Kanishka Ghiasi, Ali Mohammad Mosadeghrad, Hossein Dargahi, Ebrahim Jaafaripooyan, Mahdi Abbasi
{"title":"改善伊朗移徙者健康的战略:现实主义审查。","authors":"Kanishka Ghiasi, Ali Mohammad Mosadeghrad, Hossein Dargahi, Ebrahim Jaafaripooyan, Mahdi Abbasi","doi":"10.1186/s12992-025-01133-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Migration is a growing global phenomenon and a recognized social determinant of health, contributing to significant health inequities between migrant and host populations. Iran, hosting an estimated 4.5 million migrants-including undocumented individuals-faces persistent challenges in ensuring equitable access to healthcare. This study identifies strategies to inform context-specific interventions within Iran's health system to improve migrant health.</p><p><strong>Methods: </strong>We conducted a realist review, searching PubMed, Science Direct, Scopus, Web of Science, Google Scholar, and grey literature from 2010 to 2024. Using the Intervention-Context-Mechanism-Outcome (ICMO) framework, we analyzed 67 studies to identify effective strategies for enhancing migrant health in Iran. Ritchie and Spencer's five-stage framework method was applied to analyse the data.</p><p><strong>Results: </strong>Twenty-seven strategies were identified. Mechanisms underpinning successful interventions included trust-building through intersectoral governance, reduction of financial barriers via inclusive insurance schemes, increased accessibility through cultural competency training, and improved service reach using digital health and community-based outreach. Iran-specific implications included the potential for piloting migrant-inclusive insurance for vulnerable groups and expanding culturally tailored services through community health workers.</p><p><strong>Conclusion: </strong>Contextual adaptation of global strategies can address systemic barriers and improve health equity for migrants in Iran. The findings offer evidence-based, actionable insights for policymakers seeking to localize global best practices within Iran's healthcare infrastructure.</p>","PeriodicalId":12747,"journal":{"name":"Globalization and Health","volume":"21 1","pages":"42"},"PeriodicalIF":4.5000,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308935/pdf/","citationCount":"0","resultStr":"{\"title\":\"Strategies for improving migrant health in Iran: a realist review.\",\"authors\":\"Kanishka Ghiasi, Ali Mohammad Mosadeghrad, Hossein Dargahi, Ebrahim Jaafaripooyan, Mahdi Abbasi\",\"doi\":\"10.1186/s12992-025-01133-4\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Migration is a growing global phenomenon and a recognized social determinant of health, contributing to significant health inequities between migrant and host populations. Iran, hosting an estimated 4.5 million migrants-including undocumented individuals-faces persistent challenges in ensuring equitable access to healthcare. This study identifies strategies to inform context-specific interventions within Iran's health system to improve migrant health.</p><p><strong>Methods: </strong>We conducted a realist review, searching PubMed, Science Direct, Scopus, Web of Science, Google Scholar, and grey literature from 2010 to 2024. Using the Intervention-Context-Mechanism-Outcome (ICMO) framework, we analyzed 67 studies to identify effective strategies for enhancing migrant health in Iran. Ritchie and Spencer's five-stage framework method was applied to analyse the data.</p><p><strong>Results: </strong>Twenty-seven strategies were identified. Mechanisms underpinning successful interventions included trust-building through intersectoral governance, reduction of financial barriers via inclusive insurance schemes, increased accessibility through cultural competency training, and improved service reach using digital health and community-based outreach. Iran-specific implications included the potential for piloting migrant-inclusive insurance for vulnerable groups and expanding culturally tailored services through community health workers.</p><p><strong>Conclusion: </strong>Contextual adaptation of global strategies can address systemic barriers and improve health equity for migrants in Iran. The findings offer evidence-based, actionable insights for policymakers seeking to localize global best practices within Iran's healthcare infrastructure.</p>\",\"PeriodicalId\":12747,\"journal\":{\"name\":\"Globalization and Health\",\"volume\":\"21 1\",\"pages\":\"42\"},\"PeriodicalIF\":4.5000,\"publicationDate\":\"2025-07-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12308935/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Globalization and Health\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s12992-025-01133-4\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Globalization and Health","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12992-025-01133-4","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
摘要
背景:移徙是一种日益严重的全球现象,也是公认的健康的社会决定因素,造成移徙者和东道国人口之间严重的健康不平等。伊朗收容了大约450万移民(包括无证移民),在确保公平获得医疗保健方面面临着持续的挑战。本研究确定了在伊朗卫生系统内为改善移民健康提供具体情况干预措施的战略。方法:检索2010 - 2024年PubMed、Science Direct、Scopus、Web of Science、谷歌Scholar和灰色文献,进行文献回顾。使用干预-背景-机制-结果(ICMO)框架,我们分析了67项研究,以确定提高伊朗移民健康的有效策略。里奇和斯宾塞的五阶段框架方法被应用于分析数据。结果:确定了27种策略。支持成功干预措施的机制包括通过部门间治理建立信任,通过包容性保险计划减少财务障碍,通过文化能力培训增加可及性,以及通过数字卫生和社区外展扩大服务范围。对伊朗的具体影响包括为弱势群体试行包括移民在内的保险,以及通过社区卫生工作者扩大适合不同文化的服务。结论:全球战略的情境适应性可以解决系统性障碍,改善伊朗移民的健康公平。研究结果为寻求在伊朗卫生保健基础设施中本地化全球最佳实践的决策者提供了基于证据的、可操作的见解。
Strategies for improving migrant health in Iran: a realist review.
Background: Migration is a growing global phenomenon and a recognized social determinant of health, contributing to significant health inequities between migrant and host populations. Iran, hosting an estimated 4.5 million migrants-including undocumented individuals-faces persistent challenges in ensuring equitable access to healthcare. This study identifies strategies to inform context-specific interventions within Iran's health system to improve migrant health.
Methods: We conducted a realist review, searching PubMed, Science Direct, Scopus, Web of Science, Google Scholar, and grey literature from 2010 to 2024. Using the Intervention-Context-Mechanism-Outcome (ICMO) framework, we analyzed 67 studies to identify effective strategies for enhancing migrant health in Iran. Ritchie and Spencer's five-stage framework method was applied to analyse the data.
Results: Twenty-seven strategies were identified. Mechanisms underpinning successful interventions included trust-building through intersectoral governance, reduction of financial barriers via inclusive insurance schemes, increased accessibility through cultural competency training, and improved service reach using digital health and community-based outreach. Iran-specific implications included the potential for piloting migrant-inclusive insurance for vulnerable groups and expanding culturally tailored services through community health workers.
Conclusion: Contextual adaptation of global strategies can address systemic barriers and improve health equity for migrants in Iran. The findings offer evidence-based, actionable insights for policymakers seeking to localize global best practices within Iran's healthcare infrastructure.
期刊介绍:
"Globalization and Health" is a pioneering transdisciplinary journal dedicated to situating public health and well-being within the dynamic forces of global development. The journal is committed to publishing high-quality, original research that explores the impact of globalization processes on global public health. This includes examining how globalization influences health systems and the social, economic, commercial, and political determinants of health.
The journal welcomes contributions from various disciplines, including policy, health systems, political economy, international relations, and community perspectives. While single-country studies are accepted, they must emphasize global/globalization mechanisms and their relevance to global-level policy discourse and decision-making.