Health for vulnerable populations

Background

The COVID-19 pandemic highlighted the fact that vulnerable populations (VPs) were often left behind by the public health emergency preparedness plans and responses. VPs are defined as, but not limited to, those who are socioeconomically or physically or mentally weak and fragile.

WHO Western Pacific Regional Office specifies VP as: 1) People experiencing homelessness; 2) People living in overcrowded housing, collective sites and slums; 3) Migrant workers; 4) Refugees; 5) People with disabilities; 6) People living in closed facilities; 7) People living in remote locations (including highlands and island provinces); 8) People living in poverty and extreme poverty; 9) Intersecting and compounding vulnerabilities, 10) People affected by the digital divide.

In addition to the above 10 groups, the UN adds “women, elderly people, children and adolescents, indigenous people, minorities, people with chronic diseases such as HIV/AIDS, people affected by conflicts, and people differentiated, including LGBTI” as populations experiencing socio-economic marginalization.

To achieve universal health coverage (UHC), it is essential to ensure VPs are not left behind. Improvement not only in accessibility to health services but also in social protection (including insurance and social assistance), in response to socioeconomic vulnerabilities, is required.

Our aim

We aim to integrate VPs into national and sub-national plans and the implementation of PPRR (prevention, preparedness, response, and recovery) for health security and public health emergencies, in order to "Build Forward Better" after the COVID-19 pandemic, from the following five viewpoints:

1. Understanding VP communities (e.g., adequate surveillance & monitoring)
2. Disseminating information (e.g., risk communication for VPs by overcoming barriers such as language, contents, and channels)
3. Promoting involvement by VPs in every phase of development (community engagement)
4. Ensuring access to health & social protection services (UHC, Universal Social Protection (USP) )
5. Creating a supportive environment (considering Social Determinants of Health (SDH), climate justice, etc.)

Our actions

Since 2020, we have engaged in the following activities:

1. Developing models to disseminate health information necessary for foreigners in need (e.g., posting messages on a huge Facebook page managed by Vietnamese living in Japan, an online questionnaire survey on the impact of COVID-19, etc.)
2. Creating pathways to access health and other services for foreigners in difficult situations in Japan (e.g., establishment of “COVID-19 Vaccination Information Center for International Citizens (COVIC)” to assist them in obtaining vaccination vouchers through telephone consultation)
3. Exploring approaches to address social, economic, and cultural issues that affect the health of foreigners living in Japan (e.g., seminar series to strengthen the collaboration among administration, consultation services for foreigners, public health centers, occupational health staff, etc.)
4. Creation of synergies between initiatives for non-Japanese persons and their corresponding countries (e.g., publication of “Health Handbook for Vietnamese Workers in Japan” in cooperation with the International Organization for Migration Vietnam)

To achieve the goal to “leave no one behind” in the post-COVID-19 world, we will continue our efforts in research, practice, networking, human resource development, and policy recommendation, and to tackle issues faced by foreigners and other vulnerable populations.