Italy
In Italy, the National Health Service (NHS) guarantees everyone, incl. migrants, the right to healthcare.
Italy has no specific legislation that would be dedicated to migrant women\'s health. Accordingly, relevant provisions are to be sought for in immigration laws and decrees. The main regulations that devote some articles to the NHS for migrants are:
- Dini Decree 489/1995: art. 13, right for migrants (either regular or irregular) to have access to outpatient treatment;
- Turco-Napolitano Law 40/1998 (later merged into the Consolidated Act on Immigration, 286/1998): art. 34 deals with healthcare for regular immigrants; art. 35 sets out the right to healthcare for irregular immigrants in Italy; art. 36 regulates entry and stay for medical treatment;
- Decree of the President of the Council of Ministers, January 12th, 2017: art. 62 reaffirms equal treatment with Italian citizens in terms of healthcare.
In recent years, migration flows have been increasingly feminised which is primarily due to economic and social transformations. The phenomenon has required attention from social and health services urging them to adopt a gender approach to health being it an important tool for promoting an effective fight against inequalities in terms of social and health care (WHO 2007). The needs of migrant women mainly concern reproductive health care (pregnancy, psychological and sexual health, prevention of sexually transmitted diseases, psychological and medical support in case of sexual abuse, etc.), and a correct information about the related services.
Compared to their autochthonous counterparts, migrant women face greater difficulties in accessing NHS services, which is basically due to:
§ lack of sufficient information about healthcare services
§ communication between services and users, and language difficulties
§ economic factors having a significant impact upon sections of immigrant population.
In order to fill these gaps, it is the third sector that plays an important role through the system of associations, NGO and social cooperatives which support migrant women in accessing healthcare services: their action ranges from disseminating information to providing cultural-linguistic mediation (e.g. at hospitals), and else support services.
Good practices in healthcare:
- health services, both in hospitals and day hospitals, can be supported by cultural-linguistic mediation
- specific healthcare services for migrant women, both regular and irregular, are provided in some contexts, and arranged on appointment or on specific days for some hours a week
- this particularly applies to pregnancy and delivery, services offered for free regardless of the concerned migrant women’s legal status
- public healthcare system is rated as good by migrant women (and men): such an assessment is due to its universal coverage regardless of one’s legal status, as well as to better services and costs offered by the Italian healthcare system in comparison to what immigrants had left in their native countries.
Recommendations. Migrant women’s access to health services could be improved by means of the following initiatives:
- better information about healthcare and health services for migrant women
- training of professionals (medical staff, educators, social workers, etc.) on migrant women\'s health and potential risks related to their migration experience
- promoting actions to breakdown economic barriers that hinder migrant women’s access to health services.
“Migration as a Passport to Recognising your Skills” https://viw.pixel-online.org/case_view.php?id=NDY=: the protagonist of this story came to Italy for health reasons that she could not solve in her country of origin; she managed to get access to health care, after which she has stayed in Italy to build a new life for herself and her family.
References
Della Puppa F., Pasian P., Sanò G., 2020, “Quando la paura guida le scelte. Donne immigrate e salute riproduttiva”, Mondi Migranti, 3, pp. 71-97.
(https://www.researchgate.net/publication/347325361_Quando_la_paura_guida_le_scelte_Donne_immigrate_e_salute_riproduttiva)
The article brings important reflections on support and strategies for migrant women regarding their reproductive health.
Società Italiana di Medicina delle Migrazioni, 2015, Salute delle Donne Immigrate, Gruppo Salute Donne Immigrate
(https://www.simmweb.it/aree-tematiche/salute-delle-donne-immigrate)
This online contribution addresses the questions of a gender medicine in Italy, as well as the set of limits and strategies in promoting it.