scholarly journals Access to healthcare services for the Roma and undocumented migrants in the EU in light of the Covid-19 pandemic

2020 ◽  
Vol 2 (2) ◽  
pp. 4
Author(s):  
Bernadett Mária Varga
Keyword(s):  
Health Services ◽  
Healthcare Services ◽  
Migrant Health ◽  
Health Policies ◽  
Undocumented Migrants ◽  
Health Coverage ◽  
The European Union ◽  
Increased Risk ◽  
Legal Entitlement ◽  
The Eu

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. 

scholarly journals Gaps in coverage and access in the European Union

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E Webb ◽  
W Palm ◽  
E van Ginneken ◽  
S Lessof ◽  
L Siciliani ◽  
...  
Keyword(s):  
European Union ◽  
Health Systems ◽  
Current Data ◽  
Vulnerable Groups ◽  
Undocumented Migrants ◽  
Health Coverage ◽  
The European Union ◽  
Income Status ◽  
Barriers To Access ◽  
Collection Practice

Abstract Background At the request of the European Commission, the Observatory on Health Systems and Policies and the HSPM network have undertaken a study to explore gaps in universal health coverage in the European Union and increase the level of granularity in terms of areas or groups where accessibility is sub-optimal. Methods To explore these gaps more systematically a survey was developed based on the so-called cube model that comprises different dimensions determining health coverage, including population coverage, service coverage and cost coverage. In addition, access can also be hampered by other factors, which relate more to the physical availability of care, a person's ability to obtain necessary care or the attitude of the provider. The survey was sent to country contacts from the Health Systems and Policy Monitor network. Results Within the diversity of country cases found in the survey, the most significant barriers for accessing health care still seem to be associated with social and income status, rather than specific medical conditions. However, groups like mentally ill, homeless, frail elderly, undocumented migrants are more likely to face multiple layers of exclusion and complex barriers to access. Conclusions Health system interventions can close access gaps for these vulnerable groups and address inequities in access to care. Through detailed coverage design countries can indeed determine the extent to which financial hardship and catastrophic out-of-pocket spending can be prevented. Furthermore, scope exists to improve current data collection practice.

Health policy in developing countries

2021 ◽  
pp. 301-322
Author(s):  
Thein T. Htay ◽  
Yu Mon Saw ◽  
James Levinson ◽  
S.M. Kadri ◽  
Ailbhe Helen Brady ◽  
...  
Keyword(s):  
Developing Countries ◽  
Health Policy ◽  
Health Sector ◽  
Monitoring And Evaluation ◽  
Healthcare Services ◽  
Health Policies ◽  
Health Coverage ◽  
The Sustainable Development ◽  
Development Goals ◽  
High Standards

The purpose of this chapter is to underscore the role of an integrated stewardship process and decentralization of healthcare services through high standards of governance towards effective health policies in developing countries. Changing disease patterns and challenging health status in developing countries calls for a rigorous monitoring and evaluation of prevailing health systems so that their new health policies be able to tackle these emerging health needs. Three stages of health transition and globalization have highlighted their impacts on health problems and health policies. The optimal composition and interactions of actors in health policy have influenced the strategic directions and policy implementation. In implementing the global and national health policies within the context of health system strengthening, national policies will better assure that health priorities in local settings are addressed and country-led while international assistance supports the health sector priorities. With the creation of the Millennium Development Goals (MDGs) and now the Sustainable Development Goals (SDGs), more attention is being given in these countries to policies and programmes which are results- and outcome-oriented. Possible strategies to improve health policy and the overall status of health in developing countries are recommended including Universal Health Coverage and the SDGs, among others.

scholarly journals Regulation of non-conventional therapies in Portugal: lessons learnt for strengthening human resources in health

