Integration of migrant and refugee data in health information systems in Europe: advancing evidence, policy and practice.

Coverage of migrant and refugee data is incomplete and of insufficient quality in European health information systems. This is not because we lack the knowledge or technology. Rather, it is due to various political factors at local, national and European levels, which hinder the implementation of existing knowledge and guidelines. This reflects the low political priority given to the topic, and also complex governance challenges associated with migration and displacement. We review recent evidence, guidelines, and policies to propose four approaches that will advance science, policy, and practice. First, we call for strategies that ensure that data is collected, analyzed and disseminated systematically. Second, we propose methods to safeguard privacy while combining data from multiple sources. Third, we set out how to enable survey methods that take account of the groups' diversity. Fourth, we emphasize the need to engage migrants and refugees in decisions about their own health data. Based on these approaches, we propose a change management approach that narrows the gap between knowledge and action to create healthcare policies and practices that are truly inclusive of migrants and refugees. We thereby offer an agenda that will better serve public health needs, including those of migrants and refugees and advance equity in European health systems. Funding: No specific funding received.

Meeting the health needs of displaced people fleeing Ukraine: Drawing on existing technical guidance and evidence.

The invasion of Ukraine has unleashed a humanitarian crisis and the impact is devastating for millions displaced in Ukraine and for those fleeing the country. Receiving countries in Europe are reeling with shock and disbelief and trying at the same time to grapple with the reality of providing for a large, unplanned, unprecedented number of refugees mainly women and children on the move. Several calls for actions, comments and statements express outrage, the risks, and the impending consequences to life and health. There is a need to constantly assess the situation on the ground, identify priorities for health and provide guidance regarding how these needs could be addressed. Therefore, the Lancet Migration European Regional Hub conducted rapid interviews with key informants to identify these needs, and in collaboration with the World Health Organization Health and Migration Programme, summarized how these could be addressed. This viewpoint provides a summary of the situation in receiving countries and the technical guidance required that could be useful for providing assistance in the current refugee crisis.

Assessment of the indoor environment and implications for health in Roma villages in Slovakia and Romania.

OBJECTIVES: The objective of this paper is to provide information on indoor air quality and on the quality of the broader indoor environment of the houses in Roma villages in Slovakia and Romania and to discuss possible implications for health. METHODS: Indoor air was sampled in 11 houses in a Romanian Roma village and in 19 houses in a Slovakian Roma village. Levels of carbon monoxide (CO), carbon dioxide (CO2), total particulate matter (PM), temperature and humidity were measured. A questionnaire and a checklist were used to obtain additional information on the indoor environment and behavioural factors. We have sampled the same houses in winter and in summer. RESULTS: Levels of CO and CO2 were higher in winter in both countries as compared to summer. The limit value of 10 mg/m3 CO was exceeded in a few cases in both countries. In general, levels of CO, CO2 and PM were higher in Romania. Further environmental and behavioural hazards such as indoor smoking, pets inside or lack of ventilation were found. The reported self-perceived quality of the indoor environment was poor in many aspects. CONCLUSIONS: Our findings of CO, CO2 and PM levels suggest that indoor air pollution in Roma settlements has the potential to be a health threat. The fact that the inhabitants spend a relatively long time inside the houses and that a number of additional environmental and behavioural hazards were identified by our study emphasizes the importance of the indoor air quality for health and thus priority attention should be paid to these issues by health authorities and researchers. Further research is essential and study designs must consider cultural background and specific characteristics of the community, especially in order to obtain valid data on health outcomes.