Background
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What is known about the physical and mental health status of migrants and refugees in the EU member states? This topic was included in the literature review because it provides insight into the access to healthcare question.
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What is known about healthcare access and use of migrants and refugees in the EU member states?
Methods
Sources of evidence
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Time frame: 2011 to 2017 (the rationale for this is that 2011 saw the beginning of the Syrian and Libyan revolutions accompanied by an increase in the flow of migrants towards the EU 28 countries)
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Databases: PubMed, ScienceDirect, Scopus, PsycInfo, Social Services Abstracts (also in ProQuest), Cochrane library, CABI. Eurostat, OECD, Eurofound, CORDIS and any other databases that are available in the different languages included in the search.
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The search terms: Topic: (migrant* or migration or immigrant* or foreign* or (minority near groups) or refuge* or asylum) AND TOPIC: service* or access* or planning or delivery) AND TOPIC: (health or medical), dental care, obstetrics/gynaecology, mental health, social care
Selection process
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Academic articles and literature reviews (each country in its own language)
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Grey literature (think tanks, non-governmental organisation and government reports)
Data extraction and coding
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Migrants’ health status. This theme is divided in
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◦ communicable and non-communicable diseases
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◦ mental health in adult refugees and migrants
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◦ children’s health status
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Social determinants of health. This theme is included for the link between socio-economic condition and health status.
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Access to healthcare. The theme is divided in
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◦ access to maternal health services
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◦ communication and information issues
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Use of healthcare service
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Challenge to healthcare provision in transfer countries. This is a theme in its own right because transfer countries are reported to face common problems but to a higher degree.
Results
Migrants’ health status
Communicable and non-communicable diseases
Mental health in adult refugees and migrants
Children’s health status
Social determinants of health
Access to healthcare
Access to maternal health services
Communication and information issues
Migrants’ healthcare use
Challenges to healthcare provision in transfer countries
Discussion
Limitations and strengths
Conclusion
Annex
Study | Country | Type of study | Study design | Population | Sample size | |||
---|---|---|---|---|---|---|---|---|
Scholarly article | Grey literature | Quantitative | Qualitative | |||||
Cross sectional | Longitudinal | |||||||
Matlin et al. (2018) | Europe and beyond (region, country and province and city jurisdictional level) | Yes (literature review | ||||||
Aichberger at al. (2012) | Germany | Yes | Yes | German residents50+ born outside or who have immigrated to Germany | 2890 | |||
Berchet & Jusot (2012) | France | Yes (Literature Review) | ||||||
Estrada & Lazimi (2013) | France | Yes | Yes (128) | Yes (33 interviews) | Women visiting MdM health facilities in Paris and St Denis | |||
Rechel at al. (2012) | European Union | Yes (Literature Review) | ||||||
Rommel et al. (2015) | Germany | Yes | Yes | Population-wide 18+ | 8151 | |||
Bozorgmeh et al. (2016) | Germany | Yes | Yes | Yes | Heads of all German public health authorities | 389 | ||
Biffl (2003) | Austria | Yes (Conference paper) | Yes | Population wide | ||||
Padovese et al. (2015) | Malta | Yes | Yes | Migrants men and women | 2216 | |||
Kotsioni & Egidi (2013) | Malta and Greece | Yes (Report) | Yes | Migrants and asylum seekers in immigration detention facilities in Greece and Malta between 2008 and 2011 | ||||
D’Hermies and de Champs-Léger (2015) | France | Yes | Yes | Outpatients with ophthalmic issues from the free access to healthcare facilities at an Hospital in Paris | 150 | |||
Lot et al. (2012) | France | Yes | Yes | Migrants with HIV, TB or Hepatisis B | National data base | |||
Che & Antoine (2011) | France | Yes | Yes (epidemiological) | TB | National data base | |||
Albares et al. (2012) | Spain | Yes | Yes (epidemiological) | All immigrant patients seen at the dermatology clinic between February 2005 and February 2006 in Alicante (Spain). | ||||
Aguilar-Duran & Sánchez Martínez (2014) | Spain | Yes | Yes | All the patients diagnosed with TL in Hospital del Mar (Barcelona) between 1990 and 2009. | ||||
Calderón Sandubete et al. (2014) | Spain | Yes (Literature review) | ||||||
