Migrants and access to healthcare: the Italian public health residents action plan

Abstract

Background Fighting health inequalities have been included in the WHO Sustainable Development Goals as a priority. Migrants are between the most vulnerable individuals and healthcare interventions, also during the post-migration period, should be oriented, context-specific and aimed at identifying reasons underlying inequalities, as suggested by the recent WHO report ’No public health without migrant health’. The “Inequality Working Group” of the Italian network of public health (PH) residents of the Italian Society of Hygiene, Preventive Medicine and Public Health (SItI) aims at identifying an interdisciplinary approach suitable to detect barriers to healthcare access for migrants in different Italian regions. Secondly, we aspire to develop some strategies to overcome unequal healthcare access. Methods Focus group methodology was applied to set working group educational needs, priorities of action and working plan. Moreover, we implemented a network between various professionals involved in migrant healthcare, particularly with the Regional Groups of the Italian Society of Migration Medicine (SIMM). Results After a period of peer-to-peer education about social determinants of health and migration, we reviewed Italian policies about migrants’ healthcare and considered potential discrepancies from WHO recommendations. Furthermore, we mapped practices regarding access to care for migrant population and we focused on causes underlying unequal healthcare access. Conclusions Although with regional differences, migrants have limited access to healthcare services and therefore represent a vulnerable subpopulation. Key messages Fighting against the barriers that limit access to care for migrants is a priority for health systems. PH residents have a relevant role in identifying and defining critical issues, designing enforcement measures and implementing advocacy actions.

The interplay between structural and systemic vulnerability during the COVID-19 pandemic: migrant agricultural workers in informal settlements in Southern Italy

“…In addition, healthcare workers often fail to assign the code X01, necessary to have free health services, making these services prohibitively expensive, and therefore inaccessible. Local healthcare services also lack personnel trained in cultural and linguistic mediation, making it more difficult for migrants, who often lack Italian-language capacity, to navigate the NHS's complex bureaucracy (Mammana et al 2019). The organisation of the NHS complicates the procedures of registration with a GP for people not residing permanently in one place.…”

Drug Prescriptions among Italian and Immigrant Pregnant Women Resident in Italy: A Cross-Sectional Population-Based Study

“…Although Italy offers universal access to health care including maternal care [ 12 ], differences in maternal and perinatal outcomes persist, according to women’s country of origin and/or citizenship [ 13 , 14 ]. Despite a decrease in the last 10 years, the average number of children (1.89) among foreign women remains higher compared to Italian mothers (1.17) [ 15 ], likely due to the younger age of migrant women and due to their different fertility model, which tends to anticipate the age at childbirth compared to Italian women.…”