Maastricht Centre for Global Health, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, The Netherlands.
Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Global Health. 2018 Jun 15;14(1):57. doi: 10.1186/s12992-018-0373-6.
The current migration flow into Europe is leading to a growing ethnically diverse population in many European countries. Now more than ever, those populations have different healthcare needs, languages, traditions, and previous level of care. This higher level of diversity is likely to increase health inequalities that might challenge healthcare systems if not addressed. In this context, this study aims at reviewing the policy framework for migrants' access to healthcare in Spain, Portugal and Ireland, countries with a long history of immigration, to identify lessons to be learned for policies on migrants' health.
A content analysis of official policy documents was undertaken and the conceptual framework developed by Mladowsky was adapted to classify the actions indicated in the policies.
The content analysis revealed that the policy aim for all three analysed countries is the improvement of the health status of the immigrant population based on equity and equality principles. The main strategies are the adaptation of services through actions targeting patients and providers, such as the implementation of cultural mediators and trainings for health professionals.
The three countries propose a great range of policies aiming at improving access to healthcare services for immigrants that can inspire other European countries currently welcoming refugees. Developing inclusive policies, however does not necessarily mean they will be implemented or felt on the ground. Inclusive policies are indeed under threat due to the economic and social crises and due to the respective nationalistic attitudes towards integration. The European Union is challenged to take a more proactive leadership and ensure that countries effectively implement inclusive actions to improve migrant's access to health services.
当前进入欧洲的移民潮导致许多欧洲国家的人口日益多样化。现在，这些人群有着不同的医疗保健需求、语言、传统和以往的医疗水平。这种更高水平的多样性可能会加剧不平等，如果不加以解决，这些不平等可能会对医疗保健系统构成挑战。在这种情况下，本研究旨在审查西班牙、葡萄牙和爱尔兰这三个移民历史悠久的国家的移民获得医疗保健的政策框架，以确定有关移民健康政策的经验教训。
对官方政策文件进行了内容分析，并对 Mladowsky 开发的概念框架进行了调整，以对政策中指出的行动进行分类。
内容分析显示，这三个分析国家的政策目标都是基于公平和平等原则，改善移民人口的健康状况。主要策略是通过针对患者和提供者的行动来调整服务，例如实施文化调解员和对卫生专业人员进行培训。
这三个国家提出了一系列旨在改善移民获得医疗保健服务的政策，这些政策可以为目前正在接纳难民的其他欧洲国家提供启示。然而，制定包容性政策并不一定意味着它们会在实际中得到实施或感受到。包容性政策确实受到经济和社会危机以及各自对融入的民族主义态度的威胁。欧盟面临着采取更积极主动的领导地位并确保各国有效实施包容性行动以改善移民获得医疗服务的机会。