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Pascoal Amaral ◽  
Inês Fronteira
Keyword(s):  
Health Services ◽  
Continuous Production ◽  
Universal Coverage ◽  
Health Service Delivery ◽  
Health Policies ◽  
Health Coverage ◽  
Defining Moment ◽  
Health Services Delivery ◽  
Minimum Quality Standards ◽  
Services Delivery

Abstract Background The integration of non-conventional therapies (NCT) into health policies and health services delivery is a worldwide trend and might have a role in achieving Universal Health Coverage. WHO has encouraged countries to integrate NCT into health service delivery and to increase the interest and utilization by consumers. Following two resolutions by the European Parliament and by the Council of Europe, in the late 1990s, recommending the recognition of NCT and calling for EU legislation on non-conventional forms of medicine, Portugal initiated, in 2003, its path towards regulation of NCT. We analyze this process and discuss its implications and impacts in terms of health policies, health services delivery and overall health workforce. Case presentation The need to regulate NCT in Portugal stemmed from a growing demand for NCT (and acceptability) among lay citizens and a positive attitude among conventional health professionals which also advocated for a regulatory framework. Political efforts undertaken since 2003 allowed for important advances in the regulation of NCT, beneficiating safe professional practices, and ensuring future academic training at the highest standards, with the defining moment of the social and legal model transition occurring in 2013, when acupuncture, chiropractic, homeopathy, naturopathy, osteopathy, phytotherapy and traditional Chinese Medicine were recognized and regulated. Nevertheless, and because the process knew important time gaps, significant deficiencies arose, mainly between regulation of the training and of the professional activities and the capacity to ensure the continuous production of NCT professionals at an acceptable rate and with minimum quality standards guaranteed. Conclusions The regulation of NCT in Portugal was lengthy but steady and was able to bring consumers a safer practice environment and NCT professionals a legal and deontological umbrella for their training, practice, and professional development. Nevertheless, and despite the growing acceptability and normative quality assurance of NCT and its workforce, the regulation process has highlighted some fragilities in terms of accessibility and availability that need attention and urgent action to achieve universal coverage.

scholarly journals Equity and determinants in universal health coverage indicators in Iraq, 2000–2030: a national and subnational study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Hiroko Taniguchi ◽  
Md Mizanur Rahman ◽  
Khin Thet Swe ◽  
Md Rashedul Islam ◽  
Md Shafiur Rahman ◽  
...  
Keyword(s):  
Health Service ◽  
Health Services ◽  
Antenatal Care ◽  
Universal Health Coverage ◽  
National Level ◽  
Health Coverage ◽  
Reconstruction Process ◽  
Targeted Interventions ◽  
Increased Risk ◽  
Universal Health

Abstract Background Equity is one of three dimensions of universal health coverage (UHC). However, Iraq has had capital-focused health services and successive conflicts and political turmoil have hampered health services around the country. Iraq has embarked on a new reconstruction process since 2018 and it could be time to aim for equitable healthcare access to realise UHC. We aimed to examine inequality and determinants associated with Iraq’s progress towards UHC targets. Methods We assessed the progress toward UHC in the context of equity using six nationally representative population-based household surveys in Iraq in 2000–2018. We included 14 health service indicators and two financial risk protection indicators in our UHC progress assessment. Bayesian hierarchical regression model was used to estimate the trend, projection, and determinant analyses. Slope and relative index of inequality were used to assess wealth-based inequality. Results In the national-level health service indicators, inequality indices decreased substantially from 2000 to 2030. However, the wide inequalities are projected to remain in DTP3, measles, full immunisations, and antenatal care in 2030. The pro-rich inequality gap in catastrophic health expenditure increased significantly in all governorates except Sulaimaniya from 2007 to 2012. The higher increases in pro-rich inequality were found in Missan, Karbala, Erbil, and Diala. Mothers’ higher education and more antenatal care visits were possible factors for increased coverage of health service indicators. The higher number of children and elderly population in the households were potential risk factors for an increased risk of catastrophic and impoverishing health payment in Iraq. Conclusions To reduce inequality in Iraq, urgent health-system reform is needed, with consideration for vulnerable households having female-heads, less educated mothers, and more children and/or elderly people. Considering varying inequity between and within governorates in Iraq, reconstruction of primary healthcare across the country and cross-sectoral targeted interventions for women should be prioritised.

