Background
Methods
COUNTRY | Academia | NGO | Policymaker | Practitioner |
---|---|---|---|---|
AUSTRIA | Sociology (3) | Political sciences | Political sciences (2) | Medicine (2) |
BELGIUM | Public health Sociology (2) Pedagogy | Medicine Social work | Medicine Anthropology | Public health Medicine (2) |
DENMARK | Psychiatry(2) | Psychiatry | Public Health Sociologist | Public health Internal medicine Medicine |
ENGLAND | Researcher Nursing | Social work | Medicine (2) | Psychiatry Occupational therapy Psychology |
FINLAND | Social sciences Master of Arts in Comparative Religion | Psychiatric nursing Psychiatry | Law | Psychiatry Public health Nursing (2) |
FRANCE | Public health (2) | Medicine Social work | Public health Psychologist | Psychiatry Medicine |
GERMANY | Psychiatry (3) Political sciences Sociology Medical psychology | Psychotraumatology Political sciences NGO activist | Social sciences | Psychiatry |
GREECE | Law Public health | Medicine | Health economy | Psychiatry Psychology Medicine (2) |
HUNGARY | Sociology Geography | Economical sciences Chemical sciences | Social worker (2) | Medicine (2) |
ITALY | Public health Psychiatry | Psychiatry Medicine | Psychiatry (2) | Public health Psychiatry |
LITHUANIA | Medicine Medical anthropology | Medicine Social Sciences/Law | Public health (2) | Gynaecology Medicine |
NETHERLANDS | Sociology Epidemiology | Paediatrics Medical anthropology | Management Public Health | Medicine (2) |
POLAND | Political sciences Migration studies | Cultural anthropology NGO Activist | Law Psychology | Medicine (2) |
PORTUGAL | Medicine Sociology | Medicine Biochemistry | Intercultural relations Nursing | Public Health Nursing |
SPAIN | Human Geography Economical Sciences | Medicine (2) | Medicine (2) | Gynaecology Psychology |
SWEDEN | Public Health Psychology | Nursing | Nursing Sociology Psychology | Medicine (2) |
Results
COUNTRY
|
1st round
|
2nd round
|
Final
|
Scores
|
---|---|---|---|---|
AUSTRIA | 48 | 17 | 11 | 4.4-4.0 |
BELGIUM | 91 | 21 | 10 | 4.6-4.3 |
DENMARK | 60 | 32 | 11 | 5.0-4.4 |
ENGLAND | 64 | 28 | 10 | 4.9-3.5 |
FINLAND | 50 | 22 | 13 | 4.9-4.0 |
FRANCE | 84 | 41 | 16 | 4.9-4.1 |
GERMANY | 64 | 30 | 12 | 4.8-4.2 |
GREECE | 24 | 24 | 10 | 4.6-4.0 |
HUNGARY | 65 | 16 | 10 | 4.0-3.3 |
ITALY | 80 | 11 | 10 | 4.6-3.8 |
LITHUANIA | 45 | 35 | 14 | 4.8-4.1 |
NETHERLANDS | 54 | 26 | 12 | 4.9-3.9 |
POLAND | 63 | 31 | 16 | 4.8-4.0 |
PORTUGAL | 57 | 18 | 10 | 4.8-4.0 |
SPAIN | 75 | 14 | 10 | 5.0-3.2 |
SWEDEN | 76 | 30 | 11 | 4.9-4.5 |
Consensus
Theme | Description | Details | Countries mentioning theme | Countries not mentioning theme in first 10 |
---|---|---|---|---|
Easy and equal access | A health care system that is easy to access for migrants | • Accessibility on the same terms as the general population: | 16 | |
◦ In health care systems with free access, free access to care for migrants. | ||||
◦ In insurance-based health care systems, migrants should have the right to be insured. | ||||
• Remove barriers to accessing secondary care. | ||||
• Special health services should be made available in areas with high migrant populations | ||||
• Service hours should adapt to the needs of their users, including migrants. | ||||
• Services should be affordable: governments should provide the necessary resources and adapt legislation to achieve this. | ||||
• Inform health professionals about the legislation related to the rights to health care for migrants in their country. | ||||
Empowerment | Empower migrants with regard to health & health determinants | • Provision of information for migrants in their own language
| 15 | DK |
◦ about their rights and the functioning of the health care system and social care system. | ||||
◦ about health, illness and prevention
| ||||
◦ Provide a special consultation the first time people access the health care system. | ||||
• Outside the health care sector: | ||||
◦ improving access to work as well as work and living conditions empowers migrants and may consequently | ||||
◦ improve their health. providing opportunities to learn the language of the host country will facilitate integration into the host country and consequently also access to health care. | ||||
• Participation of migrants and non-governmental organisations (NGOs) dealing with migrants in the organisation of health care services. | ||||
