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WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTÉ WELTGESUNDHEITSORGANISATION Date: 26 November 2021 ВСЕМИРНАЯ ОРГАНИЗАЦИЯ ЗДРАВООХРАНЕНИЯ REGIONAL OFFICE FOR EUROPE BUREAU RÉGIONAL DE L’EUROPE Circular letter to all Member States in the WHO REGIONALBÜRO FÜR EUROPA ЕВРОПЕЙСКОЕ РЕГИОНАЛЬНОЕ БЮРО European Region Head office: UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark Tel.: +45 45 33 70 00; Fax: +45 45 33 70 01 Email: [email protected] Website: http://www.euro.who.int Dear Sir/Madam, Survey to follow-up on the implementation of the Strategy and Action Plan for Refugee and Migrant Health in the WHO European Region - Third and final round of implementation reporting for the WHO Regional Committee in 2022 The first Strategy and Action Plan for Refugee and Migrant Health in the WHO European Region was adopted by the 66th session of the WHO Regional Committee for Europe on 13 September 2016. The Strategy and Action Plan has since been a commitment for actions to improve the health of refugees and migrants in the WHO European Region, and also a guide in promoting this area of work in other WHO regions. As agreed by the Member States and stated in resolution EUR/RC66/R6, the Regional Office will monitor the implementation of the Strategy and Action Plan through a biennial survey. The results of the first and second biennial surveys were reported to the 68th and 70th sessions of the WHO Regional Committee for Europe in 2018 and 2020, respectively. The final report on the implementation of the Strategy and Action Plan will be on the agenda of the 72nd session of the WHO Regional Committee for Europe in September 2022. We would highly appreciate your active participation and valuable contributions to the final report through this final survey. Your responses will allow us to measure progress in the area of health of refugees and migrants in the Region but also to find out about the joint work that lies ahead of us. Please find the questionnaire attached to this correspondence. Furthermore, the WHO Regional Office for Europe is convening a high-level meeting on the health of refugees and migrants in 2022 that aims to bring together all Member States of the Region, accompanied by technical experts, to discuss current achievements and identify gaps and future needs. The synergy between the survey results and the final report, along with the high-level meeting discussions, will be an important step forward in developing a future action plan and setting goals jointly in an effort to improve the health of refugees and migrants across the Region and beyond. UN City, Marmorvej 51 Tel.: +45 45 33 70 00 Email: [email protected] DK-2100 Copenhagen Ø Fax: +45 45 33 70 01 Website: http://www.euro.who.int Denmark The focal point for data collection and reporting is Dr Elisabeth Waagensen, Migration and Health Programme at the WHO Regional Office for Europe. Should you have any queries related to the questionnaire, please contact the Migration and Health Programme at [email protected]. Please kindly complete the questionnaire and return it to us, at your earliest convenience but no later than 23 December 2021. Thank you for your continued commitment to the health of refugees and migrants and looking forward to our future cooperation. Yours faithfully, Dr Gundo Aurel Weiler Director Division for Country Support, Emergency Preparedness and Response –2– Questionnaire to follow up on the implementation of the Strategy and Action Plan for Refugee and Migrant Health in the WHO European Region third and final round of implementation reporting for the RC72 in 2022 Introduction The questionnaire aims to collect national data to measure and monitor the implementation of the Strategy and Action Plan for Refugee and Migrant Health in the WHO European Region , which was adopted by all Member States of the Region during the 66th session of the WHO Regional Committee for Europe in 2016 . Implementation progress reporting is mandated by EUR/RC66/R6. The questionnaire has been developed based on the five indicators in the Strategy and Action Plan ( Annex 2 ). The questions should be answered based on the activities carried out by the Member State to date, or any new activities since the last round of questions were issued in December 2019 if the M ember S tate provided information to that round of implementation reporting. Please note that the WHO Regional Office for Europe uses the term refugees and migrants to refer to refugees and all groups of migrants, including asylum seekers, irregular migrants, migrant workers, victims of human trafficking across international borders and more, unless otherwise specified. The survey consists of 43 questions ; however , not all questions need to be answered as some are dependent on the response to the previous question . There is a box for general comments at the end of the survey. Completing the survey : i nstructions The questionnaire is provided in a Word document format that can be shared internally in Member States with responsible stakeholders. We kindly ask that each Member State submit