Health and access to care for undocumented migrants living in the European Union: a scoping review (original) (raw)
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A systematic review on the use of healthcare services by undocumented migrants in Europe
BMC health services research, 2018
Undocumented migrants face particular challenges in accessing healthcare services in many European countries. The aim of this study was to systematically review the academic literature on the utilization of healthcare services by undocumented migrants in Europe. The databases Embase, Medline, Global Health and Cinahl Plus were searched systematically to identify quantitative, qualitative and mixed methods studies published in 2007-2017. A total of 908 articles were retrieved. Deletion of duplicates left 531. After screening titles, abstracts and full texts according to pre-defined inclusion and exclusion criteria, 29 articles were included in the review. Overall, quantitative studies showed an underutilization of different types of healthcare services by undocumented migrants. Qualitative studies reported that, even when care was received, it was often inadequate or insufficient, and that many undocumented migrants were unfamiliar with their entitlements and faced barriers in utiliz...
Health care for undocumented migrants: European approaches
Issue brief (Commonwealth Fund), 2012
European countries have smaller shares of undocumented migrants than does the United States, but these individuals have substantial needs for medical care and present difficult policy challenges even in countries with universal health insurance systems. Recent European studies show that policies in most countries provide for no more than emergency services for undocumented migrants. Smaller numbers of countries provide more services or allow undocumented migrants who meet certain requirements access to the same range of services as nationals. These experiences show it is possible to improve access to care for undocumented migrants. Strategies vary along three dimensions: (1) focusing on segments of the population, like children or pregnant women; (2) focusing on types of services, like preventive services or treatment of infectious diseases; or (3) using specific funding policies, like allowing undocumented migrants to purchase insurance.
Public Health Reviews, 2016
Undocumented migrants (UMs) are at higher risk for health problems because of their irregular status and the consequences of economic and social marginalization. Moreover, the emergent reality of undocumented migration in Europe calls for action in the field of management of UM's health demands as their access to health services has become a sensitive political and social issue. In this light, this paper aims to address UMs' entitlement and barriers to healthcare and related policies citing evidence from peer-reviewed and grey literature concerning people living in a country within the European Union without the legal right to be/remain in the destination country. A systematic review was performed using several databases and websites, and a total of 54 publications in English, with full text available, were taken into consideration. Between 2000 and 2015, Europe hosted the second largest number of international migrants (20 million, 1.3 million per year) after Asia. Even though there is limited evidence specifically focused on UMs' health, it is possible to state that infectious diseases, chronic illnesses, mental disorders, maternal-child conditions, dental issues, acute illnesses and injuries are the most common pathologies. In most cases across Europe, UMs have access only to emergency care. Even in countries where they are fully entitled to healthcare, formal and informal barriers hinder them from being or feeling entitled to this right. Socio-cultural barriers, such as language and communication problems, lack of formal and informal social and healthcare networks and lack of knowledge about the healthcare system and about informal networks of healthcare professionals are all common impediments. From the healthcare providers' perspective, there can be difficulties in providing appropriate care and in dealing with cultural and language barriers and false identification. Communication strategies play a central role in addressing the inequalities in access to healthcare services, and the definition and provision of specific training, focused on UMs' health needs, would be desirable. Improving access to healthcare for UMs is an urgent priority since the lack of access is proven to have serious consequences for UMs' health and wellbeing. Notwithstanding, few available examples of policies and best practices aimed at overcoming barriers in the delivery of healthcare to UMs are available.
European journal of public health, 2017
Undocumented migrants, in particular pregnant women and their newborns, constitute a particularly vulnerable group of migrants. The aim of this study was to systematically review the academic literature on the use and outcomes of maternal and child healthcare by undocumented migrants in the European Union (EU) and European Free Trade Association (EFTA) countries. The databases, MEDLINE, Embase, CINAHL Plus, Global Health and Popline were searched for the period 2007 to 2017. Two independent reviewers judged the eligibility of studies. The final number of included studies was 33. The results of quantitative, qualitative and mixed methods studies were analysed separately due to their differences in study design, sample size and quality. Overall, the quantitative studies found that undocumented women underutilised essential maternal and child healthcare services, and experienced worse health outcomes. Qualitative studies supported these results, indicating that undocumented migrants we...
Access to Health Care for Undocumented Migrant Children. European Regulations and Practices
Dilemata, 2016
Health plays a prominent role in the Convention of the Rights of the Child. Article 24 explicitly states the "right of the child to the enjoyment of the highest attainable standard of health" where "States Parties shall strive to ensure that no child is deprived of his or her right of access" (UN/CRC 1989). For children residing in Europe as undocumented migrants, this universal right to health in a majority of European Member States is overruled by national regulations that restrict access to health care to emergency care. Recent studies indicate that only 8 EU member states grant undocumented migrant children the same entitlements as national children. This puts health care professionals into a paradox situation: to save-guard ethical standards, they have to act against national regulations. Documentations on practices from first line healthcare providers show the high degree of vulnerability for undocumented children and underline the need of proper health c...
