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      Europe’s collective failure to address the refugee crisis

      editorial
      , ,
      Public Health Reviews
      BioMed Central
      Europe, European Union, Migrant, Refugee

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          Abstract

          The European response to the refugee crisis has been lamentable. A preoccupation with numbers has, too often, ignored how each refugee is an individual, many of whom have experienced the most appalling conditions in their countries of origin and in transit. These stories are only rarely heard, when the cameras are there to capture the tragedies. In this commentary we review the challenges of responding to the health needs of refugees, including examples of best practice, but above all call for a concerted political response that will both reduce the pressure on refugees to flee conflict-afflicted countries and recognize their contribution if they do come to Europe.

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          Good practice in health care for migrants: views and experiences of care professionals in 16 European countries

          Background Health services across Europe provide health care for migrant patients every day. However, little systematic research has explored the views and experiences of health care professionals in different European countries. The aim of this study was to assess the difficulties professionals experience in their service when providing such care and what they consider constitutes good practice to overcome these problems or limit their negative impact on the quality of care. Methods Structured interviews with open questions and case vignettes were conducted with health care professionals working in areas with high proportion of migrant populations in 16 countries. In each country, professionals in nine primary care practices, three accident and emergency hospital departments, and three community mental health services (total sample = 240) were interviewed about their views and experiences in providing care for migrant patients, i.e. from first generation immigrant populations. Answers were analysed using thematic content analysis. Results Eight types of problems and seven components of good practice were identified representing all statements in the interviews. The eight problems were: language barriers, difficulties in arranging care for migrants without health care coverage, social deprivation and traumatic experiences, lack of familiarity with the health care system, cultural differences, different understandings of illness and treatment, negative attitudes among staff and patients, and lack of access to medical history. The components of good practice to overcome these problems or limit their impact were: organisational flexibility with sufficient time and resources, good interpreting services, working with families and social services, cultural awareness of staff, educational programmes and information material for migrants, positive and stable relationships with staff, and clear guidelines on the care entitlements of different migrant groups. Problems and good care components were similar across the three types of services. Conclusions Health care professionals in different services experience similar difficulties when providing care to migrants. They also have relatively consistent views on what constitutes good practice. The degree to which these components already are part of routine practice varies. Implementing good practice requires sufficient resources and organisational flexibility, positive attitudes, training for staff and the provision of information.
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            Will austerity cuts dismantle the Spanish healthcare system?

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              Access to healthcare and alternative health-seeking strategies among undocumented migrants in Denmark

              Background As in many European countries, undocumented migrants in Denmark have restricted access to healthcare. The aim of this study is to describe and analyse undocumented migrants' experiences of access to healthcare, use of alternative health-seeking strategies; and ER nurses' experiences in encounters with undocumented migrants. Methods Qualitative design using semi-structured interviews and observations. The participants included ten undocumented South Asian migrants and eight ER nurses. Results Undocumented migrants reported difficulties accessing healthcare. The barriers to healthcare were: limited medical rights, arbitrariness in healthcare professionals' attitudes, fear of being reported to the police, poor language skills, lack of network with Danish citizens, lack of knowledge about the healthcare system and lack of knowledge about informal networks of healthcare professionals. These barriers induced alternative health-seeking strategies, such as self-medication, contacting doctors in home countries and borrowing health insurance cards from Danish citizens. ER nurses expressed willingness to treat all patients regardless of their migratory status, but also reported challenges in the encounters with undocumented migrants. The challenges for ER nurses were: language barriers, issues of false identification, insecurities about the correct standard procedures and not always being able to provide appropriate care. Conclusions Undocumented migrants face formal and informal barriers to the Danish healthcare system, which lead to alternative health-seeking strategies that may have adverse effects on their health. This study shows the need for policies and guidelines, which in accordance with international human rights law, ensure access to healthcare for undocumented migrants and give clarity to healthcare professionals.
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                Author and article information

                Contributors
                bayard.roberts@lshtm.ac.uk
                adrianna.murphy@lshtm.ac.uk
                +44 (0)20 7927 2229 , martin.mckee@lshtm.ac.uk
                Journal
                Public Health Rev
                Public Health Rev
                Public Health Reviews
                BioMed Central (London )
                0301-0422
                2107-6952
                8 July 2016
                8 July 2016
                2016
                : 37
                : 1
                Affiliations
                GRID grid.8991.9, ISNI 000000040425469X, ECOHOST – The Centre for Health and Social Change, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, ; 15-17 Tavistock Place, London, UK
                Author information
                http://orcid.org/0000-0002-0121-9683
                Article
                15
                10.1186/s40985-016-0015-6
                5810114
                5a5a36c7-87a2-44b7-86f2-c2f03e6c1183
                © Robets et al. 2016

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 16 June 2016
                : 18 June 2016
                Categories
                Editorial
                Custom metadata
                © The Author(s) 2016

                europe,european union,migrant,refugee
                europe, european union, migrant, refugee

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