- Report -

Ukraine

Making every school a health-promoting school: global standards and indicators

Credits

author

Outcome

Improved access to quality essential health services irrespective of gender, age or disability status

[COUNTRY STORY]

Strengthening access to health for migrants in Chile

Chile

Photo: PAHO/WHO Chile A dupla team provides information about health services in a public park in Chile.

Improving migrants access to social and health services

During the COVID-19 pandemic and due to the international border closures from 2020 to 2022, over 100,000 people entered Chile's northern tri-border region. With limited documentation, they had limited rights and access to basic services. They were also vulnerable to mental health issues, violence, COVID-19, and human trafficking. To address this humanitarian crisis, Chile’s Ministry of Health (MoH) requested support from the Pan American Health Organization (PAHO/WHO) who established local health support teams, or “duplas”. By 2021, 11 duplas had conducted 10,000 interventions, representing 50 percent of the total interventions provided by the Inter-agency Coordination Platform for Refugees and Migrants from Venezuela (R4V) in the country [1]. The programme’s success led to its expansion with 28 duplas consisting of 56 professionals working in six regions of Chile by mid-2022.

Key WHO Contributions

Forming a working group to deliver planning support
Funding, training, and equipping 56 health professionals to work in 28 “dupla” teams that help migrants access health and social services
Monitoring duplas activities to identify needs and gaps and update the action plan
Coordinating with diverse regional, national, and international actors to align activities and mobilize resources.

How did Chile, with the support of the PAHO/WHO Secretariat, achieve this?

In February 2021, the MoH received planning support from PAHO/WHO Chile. The office proposed forming a working group led by the MoH and including various United Nations (UN) Agencies. The group examined migration routes, identified three areas of critical need in Chile's northern region, and conducted field visits to assess the situation using an adapted Rapid Needs Assessment Methodology.

PAHO/WHO Chile funded 11 clinical and psychosocial health professionals to meet migrants' identified health needs. PAHO/WHO Chile provided the professionals with training, Personal Protective Equipment (PPE), first aid kits, transportation, and other necessary supplies to establish the dupla teams. The training covered various topics, including their responsibilities, national health legislation and policies, organization of health services and social support networks, human rights, Security in the Field (Bsafe), Prevention of Sexual Exploitation and Abuse, Psychological First Aid, gender, maternal and child health, and intercultural competencies. PAHO/WHO’s global, regional, and national resources were used for training, adapted to the local context by PAHO/WHO Chile.

Upon arrival, migrants relied on duplas as their initial point of contact for healthcare needs. The duplas provided health assessments and guidance on accessing health services, while also connecting migrants with relevant government, Civil Society Organizations (CSOs), and International Organizations. They educated migrants on their rights and administrative procedures, empowering them to access social and health services that complied with national legislation and norms. If necessary, they accompanied people to health care establishments to overcome cultural barriers. For complex cases such as children, older adults, and pregnant women, tailored responses were available as migrants were linked to Chile's wider social protection system.

^{Dupla teams work in areas of highest need, such as this shelter in Colchane, a border-region of Chile.}Photo credit:PAHO/WHO Chile.

Duplas present PAHO/WHO Chile with a monthly activity report, offering a comprehensive overview of individual, familial, and community interventions, health, and demographic information. The data is shared with the MoH and collected in the Regional Refugee and Migrant Response Platform (R4V), a coordination platform that includes over 200 organizations working together under the Venezuela Refugee and Migrant Response Plan (RMRP) across 17 countries in Latin America and the Caribbean. PAHO/WHO is currently piloting a web-based reporting system and mobile application to streamline this process.

To further enhance coordinated action, PAHO/WHO Chile enlisted a consultant to help the MoH with coordination and supervision. The dupla project coordination team, consisting of the MoH's Department of Public Health Policies, Department of Primary Health Care, and PAHO/WHO Chile, meets regularly to identify needs and gaps. In August 2021, a joint technical visit was conducted to assess the project's progress and update the action plan, which resulted in the expansion of the project to 56 personnel deployed in 28 dupla teams.

"The impact of our work has been to create the first entrance to a support network for people who do not know our health system and lack support networks"

- Helena Opazo, social worker, Arica.

To strengthen the national response, PAHO/WHO Chile partnered with other UN agencies to provide training to healthcare professionals on human rights approaches and national policies related to migration. PAHO/WHO Chile also advocated with the MoH and the National Insurance Fund (FONASA) to streamline the registration process for migrants in the social security system and is a member of the United Nations Working Group on Migration, which meets every two months and works with national institutions and partners to identify solutions. Further, PAHO/WHO Chile attends Chile’s First Response Committee for Migration meetings upon the request of the Chilean MoH, leads the coordination of the Health Sector in the Inter-Agency Coordination Platform for Refugees and Migrants from Venezuela, and participates in the regional coordination mechanism for the northern region with the MoH.

“The teams have worked intensely safeguard the rights of humans to migrate with dignity, a right that is fundamental and cannot be stripped away from anyone. We, as individuals and institutions, must ensure that these rights are respected and upheld”

- David del Valle, Tarapacá Region Ministerial Secretary of Health (Seremi)

The dupla approach has been highly successful but securing resources to sustain the project remains a challenge due to Chile's high-income status. PAHO/WHO Chile continues to work to modify perceptions of migration that impede the response to the situation and advocate for the mobilization of resources and change at the highest political levels.

References

R4V - Regional Inter-Agency Coordination Platform for Refugees and Migrants from Venezuela