Hanssen Irsa R M, Yerkes Mara A
Department of Interdisciplinary Social Science, Utrecht University, Utrecht, The Netherlands.
Centre for Social Development in Africa, University of Johannesburg, Johannesburg, South Africa.
Int J Equity Health. 2025 Aug 11;24(1):219. doi: 10.1186/s12939-025-02594-0.
Undocumented migrants (UMs) in the Netherlands face significant barriers to accessing healthcare despite legal entitlements to ‘necessary medical care.’ Non-governmental organisations (NGOs) play a critical role in facilitating healthcare access for UMs, yet empirical research on their contributions remains limited. This study aims to explore how NGOs perceive their role in facilitating healthcare access for UMs in the Netherlands and how these perceptions align with their actual practices.
The research employs a qualitative exploratory design, conducting twelve semi-structured interviews with professionals from various NGOs supporting UMs in the Netherlands. Thematic analysis was used to identify key roles and strategies employed by these organisations.
The data revealed four main roles: (1) mediating, (2) educating, (3) advocating, and (4) delivering services. The findings suggest that while Dutch NGOs appear to share a common goal of facilitating healthcare access for UMs within the existing Dutch healthcare system, some of their strategies exist outside the regular system, thereby creating a parallel system. This parallel system subsequently results in a discrepancy between how NGOs perceive themselves (i.e., the role they they should take) and the role they play in practice. Findings further suggest that the Dutch NGOs in this study face a humanitarian-equity dilemma, where limited resources and high pressure from UMs’ immediate needs lead them to prioritize direct assistance over addressing systemic issues. Consequently, many NGO strategies offer temporary solutions that help individual cases but fail to integrate UMs into the regular healthcare system sustainably.
Dutch NGOs play a critical role in facilitating healthcare access for UMs in the Netherlands. Despite their invaluable efforts in addressing immediate needs, NGOs risk legitimizing a parallel system that allows the state to retreat from its welfare duties. To facilitate lasting change, NGOs should focus more on educational and advocacy roles and collaborate to reduce costs and enhance effectiveness. This strategic shift is essential for creating sustainable, inclusive health care solutions that ensure UMs are integrated into the regular healthcare system, thereby upholding the principles of equity and justice.
尽管荷兰的无证移民（UMs）依法享有“必要医疗护理”的权利，但他们在获取医疗保健方面面临重大障碍。非政府组织（NGOs）在帮助无证移民获得医疗保健方面发挥着关键作用，然而，关于其贡献的实证研究仍然有限。本研究旨在探讨非政府组织如何看待其在帮助荷兰无证移民获得医疗保健方面的作用，以及这些看法如何与它们的实际做法相一致。
该研究采用定性探索性设计，对荷兰支持无证移民的各类非政府组织的专业人员进行了12次半结构化访谈。采用主题分析法来确定这些组织所采用的关键作用和策略。
数据揭示了四个主要作用：（1）调解，（2）教育，（3）倡导，以及（4）提供服务。研究结果表明，虽然荷兰的非政府组织似乎有一个共同目标，即在现有的荷兰医疗保健系统内帮助无证移民获得医疗保健，但它们的一些策略存在于常规系统之外，从而形成了一个平行系统。这个平行系统随后导致了非政府组织对自身的认知（即它们应该扮演的角色）与它们在实践中所扮演的角色之间的差异。研究结果进一步表明，本研究中的荷兰非政府组织面临着人道主义公平困境，有限的资源和无证移民紧迫需求带来的巨大压力导致它们将直接援助置于解决系统性问题之上。因此，许多非政府组织的策略提供的是临时解决方案，有助于个别案例，但未能将无证移民可持续地纳入常规医疗保健系统。
荷兰的非政府组织在帮助荷兰无证移民获得医疗保健方面发挥着关键作用。尽管它们在满足紧迫需求方面做出了宝贵努力，但非政府组织有使一个平行系统合法化的风险，这个平行系统会让国家从其福利职责中退缩。为了促进持久的变革，非政府组织应更多地关注教育和倡导作用，并进行合作以降低成本和提高效率。这一战略转变对于创造可持续、包容性的医疗保健解决方案至关重要，这些解决方案可确保无证移民融入常规医疗保健系统，从而维护公平和正义的原则。