only ONE consolidated form with responses. You are encouraged to select the answer that is most representative for your Member State . I t may require contact with other relevant stakeholders/bodies to respond . When mandatory (*) sections are incomplete or un answered, it will not be possible for WHO to use the submitted responses at all . WHO may revert to you if answers are missing . The data obtained from the Questionnaire will be reported in an aggregated format , without mentioning country names, during the 7 2nd session of the WHO Regional Committee for Europe in 202 2 . The presentation of the results may only contain specific country names when highlighting best practices. The data may also be used in other relevant WHO publications on the same terms . MANDATORY FIELDS (*) We, hereby, ask your consent to share relevant results of this survey with Uppsala University, Department of Women's and Children's Health for analysis purposes only , under appropriate contractual modalities, including confidentiality obligations and strict prohibitions on sharing any data or information with anyone . ☐ Yes, I agree ☐ No, I do not agree ( p lease do not comp l ete the survey as WHO will not be able to analy s e your responses) . Your contact details will only be used for communication with you, e.g. for updates and additional questions on the Questionnaire. Your contact details will be removed and erased as soon as this communication is not opportune anymore or on your first request. The data without your contact details will be stored for 10 years. We, hereby, ask your consent to the processing of personal information included in this Questionnaire, according to the above statement. ☐ Yes, I agree ☐ No, I do not agree Contact information (ALL FIELDS MUST BE FILLED) * Name of authorized representative: Click or tap here to enter text. * Job title: Click or tap here to enter text. * Ministry/organization: Click or tap here to enter text. * Country: Click or tap here to enter text. * E-mail address: Click or tap here to enter text. * Phone number: Click or tap here to enter text. Section A. Indicator 1: e valuating national health policies, strategies and plans Total number of questions: 7 Policies, strategies and plans * A.1. Does the national health policy, strategy and/or plan have at least one explicit component • on migration and health? • Explicit component on migration and health: written documentation on promoting equal access to health services for refugees and migrants on a par with the host population ; an increase in social protection for these population groups; policies that respect the right to health and promote the well-being of all at all ages. ☐ Yes ☐ No A.1.a (if response to question A.1 is Yes ). Please indicate to which migrant group(s) the policy/strategy/plan applies. Choose all that apply. ☐ Refugees ☐ Asylum seekers ☐ Irregular migrants ☐ Labour migrants ☐ Other groups, please specify : Click or tap here to enter text. A.1.b (if response to question A.1 is Yes ). Which aspect(s) of refugee and migrant health does the explicit component(s) refer to? Choose all that apply. ☐ Access to health-care services • • This could include measures to reduce legal, administrative, language and financial barriers limiting access to health care. ☐ Social protection • • Social protection in health means warranty given by society, through a country’s public authorities, to ensure that an individual, or group of individuals, can satisfy their health needs and demands and obtain adequate access to the health system or any of its subsystems without the ability to pay being a limiting factor . ☐ Collection of data on refugee and migrant health ☐ Training for health-care professionals ☐ Other, please specify : Click or tap here to enter text. Strategic priority areas A. 2 . a (if response to question A.1 is Yes ). Which of the nine strategic areas does the component(s) address? Choose all that apply. ☐ Strategic area 1: establishing a framework for collaborative action ☐ Strategic area 2: advocating for the right to health of refugees, asylum seekers and migrants ☐ Strategic area 3: addressing the social determinants of health ☐ Strategic area 4: achieving public health preparedness and ensuring an effective response ☐ Strategic area 5: strengthening health systems and their resilience ☐ Strategic area 6: preventing communicable diseases ☐ Strategic area 7: preventing and reducing the risks posed by noncommunicable diseases ☐ Strategic area 8: ensuring ethical and effective health screening and assessment ☐ Strategic area 9: improving health information and communication A. 2 . b ( i f response to question number A.1 is Yes ). Wa s the above-mentioned component (s) added since September 20 16 ? ☐ Yes ☐ No A. 2 . c ( i f response to question number A. 2.b is Yes ). Was any component added since January 20 20? ☐ Yes ☐ No A. 2 . d (if response to question A.1 is No ). Are there plans to include component(s) on migration and health in the national health policy, strategy and/or plan in the future ? ☐ Yes ☐ No Section B. Indicator 2: e valuating the assessments of the