scholarly journals Migrants and access to healthcare: the Italian public health residents action plan

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Mammana ◽  
C Milani ◽  
P Bordin ◽  
M Del Riccio ◽  
L G Sisti ◽  
...  
Keyword(s):  
Public Health ◽  
Access To Care ◽  
Working Group ◽  
Action Plan ◽  
Healthcare Access ◽  
Migrant Health ◽  
Access To Healthcare ◽  
Italian Society ◽  
Italian Regions ◽  
A Priority

Abstract Background Fighting health inequalities have been included in the WHO Sustainable Development Goals as a priority. Migrants are between the most vulnerable individuals and healthcare interventions, also during the post-migration period, should be oriented, context-specific and aimed at identifying reasons underlying inequalities, as suggested by the recent WHO report ’No public health without migrant health’. The “Inequality Working Group” of the Italian network of public health (PH) residents of the Italian Society of Hygiene, Preventive Medicine and Public Health (SItI) aims at identifying an interdisciplinary approach suitable to detect barriers to healthcare access for migrants in different Italian regions. Secondly, we aspire to develop some strategies to overcome unequal healthcare access. Methods Focus group methodology was applied to set working group educational needs, priorities of action and working plan. Moreover, we implemented a network between various professionals involved in migrant healthcare, particularly with the Regional Groups of the Italian Society of Migration Medicine (SIMM). Results After a period of peer-to-peer education about social determinants of health and migration, we reviewed Italian policies about migrants’ healthcare and considered potential discrepancies from WHO recommendations. Furthermore, we mapped practices regarding access to care for migrant population and we focused on causes underlying unequal healthcare access. Conclusions Although with regional differences, migrants have limited access to healthcare services and therefore represent a vulnerable subpopulation. Key messages Fighting against the barriers that limit access to care for migrants is a priority for health systems. PH residents have a relevant role in identifying and defining critical issues, designing enforcement measures and implementing advocacy actions.

scholarly journals Economic arguments in migrant health policymaking: proposing a research agenda

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Nora Gottlieb ◽  
Ursula Trummer ◽  
Nadav Davidovitch ◽  
Allan Krasnik ◽  
Sol P. Juárez ◽  
...  
Keyword(s):  
Public Health ◽  
Research Agenda ◽  
Healthcare Access ◽  
Migrant Health ◽  
Welfare States ◽  
Health Policies ◽  
Critical Examination ◽  
Public Healthcare ◽  
Excess Costs ◽  
Health Policymaking

AbstractWelfare states around the world restrict access to public healthcare for some migrant groups. Formal restrictions on migrants’ healthcare access are often justified with economic arguments; for example, as a means to prevent excess costs and safeguard scarce resources. However, existing studies on the economics of migrant health policies suggest that restrictive policies increase rather than decrease costs. This evidence has largely been ignored in migration debates. Amplifying the relationship between welfare state transformations and the production of inequalities, the Covid-19 pandemic may fuel exclusionary rhetoric and politics; or it may serve as an impetus to reconsider the costs that one group’s exclusion from health can entail for all members of society.The public health community has a responsibility to promote evidence-informed health policies that are ethically and economically sound, and to counter anti-migrant and racial discrimination (whether overt or masked with economic reasoning). Toward this end, we propose a research agenda which includes 1) the generation of a comprehensive body of evidence on economic aspects of migrant health policies, 2) the clarification of the role of economic arguments in migration debates, 3) (self-)critical reflection on the ethics and politics of the production of economic evidence, 4) the introduction of evidence into migrant health policymaking processes, and 5) the endorsement of inter- and transdisciplinary approaches. With the Covid-19 pandemic and surrounding events rendering the suggested research agenda more topical than ever, we invite individuals and groups to join forces toward a (self-)critical examination of economic arguments in migration and health, and in public health generally.

scholarly journals Modelling healthcare access for migrants and refugees in Europe: identifying the major health issues

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
A Gil-Salmerón ◽  
E Riza ◽  
P Karnaki ◽  
D Zota ◽  
A Linos
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Host Country ◽  
Healthcare Access ◽  
Migrant Health ◽  
Access To Healthcare ◽  
Maternal Child Health ◽  
Health Issues ◽  
Care Providers ◽  
Care Services

