GHF2010 – PS01 – Migrant Access to Health in Switzerland: From Policy to Practice

Session Outline

Parallel session PS01, Tuesday, April 20 2010, 11:00-12:30, Room 14
Chair(s): Sophie Durieux-PaillardMD MPH, Migrant Health Centre, Department of Community Medicine and Primary Care, Geneva University Hospitals, Switzerland, Corinna Bisegger, PhD, Psychologist, Department of Health and Integration, Swiss Red Cross (SRC), Switzerland
Summary: As in many western countries, the health status of migrants living in Switzerland is often poorer than that of the native population. This is particularly true for migrants living in precarious conditions, due to stressful circumstances before or during migration, exhausting working conditions, discrimination, as well as communication and cultural barriers. Additionally, in many Swiss cantons, undocumented migrants encounter obstacles to accessing care that are related to differing health policies from one canton to another. This session offers case studies and policy views from various actors in the field of migrant health in Switzerland. It also aims at providing an opportunity for ample discussion and sharing of experiences by the session audience on issues such as access to care for vulnerable groups and cultural competences of health professionals.
Migration and Health Strategy in Switzerland: Achievements and Perspectives on Improving Access to Health for Migrants 
Serge Houmard, Health Policy, Federal Office of Public Health, Bern, Switzerland
Access to Care for Migrants: Examples from Various Swiss Cantons
Kirsten AlmeidaRegistered Nurse and Political Scientist, Responsible for National Projects, Médecins du Monde, Switzerland
Access to Care for Vulnerable Immigrants in Swiss Cantons: Today and Tomorrow
Yves Jackson, Department of Community Medicine and Primary Care, Geneva University Hospitals, Switzerland
Improving Access to Health through Transcultural Competence: Impact of Training Healthcare Professionals 
Anke Kayser, Social Anthropologist, Swiss Red Cross, Switzerland

Session Documents

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Session Report

Photo by John Brownlee, ICVolunteers.org

The four speakers engaged in a discussion involving important issues concerning migrants and the Swiss healthcare system, proposing several improvements. Topics included the migrant health strategy, the Swiss healthcare systems, migrant resources and transcultural competence.

Serge Houmard, a political scientist of the National Program for Migration and Health, Federal Office of Public Health, Switzerland, gave a brief introduction into the Swiss health strategy. His presentation focused on the improvement of public health for migrants. He stated that Switzerland is a country of migration where immigration is important due to the fact that it has a very large migrant background. His main concern is that migrants deserve an equal opportunity and they should have the same health benefits as Swiss natives. Key Swiss projects include an intercultural translation service, migrant friendly hospitals and telephone interpreting services, some which have proven to be cost effective.

Yves Jackson, from the Department of Community Medicine and Primary Care, University Geneva Hospitals, expanded on the serious issues involving Swiss migrants’ access to healthcare.

Mr. Jackson believes that migration is a fact of life. He stated that 1 in 4 Swiss nationals are migrants and 23% of residents are foreigners. Migrants in irregular situations are particularly vulnerable. They may find healthcare unaffordable, inaccessible or too complex to understand. They may have difficulty in understanding the system and be unable to find culturally sensitive healthcare workers. Switzerland has adopted three strategies: (1) public organisation or mixed public and NGO, (2) NGOs and (3) no programme at all. Further a brief introduction to migrant services was given, such as the Programme Santé Migrants (PSM) for rejected asylum seekers or the Unité Mobile de Soins Communautaires (UMSCO) which is specifically for migrants in irregular situations. In conclusion the speaker stressed that vulnerable migrants have specific health needs frequently similar to that of the host population. His aim is to overcome barriers such as lack of federal control on law enforcement and disparities between healthcare availability to different sections of the population.

Kirsten Almeida, working for Médecins du Monde in Neuchâtel, focused on NGO systems. She spoke of the origin of NGOs, which have a history of solidarity. Today’s models of NGOs have a legal background that allows them to exercise pressure in a certain way against the authorities. NGOs have experience in creating access to healthcare for vulnerable people. She gave examples, one of which was Meditrina, a resource for undocumented migrants located in Zurich. The focus of Médecins du Monde is to promote the right of access to health services for all and to promote non-discrimination. Médecins du Monde is involved with both international and national projects.

Unlike the three previous speakers, Swiss Red Cross employee Anke Kayser spoke of a need to improve access to health through Transcultural Competence. This is “the ability to understand individual lives in terms of the particular situation and in various contexts and derive from them suitable adapted procedures” (Domeing, 2001). The Swiss Red Cross acts on different levels with transcultural competence. They rely on interaction as well as transcultural background knowledge: such as the re-examination of static and dynamic cultural understanding, racism, discrimination, religion and lifestyle choice. This background knowledge helps healthcare professionals to ask the right questions in order to make the patient more comfortable. Healthcare professionals use such methods, instruments and resources to facilitate their work for without these methods the professionals would find themselves frustrated. Therefore transcultural training is suggested on a cognitive level, affective and behaviour level

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