health needs of refugees, asylum seekers and migrants Total number of questions: 1 4 Health n eeds * B.1. Has at least one assessment been conducted within the national or regional health system on the health needs of refugees and migrants? ☐ Yes ☐ No B.1.a (if response to question B.1 is Yes ). Which of the following areas were covered during the health needs assessment ? Choose all that apply. ☐ Communicable diseases , excluding COVID-19 (see Section F) ☐ Noncommunicable diseases, excluding mental health ☐ Mental health ☐ Sexual and reproductive health ☐ Maternal and child health ☐ Adolescent health ☐ Older refugees and migrant s ☐ Long-term care, special needs, disabilities ☐ Rehabilitation ☐ G ender aspects of health needs ☐ Living conditions, including detention and detention-like settings, or people living on the streets, in government housing or in private dwellings ☐ Unaccompanied m inors ☐ Health - care needs for health-care workers who are refugees and migrants or are working with refugee and migrant populations ☐ Other, please specify : Click or tap here to enter text. B.1.b (if response to question B.1 is Yes ). Please provide a brief description of the assessment(s) conducted. Click or tap here to enter text. B.1.c (if response to question B.1 is Yes ). Was the health needs assessment conducted since September 20 16 ? ☐ Yes ☐ No B . 1 . d ( i f response to question number B.1.c is Yes ). W as any component added since January 20 20? ☐ Yes ☐ No B.1. e (i f response to question B.1 is Yes ). Please indicate which migrant group(s) was covered by the assessment(s). Choose all that apply. ☐ Refugees ☐ Asylum seekers ☐ Irregular migrants ☐ Labour migrants ☐ Other groups, please specify : Click or tap here to enter text. B.1. f (if response to question B.1 is No ). Are there plans to conduct such assessments in the future ? ☐ Yes ☐ No Health service coverage * B.2. Has at least one assessment been conducted within the national or regional level on the health service coverage for refugees and migrants? ☐ Yes ☐ No B.2.a (if response to question B.2 is Yes ). Which of the following areas were covered during the health service coverage assessment ? Choose all that apply. ☐ Communicable diseases , excluding COVID-19 (see Section F) ☐ Noncommunicable diseases, excluding mental health ☐ Mental health ☐ Sexual and reproductive health ☐ Maternal and child health ☐ Adolescent health ☐ Older refugees and migrants ☐ Long-term care, special needs, disabilities ☐ Rehabilitation ☐ Gender aspects of health s ervices ☐ Living conditions (examples include detention and detention-like settings, people living on the streets, government housing or private dwellings ) ☐ Unaccompanied m inors ☐ Health -c are w orkers who are migrants or are working with refugee and migrant populations ☐ Other, please specify : Click or tap here to enter text. B.2.b (if response to question B.2 is Yes ). Please provide a brief description of the assessment(s) conducted. Click or tap here to enter text. B.2.c (if response to question number B.2 is Yes ). Was the health service coverage assessment conducted since September 20 16 ? ☐ Yes ☐ No B . 2 . d ( i f response to question number B. 2 .c is Yes ). Was any component added since January 20 20? ☐ Yes ☐ No B.2. e ( i f response to question B.2 is Yes ). Please indicate which migrant group(s) was covered by the assessment(s). Choose all that apply. ☐ Refugees ☐ Asylum seekers ☐ Irregular migrants ☐ Labour migrants ☐ Other groups, please specify : Click or tap here to enter text. B.2. f (if response to question B.2 is No ). Are there plans to conduct such assessments in the future ? ☐ Yes ☐ No Section C. Indicator 3: e valuating contingency planning and preparedness Total number of questions: 4 * C.1. Does the Member State have a regional or national contingency plan • for large arrivals of refugees and migrants? • A contingency plan should define the roles and responsibilities of the authorities and stakeholders and establish a homogeneous procedure to improve the organizational aspect of the public health response by increasing the efficiency of logistics and human resources . ☐ Yes ☐ No C.1.a (if response to question C.1 is Yes ). Was the contingency plan developed or revised since September 20 16? ☐ Yes ☐ No C . 1 . b ( i f response to question number C.1.a is Yes ). Was any component added since January 20 20? ☐ Yes ☐ No C. 1 . c ( i f response to question C.1 is No ) . Is the Member State developing such a contingency plan or does it have plans to do so? ☐ Yes ☐ No Section D. Indicator 4: e valuating health information and communication to prevent communicable diseases Total number of questions: 5 * D.1. Does the Member State routinely collect and include data on migration-related variables • in the existing local/regional/national datasets? • Examples of migration-related variables: migratory status, country of birth , citizenship, date of arrival into the country, country of birth of both parents, mode of travel, reason for migration . It may also include k nowledge of host country’s language and other variables providing information on