Being Immigrant in their Own Country: Experiences of Bosnians Immigrants in Contact with Health Care System in Bosnia and Herzegovina

Abstract

Background:Bosnia and Herzegovina became an independent state (6th April 1992) after referendum for the independence of Bosnia and Herzegovina which was held on 29 February and 1 March 1992. On the referendum voted total 2,073,568 voters (63.6% turnout) and 99.7% were in favor of independence, and 0.3% against. According to the provisions of the peace agreement, particularly in Annex IV of the Constitution of Bosnia and Herzegovina, the country continues to exist as an independent state. Like all others institutions, even the health-care system was separated between Federation and the other part of Bosnia and Herzegovina. The right to social and medical services in Bosnia and Herzegovina is realized entities level and regulated by entity laws on social and health-care.Aims:The aim was to explore how immigrants born in Bosnia and Herzegovina and living as refugees in their own country experience different institutions in Bosnia and Herzegovina with the special focus on the health-care system. We also investigated the mental health of those immigrants.Patients and Methods:Focus-group interviews, with 21 respondents born in Bosnia and Herzegovina and living as refugees in their own country, were carried out. Content analysis was used for interpretation of the data.Results:The analysis resulted in two categories: the health-care in pre-war period and the health-care system in post-war period. The health-care organization, insurance system, language differences, health-care professional’s attitude and corruption in health-care system were experienced as negative by all respondents. None of the participants saw a way out of this difficult situation and saw no glimmer of light in the tunnel. None of the participants could see any bright future in the health-care system.Conclusion:Health-care system should be adjusted according to the needs of both the local population born as well as the immigrants. Health-care professionals must be aware of the difficulties of living as immigrants in one’s own country. In order to provide health-care on a high level of quality, health-care professionals must meet all the expectations of the patients, and not to expect that patients should fulfil the expectations of the health-care professionals. Different educational activities, such as lectures, seminars and conferences, are needed with the purpose of the optimal use of the health-care system for people that have been forced to become refuges in their own country.

The Influence of Information and Religion on Organ Donation, as Seen by School Teachers in Bosnia and Herzegovina

“…Previous studies have shown that different factors, including social, cultural, ethnicity and educational issues, as well as language barriers, race, gender and religious concerns, may influence a decision against organ donation (5-7). Some of these differences may be explained by different infrastructure, law or consent systems, or the mistrust and corruption in the health-care system, particularly in countries with low deceased donation rates (5, 7, 8). …”

Factors Beyond the Language Barrier in Providing Health Care to Immigrant Patients

“…This diversity, which could be considered as a combination of culture and differences in healthcare systems and practical routines between home countries and resettlement countries, influences healthcare services for immigrant patients. Adaption of the healthcare system to the multicultural society is needed, to provide healthcare to all our patients on the same level ( 13 ). In order to provide healthcare services to immigrants, health care professionals need a better and deeper understanding of immigrants’ needs, in view of the immigrants’ cultural background and simple healthcare routines ( 24 ).…”

“…Due to barriers to health care access and efficiency, patients with a migrant background, have a higher prevalence of some chronic diseases than the majority population ( 11 ). Knowledge about attitudes towards health care in different cultures and adapting health care services to multicultural issues is essential to providing equal health care to all inhabitants in multicultural societies ( 12 , 13 ).…”

Patients’ perception of differences in general practitioners’ attitudes toward immigrants compared to the general population: Qualicopc Slovenia

“…As mentioned above, immigrants may also face different challenges in their host countries, such as language differences, homesickness for relatives still living in their countries of origin, unfamiliarity with the sociocultural system, unemployment, educational difficulties, and social exclusion, which may affect their view of their GPs’ attitudes (13 - 15) . This is why GPs must be aware of all these obstacles and difficulties that immigrants face and should try to remedy them (38 , 53) .…”