Health care provision for illegal migrants: may health policy make a difference?
The European Journal of Public Health, 2007
Illegal migrants in Europe are, generally, only entitled to emergency care and services for children and pregnant women. In 2002 legal changes in Spain made accessible medical cards and free medical care for illegal migrants in similar terms than the legal migrants or the Spanish population. We interviewed 380 migrants to assess whether there were differences on health services utilization by legal status. We did not find differences in the utilization of health services when ill between legal and illegal migrants. However, a significantly lower utilization of health services was associated with less education (RP ¼ 0.4; 95% CI: 0.2-0.9).
Health and human rights, 2012
Undocumented migrants' access to health care varies across Europe, and entitlements on national levels are often at odds with the rights stated in international human rights law. The aim of this study is to address undocumented migrants' access to health care in Denmark, Sweden, and the Netherlands from a human rights perspective. Based on desk research in October 2011, we identified national laws, policies, peer-reviewed studies, and grey literature concerning undocumented migrants' access to health care in the three involved countries. Through treaties and related explanatory documents from the United Nations and the Council of Europe, we identified relevant international laws concerning the right to health and the rights of different groups of undocumented migrants. A synopsis of these laws is included in the analysis of the three countries. Undocumented migrants in Denmark have the right to emergency care, while additional care is restricted and may be subject to pay...
Access to Health Care for Undocumented Migrants
Scientific Coordination and Editing: Ana Alexandre …, 2008
Among the respondents, a third of men (34%) and a quarter of women (23%) perceive their health as "bad" or "very bad". Most studies show a good general correlation between this indicator and objective (and/or medical) indicators of health. This is 3 times higher 6 than for the population of the 25 European Union countries. Among the youngest respondents (18-25 years), 27% of men and 12% of women already say that their health is "bad" or "very bad". 32% of people surveyed are affected by at least one chronic health problem. This is more common among men than women. These people often live in insecure accommodation (35%) and are relatively isolated (half of them feel lonely and 17% cannot count on anybody for emotional support). They need medical treatment: two thirds of respondents (65%) have at least one health problem for which treatment is considered by the doctors as preferable, necessary (29%) or indispensable (21%). 8% of those who are suffering from a condition for which treatment is considered indispensable are rough sleepers and 7% live in a shortterm or medium-term shelter. Many people also suffer from more than one health problem: 24% of people interviewed present with at least 2 health problems for which treatment is considered to be preferable. This high rate, in such a young population, is indicative of delayed access to healthcare. Thus, according to the doctors, 16% of the population present with a vital prognosis that is possibly, probably or certainly bad unless they receive treatment. Only 8% present with only one health problem for which treatment is judged to be optional. Contrary to the widespread pre-conception that foreigners would abuse European health systems, the impoverished survey population hardly seeks any care for minor health problems. Unsuitable and largely inadequate medical follow-up, irrespective of the severity of the health problem. Under half of pregnant women (48%) received antenatal monitoring during their pregnancy. Of the 1,371 health problems identified in the survey population, only a quarter (26%) were comprehensively treated or monitored. A quarter (27%) received partial treatment and nearly half (45%) were not being treated or followed-up at all on the day of the survey. Even when the health problems are serious, they receive very little treatment or follow-up: among the health problems for which treatment is judged by the doctors to be indispensable, less than half (43%) received comprehensive follow-up, one fifth were partially followed up or treated (21%) and a third (34%) did not receive any follow-up at all. When the treatment was "only" considered to be necessary, nearly half of the problems (44%) did not receive any followup either. Treatment of less serious health problems is also problematic: only 13% of less serious health problems-for which treatment is nonetheless preferable-received comprehensive medical follow-up. 6. It is important to bear in mind that the survey mostly took place in programmes of a medical organisation. * The "other" category includes Near and Middle East countries, the European Union and stateless persons. 33. Sub-Saharan African respondents were living as undocumented migrants for, on average, 3.1 years.
2016
Health plays a prominent role in the Convention of the Rights of the Child. Article 24 explicitly states the "right of the child to the enjoyment of the highest attain- able standard of health" where "States Parties shall strive to ensure that no child is deprived of his or her right of access" (UN/CRC 1989). For children residing in Europe as undocumented mi- grants, this universal right to health in a majority of Euro- pean Member States is overruled by national regulations that restrict access to health care to emergency care. Re- cent studies indicate that only 8 EU member states grant undocumented migrant children the same entitlements as national children. This puts health care professionals into a paradox situation: to save-guard ethical standards, they have to act against national regulations. Documen- tations on practices from first line healthcare providers show the high degree of vulnerability for undocumented children and underline the need of proper ...