factors affecting the health of refugees and migrants . ☐ Yes ☐ No D.1.a (if response to question D.1 is Yes ). What are the main sources • for data on refugee and migrant health? Choose all that apply. • Examples of sources. Population-based records: death/birth registration, census. Medical/utilization records: health facility records in which data are generated upon utilization of health-care services at primary, secondary or tertiary level. Health interview surveys : include population-based household surveys, behavioural surveillance surveys and health monitoring surveys. Disease-specific registers: for specific diseases such as tuberculosis or cancer. Surveillance/notification systems: for infectious diseases. ☐ Population-based records ☐ Medical/utilization records ☐ Health interview surveys ☐ Disease-specific registers ☐ Surveillance/notification systems ☐ Others, please specify : Click or tap here to enter text. D.1.b (if response to question D.1 is Yes ). Did the Member State start to collect data after September 20 16? ☐ Yes ☐ No D . 1 . c ( i f response to question number D.1.b is Yes ). Was data collection started by the Member State since January 20 20? ☐ Yes ☐ No D.1. d (if response to question D .1 is No ). Is the Member State developing such data collection or does it have plans to include migration-related variables in existing data collection tools? ☐ Yes ☐ No Section E. Indicator 5: e valuating social determinants for health Total number of questions: 6 * E.1. Has at least one assessment been conducted at the national or regional level to evaluate social determinants of health • among refugees and migrants? • The social determinants of health are the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. Examples of social determinants of health: employment, gender, education, social exclusion, race, ethnicity, physical environment (housing) . ☐ Yes ☐ No E.1.a (if response to question E.1 is Yes ). Did the Member State conduct the assessment after September 20 16 ? ☐ Yes ☐ No E . 1 . b ( i f response to question number E.1.a is Yes ). Was any component added since January 20 20? ☐ Yes ☐ No E.1. c (i f response to question E.1 is Yes ). Does the Member State involve non-health sectors • and stakeholders in conducting assessments of the health needs (including social determinants of health) of refugees and migrants? • Examples of non-health sectors: education, labour, housing, security. ☐ Yes ☐ No E.1 . d (if response to question E.1. c is No ). Is the Member State developing or does it have plans to involve non-health sectors in the conduct of assessments in the future ? ☐ Yes ☐ No E.1. e (if response to question E.1 is No ). Are there plans to conduct such assessments in the future ? ☐ Yes ☐ No Section F. COVID-19 pandemic and the impact on the implementation progress of the Strategy and Action Plan Total number of questions: 3 F.1. Ha ve any of the elements mentioned in the previous five sections been directly or indirectly influenced • (positively or negatively) by the COVID-19 pandemic? ☐ Yes ☐ No • E xample s of influence: collecting data on migratory status in a survey connected to COVID-19 OR including refugee and migrants in the national health policies because national/regional data showed how refugees and migrants might have been disproportionately affected by COVID-19 OR delay in conducting a planned health service coverage survey F.1.a (if response to question F.1 is Yes ) Which of the following areas below have been positively or negatively influenced by the COVID-19 pandemic? Choose all that apply: ☐ Indicator 1: e valuating national health policies, strategies and plans ☐ Indicator 2: e valuating assessments of the health needs of refugees, asylum seekers and migrants ☐ Indicator 3: evaluating contingency planning and preparedness ☐ Indicator 4: e valuating health information and communication to prevent communicable diseases ☐ Indicator 5: e valuating social determinants for health F.1. b If you have selected any of the i ndicators above, please explain below how the COVID-19 pandemic has influenced/is influencing the indicator area or the implementation of any element of the 9 strategic priority areas in the Strategy and Action Plan in your country : Click or tap here to enter text. Section G . P rogress to date and way forward Total number of question s : 4 G.1.a. As we come to the close on the Strategy and Action Plan 2016 – 2022, we would like to ask our Member States to reflect on its key aspects that ha ve been successfully implemented in your country , and why ? Click or tap here to enter text. G.1.b. Which elements have been difficult to implement, and why? Click or tap here to enter text. G.1.c. Which aspects of developing, implementing, following-up and reporting of the Strategy and Action Plan have been challenging, and why? Click or tap here to enter text. G.1.d. Which topics within refugee and migrant health have the highest priorities in your country and should be included in a future Strategy and Action Plan ? Click or tap here to enter text. Section H . Conclusion and final remarks Comment box for comments on the