Background In 2016–18, a large measles outbreak occurred in Romania identified by pockets of sub-optimally vaccinated population groups in the country. The aim of the current study was to gain insight into barriers and drivers from the experience of measles vaccination from the perspectives of caregivers and their providers. Methods Data were collected by non-participant observation of vaccination consultations and individual interviews with health workers and caregivers in eight Romanian clinics with high or low measles vaccination uptake. Romanian stakeholders were involved in all steps of the study. The findings of this study were discussed during a workshop with key stakeholders. Results Over 400 h of observation and 161 interviews were conducted. A clear difference was found between clinics with high and low measles vaccination uptake which indicates that being aware of and following recommended practices for both vaccination service delivery and conveying vaccine recommendations to caregivers may have an impact on vaccine uptake. Barriers identified were related to shortcomings in following recommended practices for vaccination consultations by health workers (e.g. correctly assessing contraindications or providing enough information to allow an informed decision). These observations were largely confirmed in interviews with caregivers and revealed significant knowledge gaps. Conclusions The identification of key barriers provided an opportunity to design specific interventions to improve vaccination service delivery (e.g. mobile vaccination clinics, use of an electronic vaccination registry system for scheduling of appointments) and build capacity among health workers (e.g. guidance and supporting materials and training programmes).
In spite of the existence of an extensive national and supranational legal framework, European Union (EU) citizens who exercise their right to freedom of movement to work in another Member State face numerous hurdles in accessing social protection. While recent scholarship on street‐level bureaucracy and on migration and welfare has shed light on the role of discretion and stereotypes in access to rights, little is known about the processes through which such hurdles are overcome. In this article, we focus on a specific strategy which is the recourse to what we call “welfare brokers”. These actors offer assistance to EU migrants to overcome specific cross‐border administrative challenges in the area of social protection that derive from their use of the right to freedom of movement. Relying on qualitative data collected with brokers and Romanian migrants working in Germany, the article also demonstrates that welfare brokers attempt to transform the norms, bureaucratic practices and representations that condition access to these entitlements. The article concludes by underlining how the existence of a brokerage industry is a sign of existing inequalities in the exercise of freedom of movement within the EU.
Drawing on participatory and non-participatory observation and on interviews with workers, union representatives and migrant advisors, this chapter focuses on the working conditions of Romanians posted in the construction and meat industry sectors in Germany. More precisely, it addresses their income level, housing and health, as well as union approaches towards workers in this type of employment. Both because the regulatory framework in force in 2015-16, when this research was carried out, did not grant wages above the minimum standards in Germany for posted workers, and as a result of informal agreements or unlawful practices of employers, respondents were often paid below the wages they were entitled to. Their accommodation ranged from shared apartments insides towns to living-containers at the construction site or, in extreme cases, to illegal housing in tool-containers. At the same time, even if as a result of intense work rhythm and poor work safety, posted workers are more vulnerable to health issues and accidents than regular employees, their social health protection is low. On the other hand, the constraints of the outdated regulatory framework and their limited resources are among the factors that determined unions to support advisory offices for posted workers, instead of recruiting them within their structures. In this context, posted workers have an unbalanced position in regards to that of their employers, with few who were able to enforce their rights through collective action.
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