Abstract The Mig-HealthCare systematically searched to identify the key health areas of refugee/migrant health in order to facilitate interventions that help access to care services for migrants and refugees. The literature review was carried out in March 2018 using 3 large scientific databases using a combination of search terms following the PRISMA methodology and a standard set of items used to report on systematic reviews. Based on the predefined inclusion and exclusion criteria, a total of 118 publications were used for data extraction. It is important to note, that in almost all of the sources identified, the following cross-cutting factors were described as influencing access to healthcare: Continuity of Information, how it relates to policy, how it differs between health services and across-borders. Furthermore, the organizational coordination among social and health care providers in the host country determinates the successful access to healthcare of migrants/refugees.Language & Communication takes into consideration both the healthcare service and its provision of translators and cultural mediators, and the host country language proficiency of the migrant/refugee.Organizational improvement of access and delivery of health care services for migrants and refugees in addition to Cultural Competence of the healthcare providers meaning the ability to maximize their sensitivity in the service of care to culturally diverse groups.Health literacy understood as the motivation and competences of the migrant population to access, understand, appraise, and apply health information. Additionally, the health issues of particular importance for migrants/refugees as emerged from the systematic review, including mental health, maternal/child health, health promotion, NCDs and chronic diseases, Oral/|Dental health, and Vaccinations should be included in planning future needs and healthcare access.

scholarly journals Impacts of Medical Tourism on Healthcare Access

2021 ◽  
Author(s):  
Iskra Alexandra Nola ◽  
Zdeslav Radovčić
Keyword(s):  
Public Health ◽  
Patient Safety ◽  
Organ Transplantation ◽  
Healthcare System ◽  
Medical Tourism ◽  
Healthcare Access ◽  
Access To Healthcare ◽  
Tourism Industry ◽  
Dental Services ◽  
Private And Public

Today, medical tourism is underrated and mostly perceived as a beauty tourism. However, except dermatological and dental services also organ transplantation, IVF and many other therapies are well present in medical tourism travel arrangements. Medical tourism without any doubt impacts access to healthcare. Healthcare system in many countries allows access to some of these services but all-around world approaches differ. We believe that healthcare access could greatly benefit by opening this kind of services to wider population while at the same time not endangering patient’ safety. Harmonized propositions, accreditations and certificates for medical tourism industry access covered by both, private and public health insurances, would contribute to service transparency and patient’ safety while taking care of moral aspects of such services. Therefore, if consciously incorporated, medical tourism, as a part of global healthcare could easily become an efficient and effective additional access to healthcare.

scholarly journals Health Disparities and Access to Healthcare in Rural vs. Urban Areas

2021 ◽  
Vol 14 (2) ◽  
pp. 6-27
Author(s):  
Megan Reilly
Keyword(s):  
Access To Care ◽  
Urban Communities ◽  
Rural Areas ◽  
Urban Areas ◽  
Healthcare Access ◽  
Healthcare Research ◽  
Access To Healthcare ◽  
Rural And Urban Areas ◽  
The North ◽  
Rural And Urban

Individuals and families in rural areas face disparities in health as well as access to healthcare. Research has found that when compared to urban communities, rural areas have worse health outcomes including challenges with mental health, substance abuse, physical health, and sexual health. Relevant findings have also shown that in order to understand these challenges it is important to discuss access, including the different factors involved: availability, affordability, and acceptability. Along with defining access, there are several theories and frameworks that additionally help explain healthcare access in rural areas. Although availability, affordability, and acceptability are important variables when it comes to access, there are also several barriers that must be considered, including poverty, occupation, education, insurance, and lack of competence. Once all of these aspects are addressed, different strategies can be more easily implemented in order to improve health and access to care in rural areas. These different disparities in heath and access to care can be seen throughout the North Country, and can be helpful in understanding the larger pattern of health in rural and urban areas.

scholarly journals Are Norwegian Municipality policies enabling intersectoral collaboration in migration health?

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
C Nordström ◽  
B Kumar
Keyword(s):  
Public Health ◽  
Social Determinants ◽  
Local Level ◽  
Good Health ◽  
Migrant Health ◽  
Intersectoral Collaboration ◽  
Health Work ◽  
Integration Policy ◽  
Intersectoral Action ◽  
The Social

