Migration Health - Canada and the RCM XIX Regional Conference on Migration Nicaragua, June 2014

Migration Health and the RCM Health is a key component to migration Public health risks don’t respect borders 2004 Migration and Health Seminar held in Guatemala, co- sponsored by Mexico and Canada Migration and Health Virtual Forum proposal did not advance All member countries are members of the World Health Organization and share its priority of addressing Tuberculosis Member countries and observer organizations share a number of common interests, including regular and irregular movements

Citizenship and Immigration Canada (CIC) - Mandate Mandated to develop and implement immigration and refugee protection policies and programs. In terms of health, this includes: Managing risks to public health, public safety and excessive costs to health and social services Promoting health aspects of migrant integration

Managing public health and public safety risks Immigration medical examinations are done pre-departure to protect public health, public safety, and avoid excessive costs on health and social services In case of public health risks for tuberculosis, migrants are referred post arrival to local public health authorities to ensure proper follow up and treatment as needed When certain groups of refugees or refugee-like populations have special needs or in case of crisis or emergency, pre-departure and post-arrival processes are adapted, in collaboration with domestic and international partners to mitigate the public risk while facilitating entry to Canada Resettlement medical needs that could impact the ability of refugees to successfully travel to and resettle in Canada, are assessed through the collection and distribution of pertinent medical information Limited, temporary, publicly-funded coverage of health-care benefits is provided to specific groups who are not eligible for provincial or territorial health insurance

Promoting health components of new Migrants’ Integration Health is key to migrant well-being. Federal capacity is limited: in Canada, health care is a provincial/territorial jurisdiction. Settlement-related health programming supports disease prevention, promotion of healthy living and general health orientation. Community-based health information provisions promote mental health awareness and access to health care services. Language classes include a health and safety theme (e.g. learning to explain health concerns, make appointments, healthy eating, medical emergencies).

Partnerships Partnerships are key to the delivery of CIC health-related policies and programs: At the Federal level: close collaboration with the Public Health Agency of Canada and Health Canada At the Provincial and Territorial level: Although health is largely a provincial and territorial jurisdiction in Canada, the management of public health is a shared federal, provincial and territorial jurisdiction (ex: post surveillance programs) At the Community level: partners in the delivery of integration and resettlement assistance services (service provider organizations, private sponsors).

Partnerships At the International level: partnerships are developed with International organizations (for example, UNHCR - refugee resettlement, IOM –service delivery) and Countries and forums such as the Five Country Conference, for strategies and policies, information sharing, health screening design and delivery, alignment of policies and practices, and health crisis management

Areas of key interests to CIC Better understanding the changing profile of migrants from a health perspective Revisiting the purpose and use of the health screening beyond admissibility Enhancing public health risk mitigation strategies for migrants Facilitating health knowledge transfer from source countries to destination countries, including transit countries Developing expertise, capacity and a concrete knowledge base of health-related barriers and challenges to migrants integration

Opportunities for policy and program dialogue Proposing a space in the agenda of the next RCGM/Technical Meeting dedicated to presentations to learn about member countries and observer organizations (IOM, UNHCR, ICRC) Experience with migration health policies and/or programs (i.e., medical screening, TB monitoring and risk mitigation, post-arrival issues, settlement) Regional situations, trends and issues Assess if migration health should be an ongoing agenda item for mutual updates on important and emerging issues.