Transnational healthcare as process: multiplicity and directionality in the engagements with healthcare among Polish migrants in the UK (original) (raw)
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Social Science and Medicine, 2014
This article deals with the transnational healthcare practices of Central and Eastern European migrants in Europe, taking the case of Romanian migrants in Ireland. It explores the implications of migrants' transnational healthcare practices for the transformation of citizenship in Europe, more particularly in terms of access to free public healthcare. The article places these practices in the larger perspective of global care chains, seen as including transnational flows of healthcare seekers and healthcare workers that link distant healthcare systems in an emerging European healthcare assemblage. The study adopted a holistic perspective, taking into account both formal and informal practices, as well as the use of healthcare services in both the host and the origin countries of migrants. These were explored during multisited fieldwork in Romania and Ireland, conducted between 2012 and 2013, and combining a variety of sources and methods (semi-structured interviews, informal conversations, documentary analysis, etc.). The article explores the links between migrants' transnational healthcare practices and two other important processes: 1) inequalities in access to healthcare services in migrants' countries of origin and of destination; and 2) the contribution of healthcare privatisation to these inequalities. It shows that Romanian migrants' transnational healthcare practices function as strategies of social mobility for migrants, while also reflecting the increasing privatisation of healthcare services in Ireland and Romania. The article argues that these processes are far from specific to Ireland, Romania, and the migration flows uniting them. Rather, they draw our attention to the rise of an unevenly developed European healthcare assemblage and citizenship regime in which patients' movements across borders are closely interlinked with diminishing and increasingly unequal access to public healthcare services.
Health & Place
Understanding users׳ perceptions and expectations of health care provision is key to informing practice, policy and health-related measures. In this paper, we present findings from a qualitative study conducted with recently migrated Eastern European children and their parents, reporting on their experiences of accessing health services post-migration. Unlike the case of adults, the experiences of newly migrated children have rarely been explored in relation to health services. We pay particular attention to three key areas: (1) migrant families׳ views of health service provision; (2) barriers to health service use; and (3) transnational use of health services. By using a social capital approach, we show how concerns about the Scottish health care practices enacted by migrant parents are adopted by children and are likely to impact on families׳ health beliefs and behaviours. The study highlights the important role of migrants׳ active participation as users of health services. We conclude that appropriate health services need to consider more carefully migrants׳ expectations and complex health care activities, in order to be fully inclusive and patient-centred.
2016
The 2004 EU enlargement and the subsequent migratory movements of citizens from the new member states (NMS) to old EU countries created a new transnational space in which biomedical regimes, as practiced in various locations, come together. In this study, I explore the new transnational space created by the migratory movements of Polish women living in Ireland and their healthcare practices associated with pregnancy and childbirth. I use these practices as a starting point to reflect on the power configurations characterising healthcare, particularly maternity services, in Ireland and in Poland. The study aims to answer two complementary research questions. First, how Irish and Polish healthcare services regulate women’s (pregnant) bodies? Second, how Polish migrant women engage with these regulatory regimes and how these engagements are influenced by the position they occupy in larger power configurations in the host and home countries? In order to answer these questions, I adopt a...
Migrants’ Experiences in the Healthcare System
Women, Migrations and Health, 2019
Mass migration in Europe raises many issues of societal concern. Migrants struggle with complex health problems related to causes and consequences of migration. It is no longer a question about migrants having unique health needs, concerns and challenges. The effects of language and cultural differences, lack of access to transportation and other barriers are common. These barriers hamper nurses and other healthcare professionals to deliver high quality care. An essential dimension of quality of care mirroring both patients' expectations and their exposure is the migrant patient's experience of healthcare. This chapter addresses the factors associated with migrants' healthcare experiences in the host country. A model presented here may increase nursing professionals'awareness and help to provide person centred care and overcome cultural differences.