Crepet et al. (2015) | Italy | Yes (NGO report) | Yes | Asylum seekers MSF clinics in Sicily | 385 | |||
Simonnot et al. (2016) | Europe | Yes (NGO report) | Yes | Vulnerable migrants in 31 cities/12 countries | 30,534 patients | |||
ANCI,Caritas italiana Fondazione Mifa, Servizio centrale dello Sprar (2016) | Italy | Yes (Report) | Yes | |||||
Taylor-East & Caruana (2014) | Malta | Yes | ||||||
Camilleri and Taylor-East (2010) | Malta | Yes | Yes | All patients newly admitted, with a diagnosis of psychosis; no exclusion criteria related to age, gender or ethnicity. | 111 patients, 67 of whom were male and 44 female | |||
Burbotte et al. (2011) | France | Yes | Yes | Children 1 to 15 years old | 315 | |||
Monpierre et al. (2016) | France | Yes (Thesis) | Yes (Combination of biological tests, plus medical file of patient, hospital data and data from the place where the minor lives). | Minors | ||||
Pavlopoulo et al. (2017) | Greece | Yes | Yes | Migrant and refugees Children 1 to 14 years old out patient clinic of a tertiary hospital | 300 | |||
Giannakopoulos et al. (2016) | Greece | Yes (Lancet short note) | ||||||
Bodenwinkler et al. (2012) | Austria | Yes | Yes | Children 12 years old | Representative sample of randomly selected children attending public schools | |||
Kaoutar et al. (2014) | France | Yes | Yes | Patients from the free access to healthcare facilities at the French National Health Service | 581 | |||
Kaoutar et al. (2012) | France | Yes | Yes (Quantitative, by questionnaire and medical examination) | Patients from the free access to healthcare facility at the Baudelaire Hospital - Paris | 536 | |||
Debono & Grazia (2016) | Malta | Yes (Report for the European Commission) | Desk analysis of national policies for asylum seekers and refugees | |||||
Barda et al. (2016) | France) | Yes | Yes | The population of Médecins du Monde health centers in Paris and Saint Denis in particular vulnerable migrants who faced accomodation issue | ||||
Dray Soira et al. (2015) | France | Yes | Yes | National data bases | 778 outpatients in 20 healthcare settings | |||
Bergeon & Hoyez (2015) | France | Yes | Yes | Ethnography and qualitative interviews to migrants living in squats | Well regarded study | |||
Cognet et al. (2012) | France | Yes | Yes (qualitative interviews follow up sof the quantitative survey “Trajectoires et Origines” | Not newly arrived migrants but with a life course focus on discimination linked to the country of origin | ||||
Bradby et al. (2015) | Europe | Yes (literature review) | ||||||
Tognetti (2015) | Italy | Yes (literature review) | ||||||
Affronti et al. (2014) | Italy | Yes (book chapter – desk research) | ||||||
Suess et al. (2014) | Spain | Yes (narrative review of comparative studies published between 2009 and 2012 | ||||||
Cuadra (2010) | Europe | Yes (Comparative report or laws and regulations in Eu countries) | Survey among national experts in law and regulations on care for undocumented migrants | |||||
Pithara et al. (2012) | Cyprus | Yes | Qualitative on temporary migrants to access and use effectively healthcare services in Cyprus | Semistructured interview with domestic workers and students | 13 domestic workers and 13 students | |||
Kouta et al. (2013) | Cyprus | Yes | Quantitative (closed-ended questionnaire referring to the knowledge, attitudes and behaviour of the participants in relation to HIV/AIDS | 600 partecipants: migrant from non EU countries from two cities in Cyprus (Nicosia, Limassol). | ||||
Sanchez et al. (2016) | Cyprus | Yes (report) | Literature review and face to face interviews and focus group | 9 immigrants from different countries | ||||
Marques (2012) | Europe | Yes (note reviewing undocumented migrants’ access to healthcare) | ||||||
Aditus (2013) | Malta | Yes (NGO report) | Standardized questionnaires | People in all phases of the settlement and integration processes in Malta. | 156 people, 55 female, and 101 male. | |||
Association Aides (2015) | France | Yes (NGO report) | Questionnaire | Yes | Migrants with heath issues. National foreign who apply to a regularization of their administrative situation in regards to their health status. | |||
Chappuis et al. 2015 | France | Yes (NGO report) | Yes | Yes | Patients visiting Médecins du Monde (MdM) health centers in France | |||
Bas Sarmiento et al. (2015) | Spain (Campo de Gibraltar) | Yes | Qualitative | 51 migrants from 11 countries | ||||
Kohls (2012) | Germany | Yes (report from the Federal Agency for Migration and Refugees) | Elderly people | |||||
Frank et al. (2017) | Germany | Yes (literature review on the general health care delivery for refugees/asylum seekers) | Refugees/Asylum seekers | |||||
Razum (2008) | Germany | Health reporting of the Federal German Government conducted by Robert-Koch-Institute and the Federal Statistical Office | Survey | Migrants | Statistically representative sample of the population | |||
Taglieri et al. (2013) | Italy | Yes (Healthcare Institute report) | Report on the activity of the HIV phone counselling | Non-Italian population living in Italy and accessing the Intervention for the prevention of HIV infection | ||||
Osservatorio della salute (2016) | Italy | Yes (National Institute of Statistic report) | Census data | Resident foreign population by municipality | Census | |||
