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      Exploring barriers to primary care for migrants in Greece in times of austerity: Perspectives of service providers

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          Abstract

          Background: Migration in Europe is increasing at an unprecedented rate. There is an urgent need to develop ‘migrant-sensitive healthcare systems’. However, there are many barriers to healthcare for migrants. Despite Greece’s recent, significant experiences of inward migration during a period of economic austerity, little is known about Greek primary care service providers’ experiences of delivering care to migrants.

          Objectives: To identify service providers’ views on the barriers to migrant healthcare.

          Methods: Qualitative study involving six participatory learning and action (PLA) focus group sessions with nine service providers. Data generation was informed by normalization process theory (NPT). Thematic analysis was applied to identify barriers to efficient migrant healthcare.

          Results: Three main provider and system-related barriers emerged: (a) emphasis on major challenges in healthcare provision, (b) low perceived control and effectiveness to support migrant healthcare, and (c) attention to impoverished local population.

          Conclusion: The study identified major provider and system-related barriers in the provision of primary healthcare to migrants. It is important for the healthcare system in Greece to provide appropriate supports for communication in cross-cultural consultations for its diversifying population.

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          The origins and practice of participatory rural appraisal

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            Equity of access to health care: outlining the foundations for action.

            The Ministers of Health from Chile, Germany, Greece, New Zealand, Slovenia, Sweden, and the United Kingdom recently established The International Forum on Common Access to Health Care Services, based on a common belief that their citizens should enjoy universal and equitable access to good quality health care. The ministers intend to form a network to share thinking and evidence on health care improvements, with the specific aim of sustaining and promoting equitable access to health care. Despite a vast literature on the notion of equity of access, little agreement has been reached in the literature on exactly what this notion ought to mean. This article provides a brief description of the relevance of the access principle of equity, and summarises the research programme that is necessary for turning the principle into a useful, operational policy objective.
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              Changes not for the fainthearted: reorienting health care systems toward health equity through action on the social determinants of health.

              Entrenched poor health and health inequity are important public health problems. Conventionally, solutions to such problems originate from the health care sector, a conception reinforced by the dominant biomedical imagination of health. By contrast, attention to the social determinants of health has recently been given new force in the fight against health inequity. The health care sector is a vital determinant of health in itself and a key resource in improving health in an equitable manner. Actors in the health care sector must recognize and reverse the sector's propensity to generate health inequity. The sector must also strengthen its role in working with other sectors of government to act collectively on the deep-rooted causes of poor and inequitable health.
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                Author and article information

                Journal
                Eur J Gen Pract
                Eur J Gen Pract
                IGEN
                igen20
                The European Journal of General Practice
                Taylor & Francis
                1381-4788
                1751-1402
                2017
                7 April 2017
                : 23
                : 1
                : 128-134
                Affiliations
                [ a ] Faculty of Medicine, University of Crete HeraklionGreece
                [ b ] Department of Social Work, School of Health and Social Welfare, Technological Educational Institute of Crete HeraklionGreece
                [ c ] Institute of Psychology, Health and Society, University of Liverpool LiverpoolUK
                [ d ] Discipline of General Practice, School of Medicine, National University of Ireland GalwayIreland
                [ e ] General Practice and Primary Care, Institute of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow GlasgowUK
                [ f ] Lancaster Medical School, Faculty of Health and Medicine, Furness College, Lancaster University LancasterUK
                [ g ] Department of Primary and Community Care Radboud University Medical Center Nijmegen The Netherlands
                [ h ] Pharos Centre of Expertise on Health Disparities UtrechtThe Netherlands
                [ i ] Centre for Public Health, Medical University of Vienna ViennaAustria
                [ j ] Graduate Entry Medical School, University of Limerick LimerickIreland
                Author notes
                CONTACT Maria Papadakaki mpapadakaki@ 123456yahoo.gr (Primary affiliation) Department of Social Work, School of Health and Social Welfare, Technological Educational Institute of Crete Estavromenos Heraklion PC 71004Greece; (Secondary affiliation) Clinic of Social and Family Medicine, Faculty of Medicine, University of Crete Voutes PC 71003Greece
                Author information
                http://orcid.org/0000-0001-6445-9986
                http://orcid.org/0000-0002-9324-2839
                http://orcid.org/0000-0001-6027-4781
                http://orcid.org/0000-0003-0686-905X
                http://orcid.org/0000-0003-4764-9731
                http://orcid.org/0000-0002-2700-1092
                http://orcid.org/0000-0002-4994-4008
                http://orcid.org/0000-0002-0072-8507
                http://orcid.org/0000-0002-9708-5025
                Article
                1307336
                10.1080/13814788.2017.1307336
                5774264
                28388310
                ec679956-10f0-49f7-be5a-374ec0022d9a
                © 2017 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 January 2016
                : 3 February 2017
                : 2 March 2017
                Page count
                Pages: 7, Words: 4693
                Funding
                Funded by: European Union Seventh Framework Programme
                Award ID: FP7/2007-2013
                Award ID: 257258
                The RESTORE Project has received funding from the European Union Seventh Framework Programme [FP7/2007-2013] under Grant Agreement No. 257258.
                Categories
                Article
                Original Article

                Medicine
                migrants,primary healthcare,capacity,attitudes,financial crisis
                Medicine
                migrants, primary healthcare, capacity, attitudes, financial crisis

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