One in eight people on the planet is on the move. Some migrate for economic reasons, while others are forcibly displaced by one of the many conflicts raging around the world. Climate change and natural disasters are forcing more people than ever to move within and across borders. These refugees and migrants often have poor access to healthcare and therefore may have poorer health than others.
Unfortunately, global evidence and data on refugee and migrant health is largely fragmented and often limited to migration flows and some demographic characteristics. However, access to comprehensive, representative and systematically collected data is crucial for evidence-based policymaking and to create targeted interventions that will make a difference in population health and uphold the fundamental human right to health, including for the one billion people on the move.
To fill this gap, Statistics Poland and WHO have been working together to find ways to address data limitations in the context of the Ukrainian refugee crisis. In 2022 they conducted the first-ever survey of a representative sample of Ukrainian refugees in Poland, using mixed methods to uncover not just the numbers but the human story behind the refugee crisis.
The methodology was also applied to a second round of mixed surveys conducted in 2023, which also integrated big data and administrative records.
Understanding the health needs of mobile populations
Two years later, fighting continues in Ukraine, and many of the refugees who fled to Poland are unable to return home. To understand the needs and experiences of refugees in accessing and using health services, the report authors used a quantitative survey to collect data from 4,800 refugees in their homes and temporary accommodation, as well as data on the Polish-Ukrainian border.
To gain a deeper understanding of refugees’ experiences with health services, they also conducted a qualitative behavioural insight study and 30 in-depth interviews with a selected group of survey respondents to elicit further information about their health service needs and access.
Survey findings were combined with big data and administrative records, including geospatial data from mobile network operators to identify the location of the population on the move, and data from payment card operators to provide insights into the health spending patterns of Ukrainian refugees.
A methodology with global potential
At the report launch in Warsaw, Poland on June 26, Dr. Nino Verzuli, WHO Europe Representative to Poland and Special Envoy for Refugee Hosting Countries, was one of several speakers who highlighted how this data synthesis approach could be applied in other countries.
“Integrating quantitative and qualitative research with administrative and big data to develop robust estimates on refugee and migrant health will close the gap in real-time data availability and in knowledge and action to develop evidence-based health policies and practices,” she said.
“We hope that this event will inspire a renewed collaborative approach on health and statistics, solidifying plans for future joint efforts to improve data-driven health responses and promote equity in health systems in Europe and globally.”
“This groundbreaking integration of diverse data sources, including big data, reveals a nuanced picture of refugee health in Poland. Analysing both expenditure and movements provides valuable insights that enable policymakers to make informed decisions and deliver targeted and timely health interventions,” said Dr Dominik Roszkurt, Director of Statistical Office of Poland and President of the International Institute of Official Statistics.
The event demonstrated a strong desire for better data on refugees and migrants, with several other countries presenting their information needs and experiences in improving the reliability of estimates and filling data gaps.
“Refugees and migrants are particularly vulnerable. Innovative approaches are urgently needed to understand their health needs. I commend this successful collaboration between the health sector and the national statistics offices,” stressed Dr Gundo Weiler, Director of Country Support and Partnerships for WHO/Europe and Acting Regional Emergency Director.
“The methodology implemented has the potential to generate robust estimates of the health status of refugees and migrants in Poland, as well as provide a global model for host, sending or transit countries,” he added.