Access and utilization of health services by migrant domestic helpers in Cyprus: the role of the employer

2019 ◽  
Vol 15 (1) ◽  
pp. 46-60 ◽  
Author(s):  
Marios Kantaris ◽  
Mamas Theodorou ◽  
Daphne Kaitelidou
Keyword(s):  
Health Services ◽  
Negative Impact ◽  
Dominant Role ◽  
Healthcare Services ◽  
Migrant Health ◽  
Health Needs ◽  
Sufficient Information ◽  
Healthcare Provision ◽  
Content Type

Purpose The dominant role of the employer regarding the access and use of healthcare services by migrant domestic helpers (MDH) often has a negative impact on healthcare provision for migrants in Cyprus. Research relating to the perceptions of MDH employers remains scarce. The purpose of this paper is to investigate the role of employers on the access and use of healthcare services by their MDH. Design/methodology/approach Three studies were carried out using semi-structured interviews with MDH (n=13) and employers of MDH (n=12) and structured questionnaires with MDH (n=625). Content analysis for qualitative findings was carried out using QSR Nvivo 10 and for quantitative using Statistical Package for Social Sciences version 17. Findings Findings provide information about migrant health needs from different views leading to improved documentation via multiple triangulation. Employers play a key gatekeeping role but are not in position to provide sufficient information and guidance to their MDH. MDH reported a need for health services which was not met (18 percent), attributing this to their employers not granting them permission. Originality/value The role of the employer is critical and has an impact on the quality of care provided to this migrant group. The involvement of the employer in MDH health matters functions as a barrier. A significant gap exists between employers and MDH regarding the health needs of the latter.

PALOMA project – developing National mental health policies for refugees

2017 ◽  
Vol 41 (S1) ◽  
pp. S337-S338
Author(s):  
S. Jokela ◽  
J. Mäki-Opas
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Mental Health Problems ◽  
Health Problems ◽  
Health Policies ◽  
Increased Risk ◽  
National Model ◽  
National Mental Health ◽  
Mental Health Policies

IntroductionEarlier researches have established that migrants with refugee background have increased risk for variety of mental health problems due to often traumatic reasons for leaving their home country, hazardous journey and post-migration adversity. The challenge is that mental health work with refugees is not systematically organized in Finland. PALOMA (developing National mental health policies for refugees 2016-2018) project was launched to answer these challenges. The project is carried out through the combined effort of National institute for health and welfare, The Finnish association for mental health, Helsinki and Kuopio university hospitals, and the municipality of Hämeenlinna. PALOMA Project is founded by the Asylum, migration and integration fund (AMIF).ObjectivesPALOMA project focuses on exploring existing good practices and weaknesses in mental health services in use for refugees. The objectives of the project are to develop a national model for effective mental health services for refugees and implement it nationwide in Finland.AimsThe aim of PALOMA Project is to develop a national model for effective mental health services for refugees in Finland.MethodsPALOMA Project includes three phases: data collection (interviews, literature review, seminars), building the model in expert groups and implementing the model.ResultsAs a result of PALOMA Project, there will be guidelines for professionals working in different levels of administration with refugees in Finland.ConclusionRefugees’ mental health and wellbeing will be improved as a result of better prevention, recognition and appropriate care of mental health problems.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Migrant health literacy in the European Union: A systematic literature review

2018 ◽  
Vol 78 (1) ◽  
pp. 81-95 ◽  
Author(s):  
Markia Ward ◽  
Maria Kristiansen ◽  
Kristine Sørensen
Keyword(s):  
European Union ◽  
Health Literacy ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Research Policy ◽  
Healthcare Delivery ◽  
Migrant Health ◽  
The European Union ◽  
Literacy Research ◽  
The Eu