Abstract Issue Sporadic accounts of initiatives, interventions and good practices in Migrant Health at the Municipality level account for Norways' lower score on “Measures to achieve change” in the Migrant Integration Policy Index (MIPEX). While the structure and organization at the municipality level should enable intersectoral action (as all under one umbrella), the municipal counties say lack of intersectoral collaboration is one of the main barriers for long-term public health work. Description of the Problem 51 municipalities have an immigrant population larger than the national average 17,8% (2019). In a recent Country Assessment (part of Joint Action on Health Equity Europe), limited inter-sectoral action on the social determinants of health including migration was observed. Although multiple agencies are engaged in attempts to address these issues. While there is a drive to promote public health and primary health care in municipalities, these initiatives do not pay special attention to migrants. In the first stage of this project, we have reviewed municipal policy documents to map policy and measures on public health, migrant health and intersectoral collaboration. In the second stage, municipalities will be contacted to engage them in the implementation of intersectoral actions. Results The desk review and mapping show that only 8 of the “top” 32 municipalities mention “intersectoral” in the municipal master plan (5 were not available online), its mentioned in 9 action program/budgets, but not necessarily by the same municipalities. 15 of the municipalities mention migrants, but rarely in relation to health. We observe that, the size of the municipality, financial resources and support from the County are factors that may play a significant role in prioritising migrant health and intersectoral collaboration. Lessons Advocating for and supporting the local/municipal level for intersectoral action is highly relevant, timely and essential. Key messages Intersectoral action on the social determinants of migrants’ health needs to be implemented through municipal policies to reduce inequities in migrants’ health. Implementation on the local level is the main arena for good public health work and is crucial to ensure good health for migrants.

scholarly journals Contexts and mechanisms that promote access to healthcare for populations experiencing homelessness: a realist review

BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e043091
Author(s):  
Rikke Siersbaek ◽  
John Alexander Ford ◽  
Sara Burke ◽  
Clíona Ní Cheallaigh ◽  
Steve Thomas
Keyword(s):  
Health System ◽  
Healthcare Access ◽  
Grey Literature ◽  
Realist Review ◽  
Access To Healthcare ◽  
Staff Retention ◽  
Programme Theory ◽  
Eligibility Criteria ◽  
Ovid Medline ◽  
High Level

ObjectiveThe objective of this study was to identify and understand the health system contexts and mechanisms that allow for homeless populations to access appropriate healthcare when needed.DesignA realist review.Data sourcesOvid MEDLINE, embase.com, CINAHL, ASSIA and grey literature until April 2019.Eligibility criteria for selecting studiesThe purpose of the review was to identify health system patterns which enable access to healthcare for people who experience homelessness. Peer-reviewed articles were identified through a systematic search, grey literature search, citation tracking and expert recommendations. Studies meeting the inclusion criteria were assessed for rigour and relevance and coded to identify data relating to contexts, mechanisms and/or outcomes.AnalysisInductive and deductive coding was used to generate context–mechanism–outcome configurations, which were refined and then used to build several iterations of the overarching programme theory.ResultsSystematic searching identified 330 review articles, of which 24 were included. An additional 11 grey literature and primary sources were identified through citation tracking and expert recommendation. Additional purposive searching of grey literature yielded 50 records, of which 12 were included, for a total of 47 included sources. The analysis found that healthcare access for populations experiencing homelessness is improved when services are coordinated and delivered in a way that is organised around the person with a high degree of flexibility and a culture that rejects stigma, generating trusting relationships between patients and staff/practitioners. Health systems should provide long-term, dependable funding for services to ensure sustainability and staff retention.ConclusionsWith homelessness on the rise internationally, healthcare systems should focus on high-level factors such as funding stability, building inclusive cultures and setting goals which encourage and support staff to provide flexible, timely and connected services to improve access.

scholarly journals 31.C. Workshop: Development and implementation of action plans on health literacy

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
◽  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Health Literacy ◽  
Health Information ◽  
Digital Health ◽  
Action Plan ◽  
Knowledge Society ◽  
Implementation Strategies ◽  
Social Consequences ◽  
Action Plans

Abstract Health literacy (HL) has become an important topic in many countries. As HL - meaning the ability to access, understand, appraise and apply health information (Sørensen et al. 2012) - is important to make sound health decisions, to promote health and to take an active part in managing health and illness in everyday life and navigating the health care system. In the modern digital knowledge society, HL is also indispensable for orienting oneself in the abundance of mostly digital health information, including incorrect and false information, for locating reliable information and for assessing the trustworthiness and quality of information. However, available studies show that HL is insufficient in many countries. Low HL has - as many studies show - negative social consequences ranging from unhealthy behaviour, higher risk for diseases, less self-care and deficits in coping with illness and chronicity, to over- and misuse (extensive use) of health care. The promotion of HL is therefore an important public health task. An increasing number of population studies and policy documents currently underline this. The WHO has therefore included HL into many of its strategies, like the declarations of Shanghai (2016) and Astana (2018), and has published several publications focusing on HL, like the Solid Facts (2013), the 57th Health Evidence Network Report (2018) or the Roadmap for Implementing Health Literacy Activities (2019). In many countries, strategies and national action plans to improve HL have been developed in response to the political call for action, e.g. in Scotland, Germany and recently also in Portugal. Other countries and regions are currently working on the development of a HL action plan, e.g. Belgium and the WHO European Region action plan on HL. The development and especially the implementation strategies of action plans in different countries and the experiences gained will be discussed comparatively in the workshop. Following an introduction (10'), two countries, which already have action plans will introduce their implementation strategy in one presentation each: Germany and Portugal (30'). This will be followed by two presentations of countries/regions in which action plans are currently being developed: Belgium and WHO Europe (30'). Afterwards the participants will have the opportunity to ask questions and discuss on the different strategies (20'). The workshop will help other initiatives to successfully develop and implement policy plans and strategies in different fields of public health. Key messages Strategies and national action plans to improve HL have been developed in different countries/regions. It is important to reflect on the chosen development and implementation strategies and to discuss their effects, successes and barriers.

