Migrant Health -

1. Programa Nacional de Salud 2001-2006 Migrant Health - Salud del Migrante January 2002

2. ¿Who are migrants? THEY MOVE: 13.9 millon Internally 11.8 To Foreign Countries 3.0 THEY COME FROM: • Large Cities 32% • <15000 habs 68% THEY WORK IN: • Agriculture 50% • Industry 26% • Services 25%

3. Mobility Patterns 3 millon to Foreign Countries 11.8 millons internally 502 municipalities very high mobility 20.5% of the total 2.8%

4. RISKS FOR MIGRANTS : IN THE MOVE, FAMILY DISINTEGRATION. IN THE CHANGE OF ENVIRONMENT AND CULTURE. LACK OF ACCESS TO HEALTH SERVICES EXPOSURE TO: ADDICTIONS AND MENTAL DISORDERS STD AND HIV/AIDS PULMONARY TUBERCULOSIS DIARRHEIC DISEASES RESPIRATORY INFECTIONS OTHER PROBLEMS: INCOMPLETE IMMUNIZATION SCHEDULE WOMEN HEALTH

5. Non migrants Non migrants Migrants Migrants 3.2% 0.8% 10.5% 3.5% 5.3% 1.3% 0.3% ---- -- -- 0.7% -- --- --- --- --- Inhalants Marijuana Cocaine Heroine Use 11+ times Health IssuesDrug use in rural communuties with high levels of migration Source: Salgado de Snyder & Díaz, Jalisco, México. INP, 1997

6. The risk of exposure to HIV/AIDS is 5 times greater in migrant population. For ex: Intravenous Drugs California 13.6% Mexicans vs. 1% national level. HEALTH ISSUES

7. 20 percent of the total new cases of tuberculosis notified yearly in the United States corresponds to Mexican migrants. HEALTH ISSUES

8. The prevalence of diabetes mellitus in the rural areas is twice as much as the one observed in the general population. HEALTH ISSUES

9. Protect the health of migrant population, through information and health care in their place of origin and the place of destination. Objective“Health Shield:Leave Healthy, Return Healthy Program”“Blindaje en Salud: Programa Vete Sano, Regresa Sano”

10. Integrated Services to Migrant Health Model (MAIS) FROM THE TRADITIONAL SERVICES PARADIGM TO THE SERVICES TO MOBIL POPULATIONS MODEL NATIONAL ORIGEN AND DESTINATION INTERNATIONAL DESTINATION 10 STATES MOVE TO FOREIGN COUNTRIES 502 MUNICIPALITIES ENTIRE FAMILIES 3 millon persons 11.8 millon persons PERSONS IN ORGANIZED OR CHANCE GROUPS OPTIMIZATION OF THE SERVICES SOCIAL NETWORKS ORIENTED TO LIFE CYCLE STRATEGIC SURVEILLANCE

11. SUBSTANTIVES Information to the population Preventive services Health, medical and mental services STRATEGIES Epidemiological surveillance Evaluation Program actions “Health Shield”

12. Information Guide Disease management First aid Personal hygiene and sanitation Health promotion Orientation with regards to addictions and mental health Social participation Identification of social networks Community meeting sites Migrant Associations Mutual help groups Information to the population

13. Immunization Nutritional surveillance Counseling in reproductive health Prevention of sexually transmitted infections Early detection of cancer Accident and injury prevention Alcohol and addictions prevention Oral health Preventive Services

14. National Health Weeks Immunization Card Women’s Health Card Coordination with civic and community based organizations and health sector for joint actions Preventive Services

15. “Arranque Parejo” – “Fair Start” Doctor’s appointments, emergencies and treatments Chronic Degenerative Diseases Infectious Diseases Adolescent Health Community and Migrant Health Care and Hospital referral Early detection and treatment of addictions and mental health Medical Services“In the migrant’s life cycle”

16. Simplified Epidemiological Surveillance System Evaluation of: Process Impact Epidemiological Surveillance

17. Mexico-California Cooperation Proposals • Development and distribution of “health guides” in the mexican consulates of neighbor countries • Exchange of epidemiological information • Training of community health workers promotores/as for migrant population • Exchange of health professionals and practitioners

18. Mexico-CaliforniaCooperation Cooperation Topics • Inmunizations • HIV/AIDS • Tuberculosis • Addictions* (ATOD) • Reproductive Health* *Pending to set counterpart

19. Health Week PHASE I: introductory • Binational Health Week ( October ) • Communication products of promotion PHASE II: • First National Health Week / Mexico (February) Binational Initiative • National Children’s Health Week / California (April) • Health guides • Promotores/as Training • Agenda ( health in your pocket )

20. Health Week • Counseling visits for planning of binational activities • Preparation of a communication and joint social mobilization strategy. MEXICO CALIFORNIA October 12-14, 2001 3SNS -Action in municipalities of mobile population BNTL HEALTH WEEK -Promote information on health self-care in Clinics, DHS and counties

21. Health Promotion Exchange of materials Pamphlets for health week Training Exchange of Personnel Short residencies Information Epidemiological Surveillance HIV/AIDS

22. Tuberculosis • PROMOTION • INFORMATION SYSTEM • REFERRAL SYSTEM • BINATIONAL CARD

23. Current situation • 10 federal entities selected with high mobility criteria by CONAPO. (Baja California, Colima, Guanajuato, Guerrero, Jalisco, Michoacán, Oaxaca, Puebla, San Luis Potosí y Zacatecas).

24. Current situation • 4 integrate for state interest. (Coahuila, Nayarit, Sinaloa and Tamaulipas) • 8 sent their diagnostic. (Col., Gro., Mich., Nay., Oax., Pue., S.L.P., Zac.) • 6 have a work program. (Col., Gro., Gto, Pue, Oax., S.L.P.)

25. STRATEGIC ACTIONS • Strengthening of sectorial and intersectorial coordination • Diagnosis of the health situation • Social participation with the organized communities • Utilization of the primary health care system • Human development • Marketing and social mobilization • Programming of actions and evaluations • Operating investigation

26. CHALLENGES AND OPPORTUNITIES • ARTICULATION • SYNCHRONIZATION • COMPLEMENTARIZATION • CONTINUITY