New research led by University of Limerick has called for a ‘paradigm shift’ in how refugees and migrants are involved in health research.

The paper, published in the prestigious journal The Lancet and written by academic-community partners in Ireland and Portugal along with international public health leaders in Norway and WHO Geneva, calls for a paradigm shift to meaningfully involve refugees and migrants as partners in research about their health.

The authors recommend a radical reimagining of the way research is carried out so that it becomes the norm that refugees and migrants are involved as partners in the co-design and the co-production of research.

The research paper also explains the important need for creative and culturally attuned methods, including participatory and arts-based methods such as photovoice, music and singing.

The UL-led research paper was launched at the 77th World Health Assembly at the Health Forum Conference in Geneva as part of the prestigious series ‘The Lancet Regional Health – European Region’s Addressing migration and health inequity in Europe’.

Professor Anne MacFarlane of UL’s School of Medicine is lead author and Director of the University of Limerick’s (UL) World Health Organisation (WHO) Collaborating Centre for Participatory Health Research with Refugees and Migrants.

Professor MacFarlane said: “It is essential that health researchers and policy makers regard migrants and refugees as experts of their own health and value them as research partners to generate evidence that has a real impact on their health.”

The paper is co-authored with Dr Susann Huschke, also of UL’s School of Medicine, and Professor Helen Phelan of UL’s Irish World Academy of Music and Dance, community partners Ahmed Hassan, Doras Refugee Advocacy Organisation and Anna Papyan, Shannon Family Resource Centre, and international colleagues from Portugal – Professor Sonia Dias, Dr Maria Marques, Dr Ana Gama, Dr Waala Kinaan – Professor Bernadette Kumar, Norway and Dr Santino Severoni, WHO Geneva.

Dr Susanne Huschke said: “Participatory health research uses methodologies that can disrupt ‘business as usual’ because they are designed to share power in decision-making about what gets researched and how the research is done.”

Professor Helen Phelan, Co-Director of the Participatory Health Research Unit and Director of the Irish World Academy of Music and Dance said: “There is growing evidence about the value of the arts and creativity in research processes because they embrace the multiple intelligences of the feeling, thinking and sensorial body.”

Ahmed Hassan from Doras said: “In the work with our UL research partners, we have seen that participatory arts are a valuable method in enabling migrants to share their own experiences of health and well-being”.

Anna Papyan of the Shannon Family Resource Centre explained: “Having used participatory methodologies, I can see how they create inclusive opportunities for migrants to get involved in research”.

UL Vice President Research Professor Norelee Kennedy said: “It is encouraging to see the increasing number of high-impact publications raising further awareness of the value of participatory health research as a research specialism to maximise the participation of those whose life or work is the subject of the research, across all stages of the research process.

“Our research strategy in UL is to help create healthy and inclusive societies, by harnessing the expertise and knowledge within and outside the university for the betterment of society.”

Professor Colum Dunne, Head of School of Medicine at UL congratulated the academics involved, noting that “the approach of building capacity to strengthen bottom-up generation of evidence about refugees and migrant health is in line with the recent Global Rabat Declaration, as well as the WHO Health and Migration Programme recommendations”.

Using case studies and evidence from the field of health research with refugees and migrants, the paper outlines ways that such a paradigm shift could redress current power imbalances between the Global North and the Global South and between academic researchers and the communities of refugees and migrants under study in the WHO Health Region.

The article is part of ‘The Lancet Regional Health – European Region’s Addressing migration and health inequity in Europe’ series. The new series of seven papers published in The Lancet Regional Health – Europe and presented alongside the World Health Assembly addresses the urgent need to tackle the pressing health challenges faced by migrants in Europe.

The series highlights how fewer than half of the member states in the WHO European Region report health data for migrants – a systemic failure to prioritise their wellbeing, despite 36% of the global migrant population residing in Europe.

It identifies seven key areas crucial for Europe to transition from migrant health inequity to migrant health equity, aligning with the 2030 Sustainable Development Goals agenda of leaving no one behind: 

1.           Priority setting for migrant health policies

2.           Universal Health Coverage 

3.           Tackling discriminatory, racist and xenophobic policies   

4.           Migrant-sensitive healthcare   

5.           Participatory health research approaches 

6.           Immunisation 

7.           Capacity building

The authors say addressing these areas will help cultivate a more inclusive and equitable health-care system for migrants in Europe.

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