Abstract
Background. The rising number of the EU Roma citizens from the CEE countries, non-EU Roma citizens from the Western-Balkans, and of undocumented migrants in the European Union makes it interesting to see that most of them face barriers when accessing health services [with a European Health Insurance Card (EHIC)] or have no health coverage at all [no legal entitlement]. European migrant health policies are seemingly well structured and responsive to the needs of migrants, however, results of recent studies raise the question whether the legislations are responsive enough to the needs of the Roma and undocumented migrants when accessing health services. Given the circumstances of the Covid-19 pandemic these groups are now at an increased risk and they might not be able to understand how the virus transmits and how they can protect themselves from it. Methods. Literature review focusing on the access to health services and migrant health policies in the EU and the UK was carried out. The target groups of this research were Roma citizens and third-country national undocumented migrants residing in the European Union. Results. In theory the legal entitlement for accessing healthcare for migrants in general is satisfactory, while in practice these groups face difficulties, such as prejudice, discrimination and other barriers (language, logistical) when approaching health services. Migrants lack trust in the health system and the healthcare professionals, and are not aware of their fundamental rights to healthcare either. Conclusions. Legal entitlements for EU migrant citizens do not differ within EU countries but they significantly vary for undocumented migrants Europe-wide and there seems to be a mismatch between the legal entitlements for undocumented migrants in theory and their implementation in practice. Given the circumstances of the pandemic these groups are at an increased risk and therefore their health inclusion through health literacy programs should take place, as well as health workers should be trained on diversity in order to establish diversity adapted EU health systems. Seeking adaptive practices to establish cultural diversity within the healthcare settings, and introducing the universal health coverage scheme Europe-wide in order for undocumented migrants and EU citizens without employment to benefit from proper healthcare services is encouraged and necessary.
Highlights
In the late 1960s Western-European countries were affected by migration and received an intensive immigration flow due to bilateral labor agreements between France, Belgium, Germany and Southern European, North African countries and Turkey
Most of the migrants arrived in Europe for studies or by family reunification (Eurostat, 2009), while most of the Roma migrant population arrived from Southern Serbia and Macedonia due to their asylum applications to European Union countries by 2010 (Eurostat, 2011), recent data from the United Nations Migrant Stock of 2019 shows that among Europe’s total nearly 50 000 000 migrants 170 977 are Albanians, 109 550 are Bulgarians, 322 536 are North-Macedonians and 525 028 are Romanians, while estimates count 200 000 to 300 000 Roma migrants from Eastern Europe to the West (Council of Europe), suggesting a high number of these migrants to be of Roma ethnicity
As the pre-assumption of this research based on the literature review was that Roma citizens from Central and Eastern Europe (CEE) countries and undocumented migrants in Europe are not well aware of their fundamental right to healthcare, they lack information both on the health system and their rights (Kühlbrandt et al, 2014) and that they lack trust both in the system and in the medical staff (European Commission, 2014) it will mainly focus on the findings of the literature review
Summary
In the late 1960s Western-European countries were affected by migration and received an intensive immigration flow due to bilateral labor agreements between France, Belgium, Germany and Southern European, North African countries and Turkey. Most of the migrants arrived in Europe for studies or by family reunification (Eurostat, 2009), while most of the Roma migrant population arrived from Southern Serbia and Macedonia due to their asylum applications to European Union countries by 2010 (Eurostat, 2011), recent data from the United Nations Migrant Stock of 2019 shows that among Europe’s total nearly 50 000 000 migrants 170 977 are Albanians, 109 550 are Bulgarians, 322 536 are North-Macedonians and 525 028 are Romanians, while estimates count 200 000 to 300 000 Roma migrants from Eastern Europe to the West (Council of Europe), suggesting a high number of these migrants to be of Roma ethnicity. Upon realizing the growing number of CEE countries’ Roma population, many EU countries urgently responded and created a list of safe countries including Albania, Bosnia - Herzegovina, Macedonia – Former Yugoslav Republic of Macedonia - FYROM, Kosovo, Serbia, Montenegro, and India
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