Migration and perinatal health surveillance: An international Delphi survey

ObjectiveWhile the perinatal health of migrants has been identified as a priority by many governments, there is no consensus on indicators for monitoring migration and perinatal health. The Reproductive Outcomes and Migration international research collaboration and the EURO-PERISTAT project convened an expert panel to recommend migration indicators for national and international monitoring of migration and perinatal health.Study designA Delphi consensus process involved 38 perinatal clinicians, epidemiologists, and experts in health information systems from 22 countries who completed one or more questionnaires. Panel members ranked migration indicators from a list inventoried from the published literature.ResultsCountry of birth was considered ‘essential’ or ‘recommended’ for routine collection by 100% of respondents, followed by length of time in country (88%), language fluency (70%), immigration status (67%), and ethnicity as defined by maternal parents’ place of birth (55%). Feasibility with ‘minor’ or ‘no modifications’ to current data collection systems was highest for country of birth (69%), followed by length of time in country (61%). Other indicators were judged to be less feasible. In respect to migration, the perinatal health indicators considered to be ‘essential’ by 94% of respondents included fetal, neonatal, and infant mortality. A smaller proportion (73%) considered maternal mortality to be ‘essential’.ConclusionsA strong consensus was achieved for including country of birth in core perinatal health indicator sets. Length of time in country was also recommended as a second indicator for routine data collection. Specific studies should be undertaken to complement routine data collection on: immigration status, language fluency, and ethnicity as defined by maternal parents’ place of birth.