Migration, Health and Development
Migration has always been an integral part of Sri Lanka, driving our nation's progress and economic development. Today, there are more people 'on the move' than at any other time in recorded history. Over 2 million Sri Lankans are employed overseas and they contribute the highest foreign exchange earnings to Sri Lanka. Sri Lanka is increasingly becoming a labour receiving country, with growing numbers of resident visa holders arriving each year. The Government of Sri Lanka have been working in close partnership with the International Organization for Migration (IOM) to ensure better health and development outcomes for all flows of migrant populations (inbound, outbound and internal) and the families they leave behind.
122nd Session of Executive Board of World Health Assembly
Endorsement of the Resolution on "Health of Migrants". Member countries were invited to develop Migrant friendly health environment (A61/17).
Sri Lankan Government Commitment to driving a National Agenda secured
With expressed endorsement and leadership from Minister of Health, Hon. Nimal Siripala de Silva, Chairman of the Executive Board WHO, and the president of the 62nd WHA, the Government of Sri Lanka forms partnership with IOM to establish a migration, health and development programme in Sri Lanka.
Initiating the formative phase for establishing the ground work for the migration, health and development program
IOM commitment to developing Sri Lanka’s MHD agenda
At the request of the Government of Sri Lanka, IOM through its 1035 member state funding facility, agreed to provide technical and financial assistance to catalyze the MHD agenda for Sri Lanka.
The technical partnership was consolidated via a signing of a Memorandum of Understanding between Ministry of Health and IOM on 6th January, 2010.
Global Consultation on Migrant Health, Madrid, Spain
The aim of this Global consultation was to seek ways to ensure the practical implementation of the WHA resolution on Health of Migrants adopted in 2008.
To this end, the Global consultation provided a forum to
IOM supported the Ministry of Health in participating at this landmark meeting, and contributed to the report resolutions.
1st National Consultation for Migration, health and development in Sri Lanka
Key stakeholders such as government ministries, academics, UN agencies, NGOs, foreign employment agencies got together at the launching officiated by the Hon. Minister of Health. Conceptual framework for the national migration, health and development programme was endorsed at this meeting
1st Inter Ministerial/Agency coordination framework was established
Migration Health Secretariat was established within the Ministry of Health to function as the permanent coordinating hub. Technical focal points from the each stakeholder agency were identified and Migration Health Task Force was established to formulate the policy documents and the technical proposals to be submitted at the NSC which is the highest level decision making body on policy matters and the inter ministerial coordination issues.
1st Migration Health Task Force (MHTF) meeting
Focal points from more than 10 government ministries, UN agencies and academia congregated and discussed to come to terms with issues in all domains of migration, issues in existing policies and implementation and devise the final composition of MHTF and NSC with revision of terms of reference for each of these bodies.
Representation at the regional and international scientific forums
International Epidemiological Association (IEA) conference
A joint MoH/IOM symposium on “MIGRATION HEALTH, CHALLENGES AND PERSPECTIVES” was held and the plenary speech was given by the IOM Global head on migration health and Development at global and regional level”.
Asia Pacific Academic Consortium for Public Health - 5th June 2010 , Colombo
Symposium on Migration Health Research and Development was conducted in the view of improvement of evidence base for policy and programmes.
Scientific paper presented at the 5th AAAH conference in Bali – October 2010
Best scientific paper award received for the paper presented at the Annual Sessions of the College of Medical Administrators March- 2011
1st National Steering Committee Meeting on Migration, Health and Development
National Steering Committee comprising of the highest level of decision makers including the Secretary/Director General level representatives of the key government ministries involved in migration.
Key issues to be addressed by the Migration Health Development process and the Terms of Reference of the Migration Health Task Force and proposed coordination mechanism were endorsed at this meeting.
1st regional discussion on health challenges of the Asian labour migration
Members of the Migration Health Task Force participated at the Regional Dialogue on the Health Challenges for Asian Migrant workers which was an inter country meeting with labour sending countries. A set of Joint recommendations to be followed at national and bi lateral, regional and global level recommendations were agreed upon to be submitted at the 5th Colombo Process meeting
Initiation of establishment of the health assessment for the resident visa applicants to Sri Lanka
Controller General/ Department of Immigration and Emigration solicited technical assistance from the migration health task force to establish health assessment for the resident visa applicants to Sri Lanka
A sub committee with technical expertise from vertical health programmes was appointed to develop technical guidelines to lay out the implementation plan
4th meeting of the Global Forum on migration and development
Members of the Migration Health Task Force represented migration health and development programme at the global level
Ministry of Health and IOM meets Controller General, Department of Immigration and Emigration
Discussion was conducted on establishment of health assessment for the resident visa applicants to Sri Lanka
4th Meeting of the Global Forum on Migration and Development
A Sri Lankan government delegation comprised from the ministries of Labour, Health and Foreign Employment and Migration Health Task Force represented Sri Lanka for the 1st time at global level
Launching the national research agenda- an evidence based policy process
National Migration Health Task Force/IOM commissioned national research on “Health Issues pertaining to migration” across four domains of migration i.e.: internal, out bound, inbound and families left behind on health and social issues of migration to provide imperative data to ensure evidence based migration health policy process
Treasury approval of the concept note on establishment of health assessment for the resident visa applicants to Sri Lanka
Following series of technical meetings with wide range of experts and extensive review of the literature, a technical guidance note was developed on health assessment for resident visa applicants to Sri Lanka, which was proposed to be established to prevent public health emergency and to reduce health care cost to public health sector.
