Table 4 Recommendation for the host and home country governments across different time-frames

Short term

Heat and exhaustion

+

Providing adequate hydration at work

Heat and exhaustion

+

Providing heat shields

False reports

+

Addressing issues regarding false medical reports by enforcing monitoring on screening centers

Intermediate

Low awareness

+

+

Coordination with provincial and district health offices to raise awareness on importance of lifestyle changes, physical activity and medical checkups even before the migration cycle starts

Low awareness

Coordination with companies, recruiting agencies and local health offices to raise awareness on lifestyle, physical activity and medical check ups

Surveillance and monitoring

+

+

Tracking the out-bound and in-bound migrants and addressing their health outcomes using routine health registers

Surveillance and monitoring

The information obtained from health assessment should be shared not just within migration authorities but also across health sector, and integrated within the health system in host and home country.

Adherence to medication and treatment

+

+

For those with existing CMD, counselling on adherence to medication, lifestyle changes and physical activity

Long term

Limited health promoting facilities

+

+

Health and wellbeing centers targeting outgoing and in-coming migrants

Limited insurance coverage

+

+

The insurance package should cover the health expenses when returning home with CMD, and coverage for any disability/deaths.

Low political priority

+

Cooperation at the ministerial level to accord migrant’s cardio metabolic health as a top priority. The first step will on providing exercise facility, adequate space to live and provision for adequate nutrition and hydration at work.