Identification of the Main Limitations, at Present, in Socio-Health Care with a Gender Perspective and Proposals for Improvement for an Adequate Intervention
The right of access of female immigrants to healthcare services is regulated by the existing institutional framework. In may EU countries there is no separate regulatory text that summarizes the rights of immigrants to healthcare services and social care. Relevant provisions are scattered in various laws, presidential decrees and ministerial decisions. Legally resident foreigners have access to health services through social insurance and through the procedures provided for EU citizens. In many cases hospitalization of third country nationals is feasible only for emergencies and until the stabilization of their health. Factors such as language, cultural and economic barriers, and uncertain legal status can influence the vulnerability of female refugees and migrants to vaccine-preventable diseases. The 2018 report of the World Health Organization states the following: Regarding communicable diseases female refugees and migrants can be more vulnerable to infectious diseases in places or origin, transit and destination because of exposure to infections, lack of access to health care, interrupted care and poor living conditions. In relation to vaccine-preventable diseases female refugees and migrants may arrive in Europe with incomplete or interrupted immunization schedules, thus are vulnerable to vaccine-preventable diseases in transit and destination countries. Only few EU Member States had a national immunization programme that included refugees and migrants. As regards to occupational health irregular female migrants may have informal work agreements (e.g., precarious, low-status/low-paid jobs, domestic work, caregiving, nursing, childcare, agriculture, cleaning, restaurant and tourist/hotel and personal care services regardless of legal status) without the social protection of health or social insurance, resulting in musculoskeletal, respiratory and mental health problems, work-related injuries and discrimination in the workplace and lack to rights. Concerning maternal health, there is a marked trend for worse pregnancy related indicators among refugees and migrants. Regarding obstetric and perinatal health, there are identified determinants of postpartum maternal mental health problems or depression among refugee and migrant women in EuropeIn relation to sexual and reproductive health knowledge about contraception and family planning has been shown to be highly dependent on the country of origin and previous educational attainment. Irregular migrants are at a higher risk of unintended pregnancies. Cases of female genital mutilation (FGM)occur to female migrants and leads to a number of health complications. Lack of education, refugee or migrant status and membership in certain religious groups can be associated with FGM. The lack of stable housing or lack of a residence permit increases vulnerability, the risk of a precarious living situation and the risk of victimization and of sexually transmitted infections (STIs). In relation to mental health, prevalence of PTSD among refugees who have been exposed to very stressful and threatening experiences is indicated to be higher than in the host populations, poor socioeconomic conditions, such as unemployment or isolation, are associated with increased rates of depression and anxiety in female refugees after resettlement. Concerning primary care access to health care services depends on the legal status and usually female migrants having the required residence permits follow the same pathways and services as the host population. Migrant workers may have health coverage through their employers, but the severe problem for those in informal employment regardless of theor legas status and rely on NGOs.Regarding preventive care female migrants are not adequately addressed and included in surveillance programmes and the delayed participation in screening programmes can lead to a later detection of diseases (e.g., gynecologist, special gynecological tests). In relation to oral/dental health has been recorded as poorer in the refugee and migrant population. Social support such as access to housing, and assistance for children is important. Limited funding and duration of programmes of national governments, regional and local authorities, social partners and the civil society that support early labour market integration, public employment services, access to education and trainings.
Online Resources
European Commission, 2020, Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions Action plan on Integration and Inclusion 2021-2027. Brussels, 24.11.2020 COM(2020) 758 final Brussels: European Commission.
(https://ec.europa.eu/home-affairs/system/files_en?file=2020-11/action_plan_on_integration_and_inclusion_2021-2027.pdf)
This action plan is part of the comprehensive response to tackling the challenges linked to migration put forward in the New Pact on Migration and Asylum.
Giannoni, M., Franzini, L. & Masiero, G., 2016, Migrant integration policies and health inequalities in Europe. BMC Public Health 16, 463.
(https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-016-3095-9)
The objective of this paper is to examine the role of migrant socio-economic status and the impact of migrant integration policies on health inequalities during the recent economic crisis in Europe.
World Health Organization (WHO), 2018, Report on the health of refugees and migrants in the WHO European Region: No PUBLIC HEALTH without REFUGEE and MIGRANT HEALTH. Copenhagen: WHO Regional Office for Europe.
(https://apps.who.int/iris/bitstream/handle/10665/311347/9789289053846-eng.pdf?sequence=1&isAllowed=y)
This report is intended to create an evidence base to aid Member States of the WHO European Region and other national and international stakeholders in promoting refugee and migrant health by implementing the Strategy and Action Plan for Refugee and Migrant Health in the WHO European Region, which incorporates the priority areas listed in Health 2020, the WHO European Region’s policy framework for the promotion of equitable health and well-being.