3rd National Steering Committee meeting- Official endorsement of the establishment of the Health Assessment for the resident visa applicants
Technical guidelines to establish the health assessment for the resident visa applicants to Sri Lanka was officially endorsed by the NSC and decision was made to submit a cabinet paper and a technical paper for the approval of the parliament
4th Colombo Process-Discussion on Health of the migrants for the first time
Ministerial consultation in Bangladesh, Dhaka - in the view of promoting rights ,welfare, dignity, services and emergency responses, and enhanced dialogue along with cooperation among labour sending, receiving and transit countries.
Ministry of Health Sri Lanka presented the Health Issues of Out-bound Migration, which included gaps in Services and Policies
Nations 1st report card on WHA resolution on Health of Migrants
Hon. Maithreepala Sirisena, Minister of Health, presented the report card on Sri Lanka’s progress on WHA resolution on Health of migrants which was applauded by the member states and discussions are underway to request the member countries to submit annual reporting to the WHA.
Learning about the immigration health assessment and the health assessment of the refugees
Study visit to IOM, Damak, Nepal provided greater exposure to the global best practice on Immigration health assessment
High level Ministry of Health and IOM meeting in Geneva
Hon. Minister of Health agreed to provide highest level commitment and DG IOM committed for the continued technical assistance to pursue the migration, health and development agenda at the country, regional and global level.
Ensure evidence based policy process
Key findings of the national research on 4 domains of migration (Inbound, Outbound and Internal migration and Families Left Behind) were disseminated among wide range of stakeholders from different disciplines at the national scientific symposium held on 13th October.
Sensitizing returning Sri Lankan refugees on importance of health
To achieve this, a health awareness booklet was launched to be distributed among the returning Sri Lankan refugees. This booklet, printed in Tamil, the native language of the refugees consisted of health messages on a wide range of topics such as protection from landmines, accessing emergency care and primary health care. The booklet was launched by the Hon. Lalith Dissanayake Deputy Minister of Health and handed over to the Hon. Governor of the Northern Province- Major General G.A.Chandrasiri.
Launch of the web portal- "Migration Health and Development"
The web portal on Migration Health and Development in Sri Lanka was co-launched by Dr Ravindra Ruberu, Secretary, Ministry of Health and Mr Richard Danziger, Chief of Mission, IOM, at the event held in Auditorium, Family Health Bureau with the presence of key stakeholders of Different Ministries, academia and media personnel.The website contains latest news related to migration and health, and all the information on policy process and research pertaining to policy development, along with the publications related to field and important to Sri Lanka which can be downloaded directly, and a collection of images related to development of the National Policy on Migration and Health. This will act as the knowledge hub for any person involved in the field.
The launch was followed by media seminar, during which the research findings, done specifically with the intention of evidence based policy process and the current state of the National Policy on Migration Health was distributed to key persons and Media.
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Since the adoption of the WHA resolution on “Health of Migrants” in 2008, the Government of Sri Lanka has progressed rapidly in developing the national agenda on migration health development. Recognizing that migration health has multi-sectoral determinants and impacts, the Migration Health Development programme was launched in 2009 in Sri Lanka. This programme, spearheaded by the Ministry of Health adopted a whole of government approach involving 12 key Government Ministries to advance the Sri Lanka’s Migration Health Agenda.
Inter-ministerial coordination mechanism has achieved remarkable progress in a very short amount of time. The Migration Health Taskforce (MHT) comprise with technical focal points from each key agency meets regularly to discuss the issues related to programme implementation and a high level policy decision are taken by the National steering committee on Migration Health (NSC) chaired by the Secretary of Health. A secretariat has been established within the Ministry of Health (MOH) with the support of IOM to act as the permanent coordinating hub.
Through this coordination framework, the Government of Sri Lanka has also proactively responded to the emerging migration health related challenges faced by the nation, such as the health services provision for returning refugees and the health assessments of the resident visa applicants to the country.
IOM supports the Ministry of Health’s Migration Health Strategy through the following broad areas of work:
IOM Sri Lanka received seed funding from IOM’s 1035 Facility to catalyze this important technical cooperation strategy.