scholarly journals Understanding the Spatial-Related Abstraction of Public Health Impact Goals and Measures: Illustrated by the Example of the Austrian Action Plan on Women’s Health

2021 ◽  
Vol 13 (2) ◽  
pp. 773
Author(s):  
Tatjana Fischer
Keyword(s):  
Public Health ◽  
Women’S Health ◽  
Women's Health ◽  
Spatial Planning ◽  
Action Plan ◽  
Qualitative Interviews ◽  
Health Impact ◽  
Political Awareness ◽  
Policy Paper ◽  
High Degree

The influence of spatial aspects on people’s health is internationally proven by a wealth of empirical findings. Nevertheless, questions concerning public health still tend to be negotiated among social and health scientists. This was different in the elaboration of the Austrian Action Plan on Women’s Health (AAPWH). On the example of the target group of older women, it is shown whether and to what extent the inclusion of the spatial planning perspective in the discussion of impact goals and measures is reflected in the respective inter-ministerial policy paper. The retrospective analysis on the basis of a document analysis of the AAPWH and qualitative interviews with public health experts who were also invited to join, or rather were part of, the expert group, brings to light the following key reasons for the high degree of spatial-related abstraction of the content of this strategic health policy paper: the requirement for general formulations, the lack of public and political awareness for the different living situations in different spatial archetypes, and the lack of external perception of spatial planning as a key discipline with regard to the creation of equivalent living conditions. Nonetheless, this research has promoted the external perception of spatial planning as a relevant discipline in public health issues in Austria. Furthermore, first thematic starting points for an in-depth interdisciplinary dialogue were identified.

scholarly journals Addressing lead exposure in children in Georgia: challenges and successes of a multi-agency response

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Ruadze ◽  
I Khonelidze ◽  
L Sturua ◽  
P Lauriola ◽  
H Crabbe ◽  
...  
Keyword(s):  
Public Health ◽  
Blood Concentration ◽  
Tracking System ◽  
Action Plan ◽  
Blood Lead ◽  
Relevant Information ◽  
State Intervention ◽  
Intervention Programme ◽  
Public Health Action ◽  
Pb Exposure

Abstract The national response for reducing lead (Pb) exposure in Georgia is coordinated by the National Centre for Disease Control and Public Health (NCDC&PH) and implemented as a multi-agency (CDC, UNICEF, WHO, University of Emory) response. Given concerns about the extent of Pb exposure, in 2018 Multiple Indicator Cluster Surveys (MICS) of representative samples of children have been conducted to study several demographic and health aspects, including a study of the prevalence of blood Pb levels among 2 to 7 years old children (n = 1578). This survey was conducted in collaboration with the Italian Instituto Superiore di Sanita' (ISS), UNICEF and NCDC. The laboratory analyses were conducted at ISS in Italy. Initial results showed that in 41% of all children, blood Pb concentration was ≥ 5 µg/dl, a challenge which motivated public agencies to establish an initial public health action plan to assess environmental samples (paint, dust, water, soil, selected food items such as spices and imported sweets) in families where Pb concentrations were ≥ 10 µg/dL. A State intervention programme, monitoring Pb blood concentration among MICS children and their family members, provided relevant information on exposed households and led to a reduction of Pb blood concentration across the most exposed households. In collaboration with Public Health England, NCDC has conducted a small Pb isotope ratio study aimed at identifying the most relevant sources of Pb exposure contributing to elevated blood Pb in MICS children. It is expected that these data will support the design of more detailed public health interventions to reduce exposure to key sources of Pb, thus leading to further reduction of Pb-induced health effects in Georgia. In addition, this experience will clarify elements of an ongoing monitoring of environmental factors such as an Environmental Public Health Tracking system, to support national capacity to manage the risks to public health. Key messages Environmental health response requires extensive research and multi-agency approach. If State implements adequate intervention it is possible to reduce blood lead (Pb) level.

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