GHF2010 – PS21 – Improving Migrant Health in Europe

Session Outline

Parallel session PS21, Tuesday, April 20 2010, 16:00-17:30, Room 14
Chair(s): Daniel Eduardo Lopez-Acuna, Health Action in Crises (HAC), World Health Organization, Switzerland
Results of the Madrid Global Consultation on the Health of Migrants
Daniel Eduardo Lopez-Acuna, Health Action in Crises (HAC), World Health Organization, Switzerland 
Best Practices in Promoting Migrants' Access to Health Services in Europe
Guglielmo Schininà, Central Service for Mental Health, Psychosocial Response, and Cultural, Medical Integration, International Organization for Migration, Switzerland 
Self-Medication among Undocumented Latin American Migrants in Geneva, Switzerland: A Good Solution for Improving Access to Healthcare?
Marius Besson, Community Medicine and Primary Care Department, University Hospitals of Geneva and University of Geneva, Switzerland

Session Documents

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Session Report

Submitted by: Cristina Cordova (ICVolunteers); Contributors: Stacy Topouzova (ICVolunteers)

Photo by John Brownlee, ICVolunteers.org

Migration is an important emerging issue in regard to health in Europe. This session provided an in-depth look at migration and its effects on European health care.

This session addressed the need to improve migrant health in Europe and began with Daniel Eduardo Lopez-Acuna, from the World Health Organization (WHO), covering the results of the Madrid Global Consultation on the Health of Migrants.

Mr. Lopez-Acuna underlined the point that, most commonly, migrants are healthy upon arrival in their host country, but that the conditions surrounding their migration pose health risks. The negative health outcomes for migrants result not from their inferiority, but from their inability to obtain adequate care. He stressed the importance of a paradigm shift in health policy: from exclusion to inclusion. The traditional approach is one of exclusion whereas a more modern multi-dimensional approach of inclusion is called for. Public Health Strategies need to ensure migrant health rights and reduce their excessive mortality and morbidity.

The Madrid Global Consultation on the Health of Migrants established four main priority areas. The first of these addressed the importance of monitoring migrants’ health and the need to ensure the standardisation and comparability of data on migrant health. Another priority area is policies and legal frameworks which affect migrant health. Mr. Lopez-Acuna specifically emphasised the importance of adopting and implementing national health policies that incorporate a public health approach to the health of migrants.

In the light of global migrant issues, the conference suggested the development of migrant-sensitive health systems. This would ensure that health services are delivered in a culturally and linguistically appropriate way and would enforce laws and regulations that prohibit discrimination.

In advancing migrant rights, the development of partnerships, networks and multi-country frameworks is of particular importance in order to establish and support ongoing migration health dialogues and cooperation to address migrant health matters.

Guglielmo Schininà, from the Central Service for Mental Health, Psychosocial Response, and Cultural, Medical Integration, International Organization for Migration (IOM), outlined the best practices in promoting migrants’ access to mental health services in Europe.

Mr. Schininà stated that mental health has remained a definite issue in Europe. He questioned whether the act of migrating itself is a determinant of mental health, asserted that there are fundamental differences between populations and that social determinants play an extensive role. He provided a general intervention framework to address mental health issues among migrants. The structure of the framework begins with access to basic services and security; advances to community and familial support groups; then to focused, non-specific supports and, finally, to specialised services.

Case studies presented included the University Hospital of Geneva (HUG); the Minkoska Center Paris; the Ethno Medical Center Hannover, Germany; and finally, the National Institute for Health, Rome. The objective of Mr. Schininà’s research in these case studies was to investigate the accessibility of mental health care services to migrant

This session addressed the need to improve migrant health in Europe and began with Daniel Eduardo Lopez-Acuna, from the World Health Organization, covering the results of the Madrid Global Consultation on the Health of Migrants.

Mr. Lopez-Acuna underlined the point that, most commonly, migrants are healthy upon arrival in their host country, but that the conditions surrounding their migration pose health risks. The negative health outcomes for migrants result not from their inferiority, but from their inability to obtain adequate care. He stressed the importance of a paradigm shift in health policy: from exclusion to inclusion. The traditional approach is one of exclusion whereas a more modern multi-dimensional approach of inclusion is called for. Public Health Strategies need to ensure migrant health rights and reduce their excessive mortality and morbidity.