survey ( optional ; limit is 1000 words ). Click or tap here to enter text. Thank you for answering this questionnaire on behalf of your country . P lease, ensure that all responses from your country are consolidated into ONE form and that the mandatory fields are completed before sending it to the Migration and Health Programme at WHO Regional Office for Europe ( [email protected] ) . Privacy and personal data protection I. Data are the basis for all sound public health actions and the benefits of data sharing are widely recognized, including scientific and public health benefits. Whenever possible, WHO wishes to promote the sharing of health data, including but not restricted to surveillance and epidemiological data. As used herein, the term "Data Provider " means a duly authorized representative of the governmental body with authority to release health data of the country to WHO ( i.e. the Ministry of Health or other responsible governmental authority). The recipient of this Questionnaire is responsible for ensuring that he/she is the Data Provider , or for providing this Questionnaire to the Data Provider . In this connection, and without prejudice to information sharing and publication pursuant to legally binding instruments (such as the International Health Regulations (2005)) by providing data to WHO, the Data Provider : confirms that all data to be supplied to WHO hereunder have been collected in accordance with applicable national laws, including data protection laws aimed at protecting the confidentiality of identifiable persons; agrees that WHO shall be entitled, subject always to measures to ensure the ethical and secure use of the data, and subject always to an appropriate acknowledgement of the country: to publish the data, stripped of any personal identifiers (such data without personal identifiers being hereinafter referred to as “the Data”) and make the Data available to any interested party on request (to the extent they have not, or not yet, been published by WHO) on terms that allow noncommercial, not-for-profit use of the Data for public health purposes (provided always that publication of the Data shall remain under the control of WHO ); to use, compile, aggregate, evaluate and analyse the Data and publish and disseminate the results thereof in conjunction with WHO’s work and in accordance with the Organization’s policies and practices. The Data Provider may in respect of certain data opt out of (or any part of) the above, by notifying WHO thereof in writing at the address listed below , provided that any such notification shall clearly identify the data in question and clearly indicate the scope of the opt-out ( in reference to the above), and provided that specific reasons shall be given for the opt-out. The data will be passed on to Uppsala University, Department of Women's and Children's Health, which will analyse the data for WHO under appropriate contractual modalities and confidentiality obligations. For any other use by WHO not covered in this Addendum, WHO will send a separate request to the designated focal points for the purpose of this questionnaire. This Questionnaire conforms to the WHO policy on the use and sharing of data collected by WHO in Member States. For further information please see the WHO Data Policy at the following link: Data policy (who.int) For additional information about the Questionnaire and the monitoring of the implementation progress of the Strategy and Plan for Refugee and Migrant health in the WHO European Region, please contact: Migration and H ealth P rogramme Country Implementation Support Unit Division for Country Support, Emergency Preparedness and Response WHO Regional Office for Europe [email protected] Saatja: WHO EURO Migration Health Programme <[email protected]> Saadetud: 01.12.2021 12:13 Adressaat: Elen Ohov <[email protected]> Koopia: Triin Uusberg <[email protected]>; SM Info <[email protected]>; <[email protected]>; <[email protected]>; <[email protected]>; <[email protected]>; KÖHLER, Kristina <[email protected]> Teema: Letter from WHO Regional Office for Europe - Last round of monitoring survey 2021-2022 on Migrant Health Please see the attached correspondence sent from the World Health Organization, Regional Office for Europe. One or more attachements may be included.Veuillez vous r¨¦f¨¦rer ¨¤ la correspondance ci-jointe du Bureau r¨¦gional de l'Europe de l'Organisation mondiale de la sant¨¦. Une ou plusieurs annexes peuvent ¨ºtre jointes.Mit der Bitte um Kenntnisnahme der beiliegenden Korrespondenz (eine oder mehrere Anlagen), Weltgesundheitsorganisation, Regionalb¨¹ro f¨¹r Europa. §³§Þ. §á§â§Ú§Ü§â§Ö§á§Ý§Ö§ß§ß§à§Ö §á§Ú§ã§î§Þ§à §à§ä §¦§Ó§â§à§á§Ö§Û§ã§Ü§à§Ô§à §â§Ö§Ô§Ú§à§ß§Ñ§Ý§î§ß§à§Ô§à §Ò§ð§â§à §£§ã§Ö§Þ§Ú§â§ß§à§Û §à§â§Ô§Ñ§ß§Ú§Ù§Ñ§è§Ú§Ú §Ù§Õ§â§Ñ§Ó§à§à§ç§â§Ñ§ß§Ö§ß§Ú§ñ (§à§Õ§Ú§ß §Ú§Ý§Ú §ß§Ö§ã§Ü§à§Ý§î§Ü§à §á§â§Ú§Ü§â§Ö§á§Ý§Ö§ß§ß§í§ç §æ§Ñ§Û§Ý§à§Ó). Ms Simona Melki Country Implementation Support for Impact Unit Division of Country Support, Emergency Preparedness and Response (CSE) World Health Organization ©¦Regional Office for Europe UN City - Marmorvej 51 - 2100 Copenhagen Ø, Denmark Phone: ©¦