Migration and perinatal health surveillance: an international Delphi survey

Objective: While 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 design: A 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.

Results: Country 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'.

Conclusions: A 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.