Healthcare Access For Refugees Research Articles

Healthcare access for refugees in Greece: Challenges and opportunities

The arrival of more than one million refugees and migrants in Europe in 2015, most of whom transited through Greece, has placed significant strains on local health systems and demonstrated the need for preparedness to meet the immediate and longer-term health needs of arrivals in EU countries. Population movements will continue to occur and the need for cost effective, appropriate provision of both primary and secondary health services to meet these needs is key. The Global Compact on Migration was ratified in 2018 and forms an overarching, international agreement to address safe, orderly and regular migration which benefits refugees and migrants as well as host communities; however, it did not give due emphasis to health. In this manuscript, we explore the evolution of the health response for refugees in Greece over the last three years, the challenges faced at different times of the response and the efforts to integrate refugees into Greece’s health system.

Impacts of the Interim Federal Health Program reforms: A stakeholder analysis of barriers to health care access and provision for refugees.

Changes to the Interim Federal Health Program (IFHP) in 2012 reduced health care access for refugees and refugee claimants, generating concerns among key stakeholders. In 2014, a new IFHP temporarily reinstated access to some health services; however, little is known about these changes, and more information is needed to map the IFHP's impact. This study explores barriers occurring during the time period of the IFHP reforms to health care access and provision for refugees. A stakeholder analysis, using 23 semi-structured interviews, was conducted to obtain insight into stakeholder perceptions of the 2014 reforms, as well as stakeholders' position and their influence to assess the acceptability of the IFHP changes. The majority of stakeholders expressed concerns about the 2014 IFHP changes as a result of the continuing barriers posed by the 2012 retrenchments and the emergence of new barriers to health care access and provision for refugees. Key barriers identified included lack of communication and awareness, lack of continuity and comprehensive care, negative political discourse and increased costs. A few stakeholders supported the reforms as they represented some, but limited, access to health care. Overall, the reforms to the IFHP in 2014 generated barriers to health care access and provision that contributed to confusion among stakeholders, the transfer of refugee health responsibility to provincial authorities and the likelihood of increased health outcome disparities, as refugees and refugee claimants chose to delay seeking health care. The study recommends that policy-makers engage with refugee health stakeholders to formulate a policy that improves health care provision and access for refugee populations.

HOW DO POLICY DOCUMENTS RELEVANT TO REFUGEES ADDRESS ISSUES RELATING TO REFUGEE’S ACCESS TO HEALTH CARE SERVICES IN SOUTH AFRICA?

Background: There is very limited literature on the provisions contained in policies relevant to refugees who seek health care services in South Africa. Yet, the need to understand how policy can influence access to healthcare services for refugees is widely acknowledged. Purpose: This study was conducted in order to examine ways in which policy documents relevant to refugees address issues relating to refugees’ access to health care services. Methods: Data for this study was derived from a review of policy documents relevant to refugees and discussions with relevant stakeholders. Six provisions were identified that relate to the facilitation of health care access among refugees. Twelve (n=12) relevant policy documents that met our inclusion criteria were analysed in terms of the six provisions and particularly how it was framed. Findings: The six provisions pertain to refugees’ rights and access to healthcare services, free access to ART, access to mental health, screening upon arrival and provision of interpreters at public healthcare facilities. The findings suggest that policy documents have not adequately addressed issues relating to refugees’ access to health care services in South Africa. Of the 12 relevant policy documents selected, only seven had one or two of the six provisions; the other five made no provision for refugees in South Africa. In addition, most of the policy documents that address the issue of health care access for refugees are international documents. Only four policy documents developed in South Africa contained one or two of the six provisions. Conclusion: Health policy makers should pay attention to the issues of refugee health within government’s limited financial and human resource capacity as it has important health ramifications for the citizens and the country at large. Further, government and policy makers should also promote access to resources to support health facility management and create greater awareness of national health policies among practitioners and refugees.

Health care access for refugees and immigrants with precarious status: public health and human right challenges.

Migration flux is being transformed by globalization, and the number of people with either undocumented or with a precarious status is growing in Canada. There are no epidemiological data on the health and social consequences of this situation, but clinicians working in primary care with migrants and refugees are increasingly worried about the associated morbidity. This commentary summarizes findings from a pilot study with health professionals in the Montreal area and suggests that the uninsured population predicament is a national problem. Although ethical and legal issues associated with data collection by clinicians, institutions and governments need to be examined, estimating the public health consequences and long-term cost associated with problems in access to health care due to migratory status should be a priority. Current regulations and administrative policies appear to be at odds with the principles of equal rights set out by the Canadian Charter of Rights and Freedoms and the UN Convention on the Rights of the Child. Beyond the commitment of individual clinicians, Canadian medical associations should take an advocacy role and scrutinize the ethical and medical implications of the present system.

Health Care Access for Refugees and Immigrants with Precarious Status

Migration flux is being transformed by globalization, and the number of people with either undocumented or with a precarious status is growing in Canada. There are no epidemiological data on the health and social consequences of this situation, but clinicians working in primary care with migrants and refugees are increasingly worried about the associated morbidity. This commentary summarizes findings from a pilot study with health professionals in the Montreal area and suggests that the uninsured population predicament is a national problem. Although ethical and legal issues associated with data collection by clinicians, institutions and governments need to be examined, estimating the public health consequences and long-term cost associated with problems in access to health care due to migratory status should be a priority. Current regulations and administrative policies appear to be at odds with the principles of equal rights set out by the Canadian Charter of Rights and Freedoms and the UN Convention on the Rights of the Child. Beyond the commitment of individual clinicians, Canadian medical associations should take an advocacy role and scrutinize the ethical and medical implications of the present system.