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Strategies for improving migrant health in Iran: a realist review
Kanishka Ghiasi1, Ali Mohammad Mosadeghrad2, Hossein Dargahi3
1International campus, School of Public Health, Department of Health Management, Policy and Economics, Tehran University of Medical Sciences, Tehran, Iran. kanishkaghiasi@gmail.com.
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.
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