Caring for migrants and refugees: access to services, common risks and continuity of care
- Safe practice
Migrants often lose access to care on the road; the nurse helps them in an emergency, guides them to join the health system and keeps their care going.
What it is
WHO explains that the health risks of refugees and migrants come mainly from the conditions of displacement (lack of water, food, shelter and services) and not from the migrants themselves, and that they do not increase the risk of communicable disease for host countries. Barriers include discrimination, exclusion of people in an irregular situation, out-of-pocket costs and language. In Colombia, MinSalud's guide for Venezuelan migrants and returning Colombians explains that a person without health insurance can be seen in emergency services, that the Temporary Protection Permit (PPT, under Decreto 216 de 2021) allows affiliation to the health system, and that PAI vaccination is offered regardless of migration status. The nurse attends, guides and links people so their care does not stop.
What it requires
- If a person arrives at an emergency service uninsured but with a valid document, the IPS can affiliate them through the transactional affiliation system (SAT).
- A person without income who has a PPT can request subsidised-scheme affiliation at the local health secretariat and the SISBÉN survey.
- Public health activities (vaccination, syphilis and HIV testing where available, active community case finding) include the migrant population.
- Women and girls on the move face more gender-based violence; unaccompanied children face exploitation and abuse.
Components
- Emergency care: always, whatever the migration status.
- Affiliation: regular status (PPT) leads to the contributory or subsidised scheme.
- Public health: vaccination, screening and community surveillance for everyone in the territory.
- Protection: violence, children alone, trafficking: activate the protection routes.
- Continuity: records, chronic treatment and pregnancy care that the move interrupted.
How it is applied (and why)
- Attend the urgent need first, without asking for papers — emergency care does not depend on migration status.
- Ask, in private, about the journey, violence, documents and who travels with the person — it shows risks and needs.
- Check and complete vaccination with the PAI — displacement interrupts schedules and raises measles risk.
- Ask about pregnancy and chronic treatment and arrange continuity — the move breaks follow-up.
- Offer syphilis and HIV testing when the territory provides it — early diagnosis protects the person and the community.
- Explain the steps to regularise status and join the health system, in plain language — access depends on it.
- Ask about sleep, fear, sadness and grief and refer when needed — stress of migration is common.
- Activate the protection route for violence, unaccompanied children or trafficking — they need more than health care.
In nursing practice
- Use the person's words and an interpreter for languages other than Spanish; check understanding of every instruction.
- Give written summaries the person can carry: vaccines, diagnoses and treatment travel with them.
- Avoid stigma: migrants are not a source of epidemics; the conditions of the journey are the risk.
- MinSalud's guide lists national lines such as 155 (guidance for women victims of violence) and 141 (ICBF child protection).
Common mistakes
- Asking for documents before attending an emergency.
- Assuming the person cannot join the health system without explaining the routes.
- Ignoring mental health because the visit is for something else.
- Discharging without a plan for the next dose, test or check-up.
Test yourself
Think of the answer, then tap the question to see it.
Can a migrant without health insurance be seen in Colombia?
Yes, in emergency services; with a valid document the IPS can also start affiliation through the transactional affiliation system (SAT).
What document allows Venezuelan migrants to join the health system?
The Temporary Protection Permit (PPT), created under the Temporary Protection Statute (Decreto 216 de 2021).
According to WHO, where do most of the health risks of migrants come from?
From the conditions of displacement, such as lack of water, sanitation, food, shelter and services, not from the migrants themselves.
Does migration status limit PAI vaccination?
No. MinSalud's guidance is that migrants can receive any PAI vaccine available, regardless of migration status.
Elsewhere in DurgiPedia
- Tutela and ways to claim the right to health
- Colombia's General System of Social Security in Health (SGSSS)
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Refugee and migrant health (fact sheet) (World Health Organization, 2025); Caja de herramientas Migración y salud «¡Hey pana!»: para la inclusión de la población migrante venezolana y colombiana retornada en el SGSSS (Ministerio de Salud y Protección Social, Colombia, 2024); Nursing: Mental Health and Community Concepts, 17.2 Vulnerable Populations (migrant workers) (Open RN (Ernstmeyer & Christman, eds.), Chippewa Valley Technical College; LibreTexts, 2022).
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Representative model, for educational purposes only.