Grech & Pisani (2016) | Malta | NGO report | FGDs and in-depth interviews | Female population | 9 Refugee Women from Syria, Somalia, Libya, Eritrea, Ethiopia, and Ivory Coast in Malta 2 health care providers | |||
Råssjö (2013) | Sweden | Yes | Quantitative (retrospective case control study) - antenatal health record) | Migrants and non-migrants women using ante-natale care | 523 Swedish-born women and 262 Somali women | |||
Villadsen et al. (2016) | Europe; North America; Australia | Yes | Literature review and case study | Best practices Best Practice & Research Clinical Obstetrics and Gynaecoloy | ||||
GLM study | Austria | Yes | ||||||
`Ganhal (2016) | Austria | Yes | Turkish, Bosnia/Croatia/Serbia | |||||
Rosano (2015) | Italy and Spain | Yes | Quantitate, secondary analysis | Migrants and native population in Italy and Spain, Census data | European Union Statistics on Income and Living Conditions (EUSILC) | |||
Koponen et al. (2014) | Finland | Yes | Yes –(Survey) | Migrants from Russian, Somali, Kurdish background aged 18–64 years | 3000 persons of Russian, Somali or Kurdish origin | |||
Wångdahl (2014) | Sweden | Yes | Yes (survey) | Adult refugees connected to language schools for migrants in Sweden | 455 adult refugees | |||
Crede´ et al. (2017) | Europe | Yes | Systematic literature review | International migrants’ using EDs in European Economic Area (EEA) countries compared with that of non-migrants | ||||
Kohls (2011) | Germany | Yes | Statistical analysis | Foreign nationals | Data from the official statistics, data of the national central register of foreign nationals and of the statutory pension insurance | |||
Halmdienst et al. (2013) | Europe | Yes | Longitudinal, multidisciplinary and international data collection (SHARE) | Migrants 50+, partly focus on groups from Former Yugoslavia | 60,000 people over the age of 50 are examined for health, age, pension-specific and financial issues in around 20 European countries and Israel. | |||
Reinprecht et al. (2016) | Austria (City of Vienna) | Yes | Survey | Qualitative interviews | Older migrant from Turkey, Former Yugoslavia, Poland, Iran | 60,000 people over the age of 50 11 qualitative interviews | ||
Tsitsakis (2017) | Greece | Yes | Secondary quantitative analysis | Data from five of the six public hospitals in the specified region; per clinic cross tabulation analysis of admission diagnosis and citizenship variables | ||||
Ben Cheikh (2011) | Spain | Yes | Retrospective longitudinal study | 2004–2007 Hospital discharges of the foreign population in public hospitals in Aragon | ||||
Carmona at al. (2014) | Spain | Yes (Systematic literature review of survey-based evidence on the use of care among migrants) | Migrants | |||||
Gistau et al. (2012) | Spain | Yes | Qualitative FGs and semi-structured interviews | Respondents of 4 professional profiles: directors or coordinators, physicians, nurses, and cultural mediators. | 73 hospital and primary health care professionals | |||
Psarros et al. (2016) | Greece | Yes | Action research to provide psychological support through education, training and psychological support | Caregivers who worked as volunteers in non-governmental organisations in the hotspot of Moria on the island of Mytilene and in Idomeni (near the northern Greek border) | 57 caregivers (30 women and 27 men) with a mean age of 32·3 years, who worked continuously for 70 days on average. | |||
Hunter (2016) | Europe | Yes (Commentary on healthcare for migrants and refugees in different European countries in historical perspective) | Migrants and Refugees | |||||
Dara et al. (2016) | Europe | Yes | Yes A questionnaire investigating screening and management practices among refugees | National TB programme representatives of all EU/European Economic Area countries of the WHO European Region, Switzerland and six additional (Albania, Bosnia and Herzegovina, the former Yugoslav Republic of Macedonia, Montenegro, Serbia and Turkey | 36 national TB programme representatives of low and intermediate TB incidence European countries/territories of the WHO European Region | |||
Morgan (2016) | Greece | Yes (Interview with senior medical officer published in The Lancet) | Refugees in a Northern Greek camp | |||||
Psoinos et al. (2017) | Greece | Missing from Zotero | ||||||
Associazione Nazionale Comuni Italiani (Anci) et al. (2016)
| Italy | Yes NGO report | Overview of the literature an best practices on mental health of migrants and refugees in Italy | Young and adult asylum seekers and refugees | ||||
Medici senza Frontiere (2016) | Italy | Yes NGO report | Survey | Qualitative (interview and focus group) | Mental health service providers and migrants with mental health problems | 135 participants (providers and migrants) | ||
HCDCP et al. (2016) | Italy, Greece and Spain | Yes NGO report | Report on health assistance to migrants, refugees and asylum seekers through civil society organizations. | Refugees and asylum seekers, but also internal migrants, irregular migrants, trafficked persons, internally displaced people | Representatives from civil society organizations and also representatives from public | |||
Tsiamis, Riza et al. (2016) | Greece | Yes (correspondence on the Lancet) | ||||||
Alcaraz et al. (2014) | Spain | Yes | Cross-sectional study | Immigrant women | 339 episodes of care from February 2008 to October 2011 in Valencia |