Background: The accession of 12 new member states to the European Union in 2004 and 2007 was associated with an increase in transnational migration in Europe, particularly from poorer countries to the established Western economies. Ensuring access to health care for migrant workers and their families in the host countries can present specific challenges. This study explored experiences of migrant parents, who have recently arrived in the United Kingdom from other European countries, in accessing health services for their children. Methods: Qualitative research methods were used. Four focus group discussions and 12 in-depth interviews were conducted with 29 migrant parents living in the town of Thetford, a relatively deprived area with a significant migrant population in Norfolk, England. Participants included recent migrants from Latvia, Lithuania, Moldova, Poland, Portugal, Russia and Slovakia. Topic guides were developed and used flexibly to explore migrants' perceptions of ch...
Illness and healthcare experiences of recent low-income international migrants in a UK city
Multiple factors account for inequality in health outcomes and in access to healthcare in the UK, including ethnicity. This thesis explores length of residency in a country after migration through the subjective experiences of a group of recent low-income international migrants who have used local health services to seek care for a range of illnesses and conditions. The project was formulated in collaboration with Brighton and Hove City Council and the then NHS Brighton and Hove (now Brighton and Hove Clinical Commissioning Group) to recruit participants and collect narratives from this hard to reach social group. The theoretical background of this research draws on ‘lived’ experience in the context of illness. Analysis of qualitative interviews used narrative typologies derived from the work of Frank (1991), revealing both the commonalities across and the specificities of illness experiences, and highlighting a multi-factorial web of bio-psychosocial and economic factors at play. The interviews overwhelmingly fitted with a chronic, ‘chaos’ typology, in which diagnoses were commonly contested. The particularities of recent migrant status impacted upon participants’ illness experiences and healthcare use with migrants making comparisons with health systems in their countries of origin and managing healthcare through social networks. The findings from the data analysis around patient experience showed that the overall experience was negative, characterised by themes of problems in communication and access. Some outcomes were explained in terms of direct and indirect discrimination. Direct discrimination and stigma were perceived by many participants with attitudes and practices of staff, and the theme of ethnicity, immigration status and faith being stated. From this study it is possible to hypothesise that some healthcare practices and policy may give rise to the perceptions of discrimination.
Health care for irregular migrants: pragmatism across Europe. A qualitative study
BMC Research …, 2012
Background: Health services in Europe face the challenge of delivering care to a heterogeneous group of irregular migrants (IM). There is little empirical evidence on how health professionals cope with this challenge. This study explores the experiences of health professionals providing care to IM in three types of health care service across 16 European countries. Results: Semi-structured interviews were conducted with health professionals in 144 primary care services, 48 mental health services, and 48 Accident & Emergency departments (total n = 240). Although legal health care entitlement for IM varies across countries, health professionals reported facing similar issues when caring for IM. These issues include access problems, limited communication, and associated legal complications. Differences in the experiences with IM across the three types of services were also explored. Respondents from Accident & Emergency departments reported less of a difference between the care for IM patients and patients in a regular situation than did respondents from primary care and mental health services. Primary care services and mental health services were more concerned with language barriers than Accident & Emergency departments. Notifying the authorities was an uncommon practice, even in countries where health professionals are required to do this. Conclusions: The needs of IM patients and the values of the staff appear to be as important as the national legal framework, with staff in different European countries adopting a similar pragmatic approach to delivering health care to IM. While legislation might help to improve health care for IM, more appropriate organisation and local flexibility are equally important, especially for improving access and care pathways.
International Journal for Equity in Health, 2019
Croatia and Slovenia were the transit countries on the Balkan route for migrants and refugees from Middle East countries in 2015 and 2016. They had to optimize health care delivery in the special circumstances in refugee camps and transit centres. Little is known about health care provision in border camps where a large number of migrants stay for only couple of hours. Previous studies emphasize that language barriers and cultural differences play a central part in the relationship between health workers and migrants inside the transit zone. The aim of the study was to identify specific characteristics of health care provision experienced by primary healthcare providers in order to prepare solutions on how to organise health care in refugee settings.