Covid-19 deaths among migrant health care workers: risks and responses

There is a paucity of robust empirical evidence about whether migrant health care workers have the same level of exposure to Covid-19 infection and deaths as non-migrant health care workers, and whether variations exist between sectors (as between the health and social care sectors) and countries (as between higher income and lower income countries). Such empirical evidence on what responses have emerged in the face of threats to the resilience of health and care workforces and to realising the global goal of universal health coverage worldwide is also weak. Weak surveillance systems and fragmented reporting systems mean that special investigations to properly monitor Covid-19 impacts on health care workers and workforces are required by national and international decision-makers.

This project aims to give proper attention to the place of migrants in health care systems during the Covid-19 pandemic. Migrant workers are of substantial and growing significance in many countries' health and care systems and are key to realising the global goal of universal health care so it is vital that we understand much better how Covid-19 is impacting on them. The project's overarching research question is, in the relation to Covid-19, what risks do migrant health care workers experience, what are the pressures on resilient and sustainable health care workforces, and how are stakeholders responding to these risks and pressures? In addition to strengthening the empirical evidence base on the risks of Covid-19 infection and death among migrant health care workers our project also tracks collective responses to such risks and challenges to sustainable health workforces for universal health coverage.

We collect qualitative and quantitative data on Covid-19 risks, pressures and responses using different methods and techniques. We undertake a systematic literature review (SLR) of academic and non-academic publications using hybrid review methodologies to search for data and content analysis methodology to extract data of interest and evaluate the methods and findings of studies and publications. Coverage of three global languages - English, Spanish and Arabic - ensures greater ethnolinguistic reach and inclusivity of the SLR. We also develop a research method to estimate Covid-19 migrant health care worker mortality rates and trial the method, undertaking statistical analysis and modelling using quantitative data drawn from WHO and OECD data and other demographic and bio-statistical data as available. In addition, we collect data through interviews and documentary analysis on the responses of stakeholders (employers, trade unions, NGOs) to chart emerging patterns of response relating to health care worker training, recruitment, retention, deployment, international migration, and challenges for migrant health care worker protection at work consistent with international recruitment and employment norms.

We involve key stakeholders from diverse communities of policy and practice during the research process, designed to have demonstrable potential for impact by meeting their time-critical requirements for robust empirical and analytical evidence about the multidimensional impacts of Covid-19 on health care workforces. This project is attuned to the urgent need for high quality data and for 'real world' solutions-focused Covid-19 research forged from collaboration. We are focused on the immediate application of proof-of concept findings to a rapidly-evolving global health crisis.