Strategies to achieve transformative migrant health outcomes: health literacy development approaches

Abstract Background Many health and equity programs developed by government, non-government and academic groups that seek to improve health and equity among migrant groups tend to fail to engage the intended groups, are unsustainable, and tend to disappear once the funding stops. This presentation will summarise health literacy development projects among migrant communities that have achieved positive impacts. The presenter will draw on practical experience of developing and implementing programs in diverse settings, highlighting not only common pitfalls, but processes that generate trust and local ownership, and that promote sustainability. Methods Narrative review of project sustainability literature, including synthesis of the development and implementation of projects in diverse contexts in Europe, Australia and other regions. Results In practice, many projects are designed using top-down approaches with no or only tokenistic application of co-design or community engagement methods. The development of interventions that respect and prioritise, rather than discount, local wisdom, culture and systems are likely to generate interventions that are needed and wanted by migrant communities. To do this, it is important to systematically measure and respond to locally identified health literacy needs and engage all relevant stakeholders in the codesign and implementation of actions. A key element is to support migrant groups to be in the “driver's seat”, to not only participate in co-design with program partners but also be trusted to undertake the co-design as lived experience partners. This requires researchers and program staff to authentically give substantial power away. Conclusions Many migrant groups experience substantial marginalisation and often find that interventions are imposed on them. Contemporary community co-design methods have the capacity to build needed, wanted, implementable and scalable interventions within and across communities.