Objective: The European Union (EU) has experienced an increasing intake of migrants in recent years. As its population diversifies, new challenges present themselves for healthcare delivery due to communication, cultural differences and health literacy of migrants. In the light of this, this systematic literature review examines the state of the art of migrant health literacy research within the EU. Methods: Based on PRISMA guidelines, a systematic literature review was conducted in 2013, 2016 and 2018 using the following databases: PubMed, Web of Science, CINAHL, MEDLINE and PsychINFO. Results: A total of 21 articles were selected for inclusion. EU-related migrant health literacy research dated from 2009, but only a small number of the EU member states were represented. Eight general research themes were identifiable. Definitions of migrants varied, however, or could not be identified within a particular study, which may hamper the further dissemination of research, policy and capacity building. Conclusion: The review shows the evolution of migrant health literacy research in the EU. More research is needed however to support health system responses, to increase the health literacy of migrants and to improve the quality of healthcare in the EU.

scholarly journals Financial Barriers to Access to Health Services for Adult People with Disability in Iran: The Challenges for Universal Health Coverage

2019 ◽  
Author(s):  
Shahin SOLTANI ◽  
Amirhossein TAKIAN ◽  
Ali AKBARI SARI ◽  
Reza MAJDZADEH ◽  
Mohammad KAMALI
Keyword(s):  
Health Insurance ◽  
Health Services ◽  
Universal Health Coverage ◽  
Healthcare Services ◽  
Health Coverage ◽  
Access To Health Services ◽  
Financial Barriers ◽  
Access To Health ◽  
People With Disability ◽  
Universal Health

Background: Reducing inequities in access to healthcare is one of the most important goals for all health systems. Financial barriers play a fundamental role here. People with disability (PWD) experience further financial barriers in access to their needed healthcare services. This study aimed to explore the causes of barriers in access to health services for PWD in Tehran, Iran. Methods: In this qualitative study, we used semi-structured in-depth interviews to collect data and selected participants through purposeful sampling with maximum variation. We conducted 56 individual interviews with people with disability, healthcare providers and policymakers from Sep 2015 until May 2016, at different locations in Tehran, Iran. Results: We identified four categories and eight subcategories of financial barriers affecting access to healthcare services among PWD. Four categories were related to health insurance (i.e. lack of insurance coverage for services like dentistry, occupational therapy and speech therapy), affordability (low income for PWD and their family), financial supports (e.g. low levels of pensions for people with disabilities) and transportation costs (high cost of transportation to reach healthcare facilities for PWD). Conclusion: Financial problems can lead to poor access to health care services. To achieve universal health coverage, government should reduce health insurance barriers and increase job opportunities and sufficient financial support for PWD. 

EU Health Policy

2015 ◽  
pp. 98-109
Author(s):  
Hakan Cavlak ◽  
Abdülkadir Işik ◽  
Davuthan Günaydin
Keyword(s):  
European Union ◽  
Health Policy ◽  
Health Sector ◽  
Maastricht Treaty ◽  
Common Market ◽  
Health Policies ◽  
The European Union ◽  
Health Issues ◽  
Market System ◽  
The Eu

Although not openly identified in treaties until the Maastricht Treaty, health has always been a crucial area for the European Union (EU), since freedoms provided and regulations brought by common market also dealt with several sections of the health sector. All concerning parts of health sector have to be subject to both freedoms and regulations of single market system. Despite the value given to health and related issues, a separate or supranational policy dealing with health issues has not been formed by the EU. The member states keep their privilege on health policies. However, the EU does not stay completely aside of health issues; on the contrary, the EU got involved in certain areas of health, especially the ones which have cross-border implications. In this chapter, the matter of to what extent the EU got involved in health issues is researched and the question of if the EU has a concrete health policy is analyzed.

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