What Strategies To Address Communication Barriers For Refugees And Migrants In Health Care Settings Have Been Implemented And Evaluated Across The Who European Region

The provision of effective health care to linguistically and culturally diverse migrant populations has been identified as a crucial public health issue. This scoping review examines strategies which have been implemented and evaluated to address communication barriers experienced by refugees and migrants in health care settings across the WHO European Region. Four main types of strategy were identified: cultural mediation interpretation translation of health information and guidance and training for health care providers. These have been used to support access to health care management of specific diseases and promotion of health across a wide variety of health care settings. Intersectoral collaboration was seen as important in the development and implementation of strategies. Policy considerations include the development of national policies and the promotion of intersectoral dialogue to augment the knowledge base and resolve the common issues identified such as provision of training and confusion regarding the roles of mediators/interpreters that affect strategy implementation and evaluation.

Worldwide, more people are on the move now than ever before, yet many refugees and migrants face poorer health outcomes than the host populations. Addressing their health needs is, therefore, a global health priority and integral to the principle of the right to health for all. The key is to strengthen and maintain health systems by ensuring that they are refugee- and migrant-sensitive and inclusive. Health outcomes are influenced by a whole host of determinants. However, refugees and migrants face additional determinants such as precarious legal status; discrimination; social, cultural, linguistic, administrative and financial barriers; lack of information about health entitlements; low health literacy; and fear of detention and deportation. This groundbreaking publication outlines current and future opportunities and challenges and provides several strategies to improve the health and well-being of refugees and migrants. It is an advocacy tool for national and international policy-makers involved in health and migration. Evidence on the health of refugees and migrants remains fragmented – comparable data across countries and over time are urgently needed to track progress towards the health-related United Nations Sustainable Development Goals. With only 8 years until the 2030 target date to transform our world, the time to act is now.

This richly illustrated book is a comprehensive guide to the dermatologic disorders that may be encountered in refugees and other migrants. It will equip readers to diagnose and treat a diverse range of skin diseases and conditions, including, but not limited to, infections caused by bacteria, viruses, fungi, and parasites, dermatologic manifestations of sexually transmitted diseases, dermatoses associated with malnutrition, pigmentary disorders, bullous diseases, connective tissue diseases, and benign and malignant cutaneous neoplasias. Attention is drawn to various neglected tropical skin diseases and to the characteristic signs of torture and genital mutilations. Helpful information is also provided on the significance of skin color and the relevance of ethnic and genetic factors. The clinical chapters are complemented by discussion of the circumstances that give rise to migration, such as poverty, war, and environmental conditions. This enables the reader to gain a more rounded understanding of patients’ circumstances that in turn will positively impact on patient care. This book will be of wide interest to dermatologists, whether experienced or in training, as well as to general physicians and researchers.

Intercultural mediators are employed to resolve linguistic and cultural barriers in a variety of health-care contexts. This report examines the main roles performed by intercultural mediators in health care across the WHO European Region and analyses evidence on their effectiveness in improving accessibility and quality of care for refugees and migrants, and the factors that enable them to have a positive impact. The beneficial impact of intercultural mediators is hindered by a lack of professionalization, insufficient training and the non-systematic and inconsistent implementation of intercultural mediation programmes. Developing training programmes and accreditation systems, further research into the effectiveness of intercultural mediators in health care, and the development of strategies that guarantee access to intercultural mediators in health care wherever and whenever needed will enormously improve the quality of health care for refugees and migrants.

Social changes in European societies place migration and cultural diversity on the European political agenda. The European initiative Migrant Friendly Hospitals (MFH) aims to identify, develop and evaluate models of effective interventions. It has the following objectives: To strengthen the role of hospitals in promoting the health of migrants and ethnic minorities in the European Union and to improve hospital services for these groups. This report reviews models of effective intervention in the medical literature and provides the background information needed to enable partner hospitals taking part in the MFH initiative to select and implement suitable interventions. The interventions reviewed in this study are grouped in four areas: Communication, Responsiveness Empowerment of migrant and minority patients and communities. Monitoring of the health of migrants and minorities and the health care they receive. [Ed.]

Refugees and asylum seekers are defined in many ways but can be considered as those who did not make a voluntary choice to leave their country of origin and cannot return home in safety. Outcome data are limited and mostly focused on perinatal and mental health but do suggest significant levels of unmet need. This scoping review considered 72 studies where refugees and asylum seekers formed part or all of the population studied. Access to appropriate health care across the WHO European Region is very varied and is overwhelmingly shaped by legal frameworks and the regulation of the migration process. The need for improved communication with asylum seekers and coordinated action between agencies within and beyond the medical system is widely noted. Improved data to support intersectoral working to address the health care needs of asylum seekers and refugees are imperative.

International migration, particularly to Europe, has increased in the last few decades, making research on aspects of this phenomenon, including numbers, challenges, and successes, particularly vital. This Special Issue highlights this necessary and relevant area of research. It presents 37 articles including studies on diverse topics relating to the health of refugees and migrants. Most articles (28) present studies focusing on European host countries. The focus on Europe is justified if we take into consideration the increased number of refugees and migrants who have come to Europe in recent years. However, there are also articles which present studies from countries in other continents. The topics discussed in the Issue include healthcare utilization, infectious diseases, mother and child health, mental health, and chronic diseases. Finding from the included articles indicate that further development of guidelines and policies at both local and international levels is needed. Priorities must be set by encouraging and funding in-depth research that aims to evaluate the impact of existing policies and interventions. Such research will help us formulate recommendations for the development of strategies and approaches that improve and strengthen the integration of migrants and refugees into the host countries.

The book is exceptionally timely and will be of interest to many professionals, students and academics. I am not aware of any other book that covers this important topic. Glenn Laverack brings credibility and kudos having direct experience of health emergencies and seen as a leading academic thinker in health promotion. Dr James Woodall, Reader in Health Promotion, Leeds Beckett University Using specific examples to illustrate broader concepts, this text provides a solid introduction to health promotion in infectious disease outbreaks. Ella Watson-Stryker, Health Promotion Manager, Médecins Sans Frontières This book is timely given the current humanitarian and development scenarios in which health promoters and development communicators must work. There is a dire need for reference materials for practitioners which expand upon theoretical/scientific concepts and principles and provide practical, straightforward guidance to professionals working in the field. The increasing amount of public health emergencies, e.g. SARS, Ebola, Zika etc. require professionals to increase their preparedness to respond in outbreak or disaster situations and this book becomes a useful tool for needed action. Dr Erma Manoncourt, Vice-President of Membership and Co-Chair Global Working Group on the Social Determinants of Health, IUHPE, Paris, France. This is the first ever practical guide to the valuable role that health promotion can play in disease outbreaks and health emergencies. Over the past 20 years the number of disease outbreaks has increased alongside a significant role played out by international agencies involved in emergency responses. The book comprehensively covers the role that health promoters have in this new and exciting field of international work including data collection, communication, community capacity building and engagement and rumour management. Part 1 provides a detailed overview of the role of health promotion in disease outbreaks and health emergencies. Part 2 directly addresses the role of health promotion in two distinct types of disease outbreaks: person to person and vector borne disease transmission. Part 3 covers the role of health promotion in specialist areas of work in disease outbreaks and health emergencies. Health Promotion in Disease Outbreaks and Health Emergencies is essential reading for health promotion and public health students worldwide, as well as for UN agencies and international NGOs working in this emerging field.