Primary care for refugees and newly arrived migrants in Europe: a qualitative study on health needs, barriers and wishes

Loenen, Tessa van; Muijsenbergh, Maria van den; Hofmeester, Marrigje; Dowrick, Christopher; Ginneken, Nadja van; Mechili, Enkeleint A.; Angelaki, Agapi; Ajduković, Dean; Bakić, Helena; Pavlič, Danica Rotar; Zelko, Erika; Hoffmann, Kathryn; Jirovsky, Elena; Mayrhuber, Elisabeth Sophie; Dückers, Michel; Mooren, Trudy; Gouweloos-Trines, Juul; Kolozsvári, László Róbert; Rurik, Imre; Lionis, Christos

doi:10.1093/eurpub/ckx210

Cited by 89 publications

(102 citation statements)

References 15 publications

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“…On the one hand culture-related communication differences were identified as hampering for mental health diagnoses, on the other hand there is a lack of mental health care options available targeted especially to refugees [15,16]. The results of this research are consistent to earlier studies [18–20].…”

Section: Introductionsupporting

confidence: 86%

“…Research has shown that PHC professionals and refugees or other migrants face equally great challenges when it comes to PHC encounters during the flight, upon and after arrival in the destination countries [15,16,18–20]. In response to these challenges, an online course/CME course for PHC professionals was developed, offering comprehensive knowledge on the issues of refugees’ and other migrants’ health to participants from different countries.…”

Section: Discussionmentioning

confidence: 99%

“…Qualitative research conducted in the framework of the EUR-HUMAN project in seven EU countries (Austria, Croatia, Greece, Hungary, Italy, the Netherlands, and Slovenia) [15,16], showed challenges that concerned both the PHC professionals and the refugees and other migrants in need of health care: knowledge gaps, systemic challenges regarding social insurance and health insurance, language barriers, and communication differences were identified as particularly challenging [15,17]. On the one hand culture-related communication differences were identified as hampering for mental health diagnoses, on the other hand there is a lack of mental health care options available targeted especially to refugees [15,16].…”

Section: Introductionmentioning

confidence: 99%

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Development and evaluation of a web-based capacity building course in the EUR-HUMAN project to support primary health care professionals in the provision of high-quality care for refugees and migrants

Jirovsky

Hoffmann

Mayrhuber

et al. 2018

Global Health Action

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Background: The ongoing refugee crisis has revealed the need for enhancing primary health care (PHC) professionals’ skills and training. Objectives: The aim was to strengthen PHC professionals in European countries in the provision of high-quality care for refugees and migrants by offering a concise modular training that was based on the needs of the refugees and PHC professionals as shown by prior research in the EUR-HUMAN project. Methods: We developed, piloted, and evaluated an online capacity building course of 8 stand-alone modules containing information about acute health issues of refugees, legal issues, provider–patient communication and cultural aspects of health and illness, mental health, sexual and reproductive health, child health, chronic diseases, health promotion, and prevention. The English course template was translated into seven languages and adapted to the local contexts of six countries. Pre- and post-completion knowledge tests were administered to effectively assess the progress and knowledge increase of participants so as to issue CME certificates. An online evaluation survey post completion was used to assess the acceptability and practicability of the course from the participant perspective. These data were analyzed descriptively. Results: A total of 390 participants registered for the online course in 6 countries with 175 completing all modules of the course, 47.7 % of them medical doctors. The mean time for completion was 10.77 hours. In total, 123 participants completed the online evaluation survey; the modules on acute health needs, legal issues (both 44.1%), and provider–patient communication/cultural issues (52.9%) were found particularly important for the daily practice. A majority expressed a will to promote the online course among their peers. Conclusion: This course is a promising learning tool for PHC professionals and when relevant supportive conditions are met. The course has the potential to empower PHC professionals in their work with refugees and other migrants.