After a series of discussions and high-level decisions at Ministerial level, the Government of Sri Lanka, led by MOH, committed to developing a “National Migration Health Policy”. A motion was also taken that the National policy and resulting work plans would not only be limited to Labour migration, but also encompass outbound, inbound, internal migration, with an aim and focus of responding to the health related impacts of throughout the migration cycle (pre-departure, travel, at destination and upon return). The health and social impacts migration places on the ‘families left behind’, was also a key consideration for the Government.
The Ministry of Health with the technical assistance of the IOM has commissioned a National Research agenda on Migration Health, to facilitate an “evidence-based” approach for guiding the technical cooperation and for policy formulation. A National Symposium on migration health is planned in late 2011 for the 4 research institutes to present their study findings, and for government, civil society, development partners, United Nations agencies and relevant industry groups to discuss and debate the implications of research findings for policy and planning.
The Sri Lankan Government has been highly active in regional and international forums (e.g. Colombo Process, Global forum on Migration and Development) in advancing the agenda on migration health and development and at the 64th World Health Assembly (WHA) in 2011 became the first country to report on the progress of the WHA resolution on Health of Migrants.
The 6 key programming elements contributing to the success of the Migration, Health and Development project in Sri Lanka are:
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As an island nation at an important geographical location at the heart of the Indian Ocean, migration has always been an integral part of Sri Lanka, be it by traders or colonial invaders. With the end of a protracted civil conflict in early 2009, Sri Lanka now prepares to embrace a new chapter of lasting peace and development. The ruling Government’s Political Manifesto “Mahinda Chintanaya” places strong emphasis on migration as a key engine for economic development. With booming investments, enhanced tourist numbers, increased international connectivity via newly developed international sea and airports, rising numbers of Sri Lanka’s labour migrant workforce to regions beyond gulf states, growing numbers of foreign workers for state and investment projects in Sri Lanka, increasing internal population mobility via road, rail and port networks and the concomitant rise in rural to urban sprawl, Sri Lanka is truly a country ‘on the move’ with global connectivity…perhaps more than any other time in the Nation’s history.
Sri Lankan health authorities have increasingly become aware of the major migration health challenges, particularly in meeting the health demands of the various types of migrant and mobile populations. The Government have been working in close partnership with the International Organization for Migration (IOM) since 2009 to ensure better health outcomes for the 3 flows of migrant populations (inbound, outbound and internal) and their families.
The Colombo process functions as an inter-ministerial coordinating body for safe and effective migration of workers. The inaugural meeting was held in 2003 in Colombo, Sri Lanka.
Reports of the Colombo process
This multi-stakeholder meeting was conducted in Bangkok in 2010 to discuss the health challenges and priorities associated with labour migration in, and from, South and Southeast Asia.
Acting as the decision making body of World Health Organization (WHO), WHA focuses on specific health agendas prepared by its executive committee. During the 61st WHA, which was chaired by Sri Lanka, the resolution on "Health of Migrants" was adopted.
An informal, non-binding, voluntary and government led initiative of the United Nations Member states to address the migration and development in an action oriented way.
Guided by the resolution on health of migrants from 61st WHA, the IOM and Ministry of Health and Social Policy of Spain organized a global consultation on Migrant Health in 2010, with the participation of government and other resource agencies/persons to formulate data on migration, legislation and actions on health of migrants and to encourage dialogue between various sectors involved in migration
Held in 2010, at a crucial time to the region which is experiencing social, epidemiological, and demographic transitions, the meeting was themed to promote use of best evidence in making decisions about planning and delivery of health services
APACPH is committed to improve professional education for public health to tackle unique public health challenges of the Asia Pacific region, including health of migrants. The session highlighted the importance for academic community to engage in research surrounding migration, health and development and to provide an evidence base for policy and programmes
The Government of Sri Lanka presents the final draft of the National Migration Health Policy for public debate after a 3-year development process.
Although nearly one in ten Sri Lankans are employed overseas and earning the highest remittance to the country, little was known about the impact of their migration on their health vulnerabilities or the health status of the families they leave behind. The health impact of other migrant and mobile populations from internal, outbound and inbound migration categories had also never been systematically determined until IOM partnered with the Government of Sri Lanka to establish a national migration health program in December 2009. As part of this, IOM and the Ministry of Health worked collaboratively to conduct a national research to determine the health vulnerabilities and status of migrant and mobile populations in order to inform policy and program development.
As a result of this effort, on 28th November 2012, the Hon. Minister of Health, Maithripala Sirisena, presented the National Policy document to the government and for public debate.  More than 60 senior government officials, policy makers, UN, NGOs and academics who were involved in the policy making process converged at the Cinnamon Hotel in Colombo for the presentation and discussion of the policy draft.
