Climate change is an increasingly important theme in Africa, where a large majority of its people depend on livestock and agricultural activities for livelihood. Concurrently, the topic of health of migrants and people on the move is rapidly raising both in the health debate and migration governance agenda in the Region. The link with climate change from the perspective of health and migration experts needs to be systematically addressed. The article aims to contribute to the discourse on the interrelation of climate change, migration, and health by providing contributions of experts in the field of health and migration directly working with migrant and refugee communities in Africa. A webinar was conducted to collect and discuss first-hand experience with 25 participants from a postgraduate online course on health and migration funded by the Austrian Government and implemented in a co-operation of the Center for Health and Migration, Austria, with Makerere University, Uganda, the International Organization for Migration - UN Migration, and Lancet-Migration. As a result from the discussions, two cases from Sudan and Zimbabwe were selected to be further analysed with desk research to illustrate and underpin the points made. All webinar participants reported to encounter climate change effects on health and migration in their professional practice. In their experience, climate change aggravates issues of health and migration by fueling forced migration and displacement, increasing health care needs, and deteriorating access to health care. Specific health challenges were identified for mental health problems caused by effects of climate change-induced migration, which remain widely undiagnosed and untreated, and the special affectedness of women and girls, with their mental, sexual and reproductive health severely deteriorated in insecure environments. The case studies from Sudan and Zimbabwe underline these observations. The interplay of effects of climate change, (internal) migration, and health is reported by a community of experts in the field of health and migration who are residing in Africa and working with migrant communities. Webinars prove to be an easy to implement tool to collect first hand evidence from practice experts, to foster exchange of experiences, and to get people engaged in further collaboration and discussion.

In public health policy debates, the 2015-2016 refugee crisis made visible that even in European welfare states with (close to) universal health coverage there are specific vulnerable groups with highly limited access to health care. Among them is a population of so-called 'undocumented' or 'irregular' migrants who have no regular status of residence and falls off the radar of publicly funded health care services and thus from the public health surveillance systems. The aim of our study is to provide the first-of-its-kind evidence on the characteristics, health problems and health care needs of one such vulnerable group in Austria - Chinese migrants residing in Vienna without a regular status. Medical records of 74 uninsured assumingly undocumented Chinese patients were analysed. The data was provided by a Non-governmental organisation (NGO) which delivers primary care to uninsured people in Vienna. The most frequently diagnosed health problems clustered around cardiovascular and metabolic-related diseases (hypertension and diabetics) and there was a high burden of multiple chorionic non-communicable diseases. Further efforts and resources are needed for collecting more data in a systematic way. A trusting relationship between science and practice and a cooperative relationship between and among the government agencies and NGOs are essential for evidence-based public health policy making.

There is robust evidence that homelessness and the associated life conditions of a homeless person may cause and exacerbate a wide range of health problems, while healthcare for the homeless is simultaneously limited in accessibility, availability, and appropriateness. This article investigates legal frameworks of health care provision, existing knowledge on numbers of homeless to be considered, and current means of health care provision for four EU countries with different economic and public health background: Austria, Greece, Poland, and Romania. National experts investigated the respective regulations and practices in place with desk research. The results show differences in national frameworks of inclusion into health care provision and knowledge on the number of people experiencing homelessness, but high similarity when it comes to main actors of actual health care provision for homeless populations. In all included countries, despite their differences in economic investments and universality of access to public health systems, it is mainly NGOs providing health care to those experiencing homelessness. This phenomenon fits into conceptual frameworks developed around service provision for vulnerable population groups, wherein it has been described as “structural compensation,” meaning that NGOs compensate a structural inappropriateness that can be observed within public health systems.

Ensuring a basic social infrastructure, encompassing welfare, healthcare, education, housing, and employment, is crucial for upholding human rights. In the context of migration, access to social infrastructures is tied to national migration and residence regulations. Undocumented migrants (UDM) often are excluded even from such basic provisions. Lacking a legal residence status, they live in a NowHereland and are subject to various forms of exploitation. The Center for Health and Migration initiated a stock-taking of legal frameworks concerning entitlements to basic social infrastructures for UDM as its Social Responsibility Project 2020. National experts provided evidence on entitlements for UDM to social welfare, healthcare, compulsory education, housing, and work, using a validated template for data collection. The chapter will present the country cases of Austria and Israel, which represent the prevailing neglect of human rights within national policies.

The current research note describes a process where by applying the qualitative method of expert interviews, researchers got confronted with a new topic in their area of expertise that was not on the radar of their research. In the framework of an evaluation study on health promotion interventions for migrants in an urban setting, researchers applied a mixed methods approach. Quantitative element was a self-assessment tool, where providers of health promotion measures described their clientele and rated the quality of their services along given categories. Qualitative element was a series of semi-structured interviews with management and front line service providers. While the self-assessment tool delivered expected results, the interviews revealed an aspect concerning needs and problems of a migrant group researchers had not thought of before. This is the group of immigrants from the 1960ies, coming mainly from Turkey and Former Yugoslavia, now reaching or having reached retirement age. This group was reported as being extremely vulnerable and at risk of a double discrimination as being “old” and “migrant”. Desk research was conducted in reaction to such data, showing that information on this group is scarce. Given the demographic developments with rising shares of (old) aged immigrants living in Austria, it will be important to improve the respective knowledge base.