Culturally sensitive care | Adjust care provision to cultural differences | • Health care providers should receive specific training on cultural competencies and communication skills. | 14 | FI, UK |
• Employ cultural mediators or health care providers of migrant descent, | ||||
• Develop specialised services in case of added value to regular services can be demonstrated. | ||||
• Health education and health promotion messages should take into account cultural diversity. | ||||
Quality care | Guarantee quality of care | • Services should consider the patient as an individual and not stereotype them with the characteristics of the cultural group they are perceived of as belonging to. | 12 | DE, LT, PT, UK |
• Quality care means taking into account the individual's specific medical history and social background and giving individualised psychological support and empathy. | ||||
• Health care professionals should take the time to listen to patients and check that both parties have understood each other. | ||||
• Other factors mentioned: | ||||
◦ establishing trust, | ||||
◦ seeking truly informed consent, | ||||
◦ guaranteeing continuity of care
| ||||
◦ adapting care to the person's lifestyle and their capacity to receive and self-manage care | ||||
Patient-health care provider communication | Provide interpreting and translation | • High quality interpreter services, either in person or by telephone, should be easily accessible. | 11 | BE, HU, IT, NL, PT |
• Services should take into account varying levels of both health literacy and mastery of the local language. | ||||
Respect towards migrants | Fight discrimination & prejudice, respect differences | • Practitioners should show respect, create trust, be interested and address patients without prejudice and with an open mind. | 9 | AT, BE, DE, EL, IT, PT, UK |
• Health care services should be delivered without xenophobia or any sign of racism. | ||||
• Health care providers should be motivated to deliver care for migrants with attention to their specific needs and priorities. | ||||
• A policy against acts of discrimination in health care facilities should be established and implemented. | ||||
Networking in and outside health care services | Effective networking, integrated care | • Networking within health care services and between health and social services
| 8 | AT, BE, DE, EL, FR, HU, LT, SE |
• Interdisciplinarity is a priority within health care services. | ||||
• Coordination between primary care services, or between primary care and refugee-specific health care services. | ||||
• Supporting migrants to develop their social networks
| ||||
• Supporting migrants or persons of migrant descent who care for other migrants. | ||||
Targeted outreach activities | Targeted outreach programmes in prevention and care | • Outreach activities in health education, screening, prevention and promotion with difficult to reach migrant groups. | 8 | AT, BE, DK, FI, LT, NL, PL, SE |
Availability of data | Data on migrants, epidemiology, research | • Health care services should be provided with relevant knowledge on health and risk factors concerning the populations they are dealing with. | 6 | DK, EL, FR, HU, IT, LT, PL, PT, SE, UK |
• Health registries
| ||||
◦ should record and monitor migrant health to facilitate migrant health research. | ||||
◦ should be able to integrate patient mobility with full respect of human rights. |
-
Accessibility: easy and equal access to health care (mentioned by all 16 countries)
-
Empowerment of migrants (15 countries)
-
Culturally sensitive health care (14 countries)
-
Quality of individual care (12 countries)
-
Patient-health care provider communication (11 countries)
-
Respect towards migrants (9 countries)
-
Networking and interdisciplinarity (8 countries)
-
Targeted outreach activities (8 countries)
-
Availability of data (6 countries)
Discordance
Country | Factors presented at 2nd round (n) | Consensus1
2nd round | Consensus final (3rd) round | Factors containing discordance in final list2
|
---|---|---|---|---|
AUSTRIA | 17 | 12% | 29% | 4 |
BELGIUM | 21 | 0% | 38% | 2 |
DENMARK | 32 | 31% | 75% | 0 |
ENGLAND | 28 | 11% | 71% | 0 |
FINLAND | 22 | 9% | 64% | 0 |
FRANCE | 40 | 12% | 61% | 2 |
GERMANY | 30 | 3% | 43% | 3 |
GREECE | 24 | 17% | 71% | 0 |
HUNGARY | 16 | 6% | 81% | 0 |
ITALY | 11 | 9% | 82% | 0 |
LITHUANIA | 35 | 14% | 49% | 1 |
NETHERLANDS | 26 | 4% | 81% | 1 |
POLAND | 31 | 3% | 61% | 2 |
PORTUGAL | 18 | 6% | 22% | 0 |
SPAIN | 14 | -3
| 80% | 0 |
SWEDEN | 30 | 20% | 83% | 0 |