Migration Health

IOM delivers and promotes comprehensive, preventive and curative health programmes which are beneficial, accessible, and equitable for migrants and mobile populations. Bridging the needs of both migrants and Member States, IOM contributes towards the physical, mental and social well-being of migrants, enabling them and host communities to achieve social and economic development. In Nepal, IOM is supporting the Government of Nepal in various aspects related to migration and health. Some of the key areas of interventions are as follows:.

1. Migration Health Assessment Services and Travel Health Assistance:

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IOM runs its health assessments services both in Kathmandu and Damak to evaluate the health status of refugees and out-bound migrants prior to their departure. IOM operates its health assessment activities for Bhutanese refugees and immigrant population in Damak. Likewise, the Migration Health Assessment Center located in Kathmandu, conducts assessment of urban refugees and out-bound immigrants mainly to USA, Australia, New Zealand and Canada. As of December 2017, IOM Nepal has conducted health assessment of more than 200,000 persons (refugees: 134,605 and immigrants: 70,746 ) based on the technical instructions provided by the intended destination countries. 

IOM also has established a well-equipped laboratory at Damak and evaluates infectious diseases of public health importance such as Tuberculosis, HIV/AIDS and STIs. For TB diagnosis, IOM offers the best diagnostics namely; GeneXpert MTB/RIF, solid and liquid culture, second line DST to rule out all possible drug resistant TB cases. For management of Drug Resistant TB Cases, IOM operated a unique center called a “Magic Mountain”, and provided in-house TB services to refugees identified as DRTB.

2. Health Promotion and Assistance for Migrants:

a. TB REACH Project:

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IOM implemented 2 waves of TB REACH funded project from December 2011 to March 2016 aiming to improve Tuberculosis case detection in nine districts through (a) Laboratory testing with point of care GeneXpert instrument and (b) improving referral of TB testing from periphery level microscopic centres. Implemented in close collaboration with National TB Program and funded through WHO Stop TB partnership, the project reached out to most vulnerable groups such as labour migrants and people living with HIV and AIDS. With this project, IOM introduced GeneXpert technology, a breakthrough in rapid diagnosis of TB for the first time in Nepal from 8 selected GeneXpert centers. The project successfully tested a total of 52,662 TB suspects with GeneXpert and detected nearly 10,000 TB cases with 596 Rifampicin Resistant cases. Likewise, IOM also supported to develop a national algorithm for GeneXpert in Nepal in consultation with NTP and other local partners working in TB in Nepal and build the capacity of the Government to scale up this technology. As of now, NTP has revised the previously developed guideline and expanded GeneXpert technologies in more than 50 centers on Nepal. Similarly, IOM supported one national level organization to implement a project entitled “Strengthening referral mechanism from private sector for early and active case findings of Tuberculosis”, among OPD patients of private health sector of 6 districts of Eastern Nepal namely; Morang, Jhapa, Sunsari, Saptari and Udaypur from September 2014 to December 2015 (16 months). A total of 148,614 patients visiting OPD of 40 selected hospitals were screened, 15,972 presumptive TB cases were identified, tested for sputum for 15,935 cases, and 1,475 TB patients were identified using smear microscopy and GeneXpert testing and enrolled in treatment. The outcome of this project, worked as a base for NTP to develop PPM strategy to identify hidden TB cases and improve case notification.

b. Support to the Government of Nepal on Migration Health related activities:

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Since 2014, IOM Nepal has started to work on Migration Health. In 2014 and 2015, a regional IOM Development Fund funded project “Strengthening Government’s Capacity of Selected South Asian Countries to Address the Health of Migrants through a Multi-Sector Approach” was implemented. As part of the project, advocacy meetings were conducted with various ministries and stakeholders, and some government officials participated in to the regional consultation held on 4-5 March 2015 in Dhaka, Bangladesh, and a baseline assessment on health vulnerabilities of migrants was conducted. Likewise, IOM Nepal implemented another IDF project namely “Promoting and Integrating Inclusive and Migrant Friendly Health Assessment Services in the National Health Sys-tem of Sri Lanka”. A rapid assessment was conducted on Migration Health Screening Services in Nepal and findings were shared with concerned ministries and stakeholders. The recommendation of this is to develop a national guideline on Migration Health Assessment Services. Since migration health policy is non-existence in Nepal, there is a need of developing a holistic National Strategic Action Plan (NSAP) to address health needs of outbound, internal and inbound migrants.

At present, IOM is implementing another IDF project entitled “Strengthening Government Capacity in the Development and Implementation of the National Strategic Action Plan on Migration Health in Nepal” with the main objective of strengthening the capacity of the Government of Nepal to address the health needs of inbound and outbound migrants by developing, endorsing and implementing the National Strategic Action Plan (NSAP) on Migration Health. More specifically, throughout the duration of the project IOM Nepal supports the Ministry of Health to develop and endorse the NSAP on Migration Health (MoH), which will assist in comprehensively addressing health vulnerabilities of migrants and protect their right to health. Additionally, IOM Nepal assists the GoN in enhancing its capacity to successfully implement selected activities further outlined in the NSAP, such as developing a national pre-departure health assessment guideline for health centers conducting assessment of migrants going for foreign employment, research on the health vulnerabilities of cross-border migrants from Nepal, support in the establishment of an inter-ministerial coordination mechanism – including a migration health secretariat and focal points in MoH and Ministry of Labour and Employment, and so forth.

In addition, IOM Nepal supports the government in developing a National Migration Health Policy aimed at promoting the health of migrants and address the health-related issues and challenges faced during the migration process.

3. Migration Health Assistance for Crisis Affected Population:

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After 2015 Nepal earthquake IOM provided its technical support to National TB Programme for rapid needs assessment. Based on the recommendation provided, IOM implemented Post Disaster TB project with support from TB REACH, in 56 displacement sites of 5 of 15 selected earthquake affected districts of Nepal namely; Kathmandu, Bhaktapur, Lalitpur, Sindhupalchowk and Gorkha. A total of 15,259 IDPs were screened for TB, 1,432 presumptive TB cases were identified, 1,106 of them were tested with GeneXpert and  29 TB cases were identified and enrolled in treatment. The chest camps organized in those settings, provided treatment for 2,355 IDPs for their various kinds of respiratory problems. In addition to this, IOM revitalized 50 different damaged DOTS centers of Sindhupalchowk district. Further detail can be found here.


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