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Section: Introductionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Development and evaluation of a web-based capacity building course in the EUR-HUMAN project to support primary health care professionals in the provision of high-quality care for refugees and migrants

Jirovsky

Hoffmann

Mayrhuber

et al. 2018

Global Health Action

Self Cite

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“…Another study detected respiratory tract infections in 41% of 33,331 patients who accessed care points of entry into Greece and Serbia [16,17,36,37]. Moreover, pregnancy-related issues are often mentioned [25,28,38]. In some cases, young mothers are too stressed to breastfeed their newborns.…”

Section: Health Problems Facing Refugeesmentioning

confidence: 99%

“…Although some refugees refused to receive any care because they wanted to continue their journey as soon as possible, the majority reported that they received inadequate information about the rules in the holding centers, as well as on the organization and location of health services [38]. …”

Section: The Refugee Crisis Challenges the Greek Healthcare Systemmentioning

confidence: 99%

Impact of the Refugee Crisis on the Greek Healthcare System: A Long Road to Ithaca

Kotsiou

Kotsios

Srivastava

et al. 2018

IJERPH

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Greece is the country of “Xenios Zeus”, the Ancient Greek god of foreigners and hospitality; however, it is also the main point of entry to Europe. Since the beginning of 2014, 1,112,332 refugees crossed the borders of Greece. Overall, 33,677 children and adolescent refugees sought asylum in Greece from 2013 to 2017, while 57,042 refugees are currently being hosted. The rapid entry of refugees into Greece raised the critical issue of health policy. The Greek National Health Service (NHS) faces many challenges. Adequate economic and human support is essential if this situation is to be managed successfully. However, Greece still bears the burden of the economic downturn since 2009. In fact, the crisis led to shortages in crucial equipment, and unmet health needs for both locals and refugees. The NHS deals with traumatic experiences, as well as cultural and linguistic differences. Overcrowded reception centers and hotspots are highly demanding and are associated with severe disease burden. This highlights the importance of guidelines for medical screening, healthcare provision, and a well-managed transition to definitive medical facilities. Furthermore, non-governmental organizations make an essential contribution by ensuring appropriate support to refugee minors, especially when they experience poor access to the NHS.

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Prescription of antibiotics in the medical care of newly arrived refugees and migrants

Kleinert

Hillermann

Jablonka

et al. 2021

Pharmacoepidemiology and Drug

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Purpose: Unnecessary and inappropriate use of antibiotics is a widespread problem in primary care. However, current data on the care of refugees and migrants in initial reception centers is pending. This article provides data on prescription frequencies of various antibiotics and associated diagnoses. Methods: In this retrospective observational study, patient data of 3255 patients with 6376 medical contacts in two initial reception centers in Germany were analyzed. Patient data, collected by chart review, included sociodemographic characteristics, diagnoses, and prescriptions. Antibiotic prescription behavior and corresponding physician-coded diagnoses were analyzed.Results: Nineteen percent of all patients in our study received systemic antibiotics during the observation period, with children below the age of 10 years receiving antibiotics most frequently (24%). The most commonly prescribed antibiotics were penicillins (65%), macrolides (12%), and cephalosporins (7%). The most frequent diagnoses associated with antibiotic prescription were acute tonsillitis (26%), bronchitis (21%), infections of the upper respiratory tract (14%), and urinary tract infections (10%). In case of acute bronchitis 74% of the antibiotic prescriptions were probably not indicated. In addition, we found a significant number of inappropriate prescriptions such as amoxicillin for tonsillitis (67%), and ciprofloxacin and cotrimoxazol for urinary tract infections (49%). Conclusion:Regarding inappropriate prescription of antibiotics in refugee healthcare, this study shows a rate ranging from 8% for upper respiratory tract infections to 75% for acute bronchitis. Unnecessary use of antibiotics is a global problem contributing to gratuitous costs, side effects, and antimicrobial resistance. This research contributes to the development of stringent antibiotic stewardship regiments in the particularly vulnerable population of migrants and refugees.

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Primary care for refugees and newly arrived migrants in Europe: a qualitative study on health needs, barriers and wishes

Abstract: Health of refugees on the move in Europe is jeopardized by their bad living circumstances and barriers in access to healthcare. To address their needs, healthcare workers have to be trained in providing integrated, compassionate and cultural competent healthcare.

Cited by 89 publications

References 15 publications

Development and evaluation of a web-based capacity building course in the EUR-HUMAN project to support primary health care professionals in the provision of high-quality care for refugees and migrants

Development and evaluation of a web-based capacity building course in the EUR-HUMAN project to support primary health care professionals in the provision of high-quality care for refugees and migrants

Impact of the Refugee Crisis on the Greek Healthcare System: A Long Road to Ithaca

Prescription of antibiotics in the medical care of newly arrived refugees and migrants

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