Challenges in access to health care among involuntary migrants in Germany. A case study of migrants' experiences in Oldenburg, Lower Saxony

Ansar, Anas; Johansson, Frida; Vásquez, Laura Marcela Londoño; Schulze, Mario; Vaughn, Taylor

doi:10.1111/imig.12326

Cited by 3 publications

(2 citation statements)

References 7 publications

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“…In recent years, a shortage of nurses and other health professionals has led to increased efforts to recruit personnel from other countries, which could explain the results [ 27 ]. These findings could also explain, why the overall cultural competence of staff as well as their awareness with respect to other diversity characteristics have been found to be limited in previous research [ 28 , 29 ]. Similar findings have been reported for German rehabilitation hospitals and nursing homes [ 26 ].…”

Section: Discussionmentioning

confidence: 84%

Diversity-sensitive measures in German hospitals – attitudes, implementation, and barriers according to administration managers

Erdsiek

Aksakal

Mader

et al. 2022

BMC Health Serv Res

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Background Populations have varying needs and expectations concerning health care that result from diversity characteristics such as a migrant background, gender identity, disability, and age. These needs and expectations must be considered to ensure adequate utilization and quality of health services. Approaches to address diversity do exist, however, little is known about the extent to which they are implemented by health care facilities. The present study aims to examine, which measures and structures hospitals in Germany employ to address diversity, as well as which barriers they encounter in doing so. Methods A mixed-mode survey among administration managers of all registered German hospitals (excluding rehabilitation hospitals; n = 1125) was conducted between May and October 2019 using pen-and-paper and online questionnaires. Results were analyzed descriptively. Results Data from n = 112 hospitals were available. While 57.1% of hospitals addressed diversity in their mission statement and 59.9% included diversity considerations in quality management, dedicated working groups and diversity commissioners were less prevalent (15.2% each). The majority of hospitals offered multi-lingual admission and exit interviews (59.8%), treatments or therapies (57.1%), but only few had multi-lingual meal plans (12.5%) and seminars or presentations (11.6%). While 41.1% of the hospitals offered treatment and/or nursing exclusively by staff of the same sex, only 17.0% offered group therapies for both sexes separately. According to the managers, the main barriers were a lack of financial resources (54.5%), a lack of incentives from the funding providers (49.1%), and organizational difficulties (45.5%). Other reported barriers were a lack of conviction of the necessity among decision makers (28.6%) and a lack of motivation among staff members (19.6%). Conclusions Administration managers from only a small proportion of hospitals participated in our survey on diversity sensitivity. Even hospitals of those who did are currently not adequately addressing the diversity of staff members and patients. Most hospitals address diversity on an ideational level, practical measures are not widely implemented. Existing measures suggest that most hospitals have no overarching concept to address diversity in a broader sense. The main reported barriers relate to economic aspects, a lack of support in organizing and implementing corresponding measures and a lack of awareness or motivation.

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Section: Discussionmentioning

confidence: 84%

Diversity-sensitive measures in German hospitals – attitudes, implementation, and barriers according to administration managers

Erdsiek

Aksakal

Mader

et al. 2022

BMC Health Serv Res

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“…However, a small group of women (who had low German proficiency and insecure residence status) used ANC less frequently. With the influx of refugees, since 2015, it is an essential time to evaluate the uptake of ANC among immigrants in Berlin.…”

Section: Introductionmentioning

confidence: 99%

The influence of migration on women’s use of different aspects of maternity care in the German health care system: Secondary analysis of a comparative prospective study with the Migrant Friendly Maternity Care Questionnaire (MFMCQ)

Seidel

Gürbüz

Großkreutz

et al. 2019

Birth

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Introduction Approximately 21% of Germany's inhabitants or their parents have been born abroad. There is evidence that immigrant women are starting antenatal care later than nonimmigrants. In Berlin, equality in health care access had improved until 2011‐2012, leaving only women with Low German language proficiency and an insecure residence status particularly at risk. With the recent influx of refugees, we analyzed whether access to antenatal and postpartum care differs depending on immigration, residence status, income, and education. Methods At our Berlin tertiary care center, a modified version of the Migrant Friendly Maternity Care Questionnaire was administered to women who delivered in the first half of 2017. Multivariate modeling compared nonimmigrant women, immigrants, and women who are direct descendants of immigrants. Results The study included 184 nonimmigrant women, 214 immigrant women, and 62 direct descendants of immigrants. Germany is relatively good in prenatal care for immigrant women, as most are getting adequate prenatal care. However, 21% of immigrants compared with 11% of nonimmigrant women started pregnancy care after the first trimester (P = .03). Low income was a more powerful predictor than immigration status for starting prenatal care after the first trimester. Immigrant women (23%) were less informed on postpartum care availability than nonimmigrants (3%) and used less postpartum midwifery care. Conclusions When designing health care interventions for immigrant women, not only migration‐specific factors should be considered but also low income as a barrier to access to maternity care.

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Equal Alternatives or Lower Standards for Immigrant Women—Analyzing Obstetric Care for Immigrant Women in Berlin Within the Framework of Cultural Health Capital

Großkreutz

Gürbüz

Borde

et al. 2023

J. Racial and Ethnic Health Disparities

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In obstetric clinics in Berlin, Germany, more than half of the women are immigrants. The main objective of the qualitative study was to explore the staff’s experiences with obstetric care for immigrants and juxtapose it with the immigrants’ comments on their birth experiences. We analyze potential differences along the framework of a cultural health capital (CHC). Between May and August 2017, semi-structured interviews were carried out with 17 obstetricians and 17 midwives at four obstetric clinics in Berlin. The verbally transcribed interview material was subjected to a qualitative content analysis according to Mayring. Furthermore, a secondary data from an interview study was analyzed in the purpose of providing some insight into the practitioner study participant perspective. Between January and May 2017, in the postpartum ward at the Berlin Charité Campus Virchow Clinic, an interview study guided by the migrant-friendly maternity care questionnaire was conducted among 410 migrant and non-migrant women. For this study, the free-text comments on the pregnancy care were analyzed. The staff interviewees identified language barrier and legal status as risk factors for the late onset of obstetric care. CHC functioning potentially as alternatives to the established health care structures were voiced. Strong family ties among immigrant families bear a high potential for support. Gratefulness was voiced by the staff and immigrant patients as a source of satisfaction with care. Our study shows that obstetric care for immigrant women remains a challenge. CHC of immigrant women might partially compensate for exclusion.

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Challenges in access to health care among involuntary migrants in Germany. A case study of migrants' experiences in Oldenburg, Lower Saxony

Cited by 3 publications

References 7 publications

Diversity-sensitive measures in German hospitals – attitudes, implementation, and barriers according to administration managers

Diversity-sensitive measures in German hospitals – attitudes, implementation, and barriers according to administration managers

The influence of migration on women’s use of different aspects of maternity care in the German health care system: Secondary analysis of a comparative prospective study with the Migrant Friendly Maternity Care Questionnaire (MFMCQ)

Equal Alternatives or Lower Standards for Immigrant Women—Analyzing Obstetric Care for Immigrant Women in Berlin Within the Framework of Cultural Health Capital

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