Abstract
BackgroundIn 2015 the increased migratory pressure in Europe posed additional challenges for healthcare providers. The aim of this study was to inform the development of a “Resource Package” to support European Union (EU) member states in improving access to healthcare for refugees, asylum seekers and other migrants.MethodsA mixed method approach was adopted: i) interviews and focus groups were carried out to gather up-to-date information on the challenges the different healthcare providers were facing related to the refugee crisis; ii) to complement the results of the FGs, a literature review was conducted to collect available evidence on barriers and solutions related to access to healthcare for refugees and migrants.ResultsThe different actors providing healthcare for refugees and migrants faced challenges related to the phases of the migration trajectory: arrival, transit and destination. These challenges impacted on the accessibility of healthcare services due to legislative, financial and administrative barriers; lack of interpretation and cultural mediation services; lack of reliable information on the illness and health history of migrant patients; lack of knowledge of entitlements and available services; lack of organisation and coordination between services. These barriers proved particularly problematic for access to specific services: mental health, sexual and reproductive care, child & adolescent care and victim of violence care.ConclusionsThe findings of this study show that solutions that are aimed only at responding to emergencies often lead to fragmented and chaotic interventions, devolving attention from the need to develop structural changes in the EU health systems.
Highlights
In 2015 the increased migratory pressure in Europe posed additional challenges for healthcare providers
A mixed method approach was adopted: firstly, a series of interviews and focus groups (FG) were carried out to gather up-to-date information on the challenges that healthcare providers were facing in providing healthcare for refugees and migrants; secondly a systematic review of the literature was conducted, to collect, summarize and critically appraise the available evidence on barriers and solutions related to access to healthcare services for these vulnerable groups
Studies were only included if all reviewers agreed. Findings of both the interviews/FGs and the systematic review (SR) are presented : (1) challenges related to specific phases of the migration trajectory (2) barriers and solutions related to accessing healthcare services in general: legislative, financial and administrative aspects; linguistic and cultural issues; information for healthcare providers; information for refugees and migrants; organisation and quality of services; lack of coordination between care providers; (3) barriers and solutions related to accessing four specific healthcare services: mental health, sexual and reproductive care, child care and victim of violence care; (4) development and dissemination of a resource package
Summary
In 2015 the increased migratory pressure in Europe posed additional challenges for healthcare providers. The number of those seeking international protection was lower than that of ‘routine’ migrants for purposes such as work, family and study [2], the increased migratory pressure in Europe posed additional challenges for the different actors providing care for these vulnerable groups. Refugees were in theory granted protection from formal registration of their application for Chiarenza et al BMC Health Services Research (2019) 19:513 asylum in the first receiving country They frequently found themselves in a situation where they had no effective healthcare coverage, awaiting an often long overdue response to their application for refugee status, at times at the stage of an appeal, or even refusal. The number of negative decisions following the peak in applications in the second half of 2015 was 449,920, 39% of the 1.148,680 decisions made in 2016 [3] Those who had been refused protected status but had not been deported remained irregular migrants
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