This week’s presentation of the policy document marks a major milestone not only for the Government of Sri Lanka but for IOM’s global work on addressing the health needs of migrant and mobile populations, and for advancing the World Health Assembly Resolution on the Health of Migrants. Indeed Sri Lanka became also the first country within the United Nations Health Assembly to present progress on the World Health Assembly Resolution on Health of Migrants in 2011.
Says Hon. Minister of Health: “In the situation of increasingly mobile population and dependency on revenue in Sri Lanka, the main challenge we face is to ensure migrants health and safety to facilitate productive migration and to protect our community, public health system and the economy to minimize the negative impacts of migrationâ€
The distinguishing features of the three year migration health development process are threefold: firstly, the entire policy making process has been orchestrated through an evidence-based approach; secondly, the process has taken a Inter governmental/ multi stakeholder  approach with 13 government ministries, academics, UN agencies and civil society participation; thirdly, the process had sought to address not only the health of outbound labour migrants but encompassed all migrant categories –inbound, outbound and internal. In addition, the process also addressed the health concerns of the families and children left behind.
Already the policy process has led to a number of significant outcomes including parliamentary approval to establish health assessment as part of the resident visa application process; capacity building of the staff in Sri Lanka’s Foreign Employment Bureau and port medical officers on managing cases of migrant worker abuse; an establishment of a “healthy return and re-integration†program for returning refugees from India.
The World Health Assembly (WHA) which convenes once a year is the decision making body of World Health Organization (WHO) to discuss commitments to Global public health issues and concerns. The resolution was first endorsed by the Sixty-first World Health Assembly in May 2008, which was chaired by Sri Lanka . The 2008 WHA Resolution on health of migrants calls upon Governments to facilitate migrant-sensitive health policies and equitable access to services; Capacity building of health system, service providers and professionals; bi- and multi-lateral cooperation, and intersectoral action to ensure health inequalities of migrant flows are mitigated in order for a safe, healthy and productive migrant experience for all.
Sri Lanka was the first nation to report on World Health Assembly (WHA) resolution on health of migrants. Sri Lanka recognizes the importance of migration plays as a key engine for the country’s economic development and also ensuring better public health outcomes. Assessing and addressing the social and health consequences for migrant and mobile populations is also a vital step in health protection for the nation.
Following the adoption of this resolution, Sri Lanka is spearheading a multi-ministerial and evidence based process towards developing a National Policy and program agenda on Migration Health, with assistance from the International Organization of Migration (IOM).
The Sixty-fifth session of WHA took place in Geneva during 21–26 May 2012. The Hon. Minister of Health Mr. Maithripala Sirisena presented the 2nd Country report card on “Health of Migrants” during this session.
The Government of Sri Lanka with the support of IOM launched a web-portal on “Migration, Health and Development” on Monday 19th December, at the Auditorium of the Family Health Bureau. The website will act as an ‘information hub’ for public, policy makers, researchers and industry groups to understand the health, social and economic impacts migration has the various migrant flows: ‘outbound’ labour migration, ‘internal’ migration, ‘inbound’ migration and the impacts on ‘left behind’ families and chidlren. The web-portal will also contain techincal fact sheets on the key-findings emerging from the 5 scientific research studies on migration health which was commissioned by the Inter-Ministerial Taskforce on Migration health in collaboration with IOM. These will be published in English, Singhalese and Tamil languages.
The Secretary of Ministry of Health (MOH), Dr Ravindra Ruberu, and the Chief of Mission, IOM Sri Lanka Mr Richard Danziger co-launched the Migration, Health and Development web-portal, which will be linked to both the MOH and IOM websites. The website will also be a site to track Sri lanka’s progress on advancing the Health of Migrant’s Resolution and contain all development milestones toward the establishment of a “National Migration Health Policy” for the Nation.
On the 18th of December, the Ministry of Health and IOM also launched a series of posters and leaflets in both Sinhalese and Tamil laungagues on promoting messages on ‘safe and healthy migration’, promoting ‘informed choice’ for families in the migration process, actions to mitigate health and social impacts for both the migrant worker and for the families and children left behind. These resource materials were developed by IOM and MOH after extensive rounds of consultations with key informants and pre-testing.
Over 20,000 leaflets will be distributed via a major nation wide campaisgn comprised of a series of awareness raising walks throughout the island starting on the 18th December. This major campaign to raise nationwide awareness on the contribution migrant workers make to the nation, led by the Ministry of Foreign Employment, Promotion and Welfare, was launched by His Excellency, the President of Sri Lanka, Mahinda Rajapaksha.
Led by the Ministry of Foreign Employment, Promotion and Welfare and launched by His Excellency president Mahinda Rajapaksha at Galleface, with the aim of raising awareness on the contribution of the migrants to the nation.
The Government of Sri Lanka presents the final draft of the National Migration Health P ...
