who died or disappeared in the process of migration towards an international destination
10.7.4
Proportion of the population who are refugees, by country of origin
10.a
10.a.1
Proportion of tariff lines applied to imports from least developed countries and developing countries with zero-tariff
10.b
10.b.1
Total resource flows for development, by recipient and donor countries and type of flow (e.g. official development assistance, foreign direct investment and other flows)
10.c
By 2030, reduce to less than 3 per cent the transaction costs of migrant remittances and eliminate remittance corridors with costs higher than 5 per cent
10.c.1
Remittance costs as a proportion of the amount remitted
SDG 14 targets covered
| Name | Description |
|---|
Deliverables & Timeline
900 interviews with migrant health services users carried out by community monitors and systematized
555 community members sensitised on health as a right, especially as regards sexual and reproductive health
1 video produced and launched
80 users reporting positive change in accessing public health
Resources mobilized
Partnership Progress
Feedback
Action Network
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Timeline
Entity
More information
Countries
SIDS regions
- Caribbean
Samoa pathway priority area
- Health and NCDs
- Gender Equality and Women’s Empowerment
- Social Development
Contact Information
Bridget, DR.
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