The Madrid Global Consultation on the Health of Migrants established four main priority areas. The first of these addressed the importance of monitoring migrants’ health and the need to ensure the standardisation and comparability of data on migrant health. Another priority area is policies and legal frameworks which affect migrant health. Mr. Lopez-Acuna specifically emphasised the importance of adopting and implementing national health policies that incorporate a public health approach to the health of migrants.

In the light of global migrant issues, the conference suggested the development of migrant-sensitive health systems. This would ensure that health services are delivered in a culturally and linguistically appropriate way and would enforce laws and regulations that prohibit discrimination.

In advancing migrant rights, the development of partnerships, networks and multi-country frameworks is of particular importance in order to establish and support ongoing migration health dialogues and cooperation to address migrant health matters.

Guglielmo Schininà, from the Central Service for Mental Health, Psychosocial Response, and Cultural, Medical Integration, International Organization for Migration (IOM), outlined the best practices in promoting migrants’ access to mental health services in Europe.

Mr. Schininà stated that mental health has remained a definite issue in Europe. He questioned whether the act of migrating itself is a determinant of mental health, asserted that there are fundamental differences between populations and that social determinants play an extensive role. He provided a general intervention framework to address mental health issues among migrants. The structure of the framework begins with access to basic services and security; advances to community and familial support groups; then to focused, non-specific supports and, finally, to specialised services.

Case studies presented included the University Hospital of Geneva (HUG); the Minkoska Center Paris; the Ethno Medical Center Hannover, Germany; and finally, the National Institute for Health, Rome. The objective of Mr. Schininà’s research in these case studies was to investigate the accessibility of mental health care services to migrants in four European countries: France, Germany, Italy and Switzerland.

Due to the difficulty of quantifying these services, indicators must be found in the future so as to be able to identify countries as being trans-culturally competent which would simplify the migratory process.

The session concluded with a presentation from Marius Besson, from the Community Medicine and Primary Care Department, University Hospitals of Geneva. He addressed the issue of self-medication amongst undocumented Latin American migrants in Geneva, Switzerland.

Mr. Besson defined self-medication as a self-care activity, which is an economically attractive alternative for migrants rather than seeking professional health care within the host country. His work primarily questioned the risk/benefit of such behaviour, especially with regard to prescription medicines, and involved the Geneva Community Care Mobile Unit (UMSCO). Their mission is to facilitate access to health care for people excluded from the health care system.

A study was undertaken involving primarily young, female Latin-Americans in an attempt to understand the depth of self-medication in Geneva. It revealed that the three largest Latin American migrant populations in Geneva come from Bolivia, Ecuador and Brazil. By conducting multiple interviews amongst these communities, it was found that the most frequently used drugs were: Paracetamol (20.2%), NSAID (20.2%), Antihistamines (14.6%) and Antibiotics (12.4%).

In conclusion, Mr. Besson noted that self-medication is commonplace among migrant communities in Geneva and is an economically attractive alternative. The session concluded with an open discussion in which much of the audience was actively involved.

Due to the difficulty of quantifying these services, indicators must be found in the future so as to be able to identify countries as being trans-culturally competent which would simplify the migratory process.

The session concluded with a presentation from Marius Besson, from the Community Medicine and Primary Care Department, University Hospitals of Geneva. He addressed the issue of self-medication amongst undocumented Latin American migrants in Geneva, Switzerland.

Mr. Besson defined self-medication as a self-care activity, which is an economically attractive alternative for migrants rather than seeking professional health care within the host country. His work primarily questioned the risk/benefit of such behaviour, especially with regard to prescription medicines, and involved the Geneva Community Care Mobile Unit (UMSCO). Their mission is to facilitate access to health care for people excluded from the health care system.

A study was undertaken involving primarily young, female Latin-Americans in an attempt to understand the depth of self-medication in Geneva. It revealed that the three largest Latin American migrant populations in Geneva come from Bolivia, Ecuador and Brazil. By conducting multiple interviews amongst these communities, it was found that the most frequently used drugs were: Paracetamol (20.2%), NSAID (20.2%), Antihistamines (14.6%) and Antibiotics (12.4%).

In conclusion, Mr. Besson noted that self-medication is commonplace among migrant communities in Geneva and is an economically attractive alternative. The session concluded with an open discussion in which much of the audience was actively involved.

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