Capacity strengthening through pre-migration tuberculosis screening programmes: IRHWG experiences
Effective tuberculosis (TB) prevention and care for migrants requires population health-based approaches that treat the relationship between migration and health as a progressive, interactive process influenced by many variables and addressed as far upstream in the process as possible.
By including capacity building in source countries, pre-migration medical screening has the potential to become an integral component of public health promotion, as well as infection and disease prevention, in migrant-receiving nations, while simultaneously increasing capabilities in countries
of origin. This article describes the collaborative experiences of five countries (Australia, Canada, New Zealand, United Kingdom and the United States of America, members of the Immigration and Refugee Health Working Group [IRHWG]), with similar pre-migration screening programmes for TB that
are mandated. Qualitative examples of capacity building through IRHWG programmes are provided. Combined, the IRHWG member countries screen approximately 2 million persons overseas every year. Large-scale pre-entry screening programmes undertaken by IRHWG countries require building additional
capacity for health care providers, radiology facilities and laboratories. This has resulted in significant improvements in laboratory and treatment capacity, providing availability of these facilities for national public health programmes. As long as global health disparities and disease
prevalence differentials exist, national public health programmes and policies in migrant-receiving nations will continue to be challenged to manage the diseases prevalent in these migrating populations. National TB programmes and regulatory systems alone will not be able to achieve TB elimination.
The management of health issues resulting from population mobility will require integration of national and global health initiatives which, as demonstrated here, can be supported through the capacity-building endeavours of pre-migration screening programmes.
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Document Type: Research Article
Health Services and Policy Division, Department of Immigration and Border Protection, Sydney, New South Wales, Australia
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
Centre of Infectious Disease Surveillance and Control, Public Health England and Institute of Global Health University College, London, UK
Service Design and Performance, Immigration New Zealand, Wellington, New Zealand
Institute for Global Health, University College London, London, UK
Immigration, Refugees and Citizenship Canada, Migration Health Branch, Ottawa, Ontario, Canada
Publication date: July 1, 2017
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