Experiences and Perceived Barriers of Asylum Seekers and People with Refugee Backgrounds in Accessing Healthcare Services in Romania

Abstract

Traditionally a country of emigration, Romania recently experienced an increased migration influx, although it is more a country of transit than a destination for refugees and irregular migrants. Refugees often face difficulties when trying to meet their needs and access essential services. This study aims to explore the experiences and barriers of asylum seekers and people with refugee backgrounds in accessing healthcare services in Romania. It is an exploratory study with a qualitative research design, which uses an inductive and deductive approach, with thematic analysis being applied in order to grasp the difficulties and barriers that asylum seekers and people with refugee backgrounds experience in accessing essential social services. The research was based on seven in-depth interviews with representatives of significant national or international non-governmental organisations assisting refugees and asylum seekers in Romania and 129 semi-structured interviews with different categories of people with refugee backgrounds from Southwest Asia, Eastern Africa and Ukraine. One of the most salient themes we identified relates to accessing the healthcare system. Participants talked about what information they needed to access medical services, where they looked for this information, and what barriers they faced in the process. Cultural, linguistic, structural, and financial barriers were perceived as the most significant. Improved public awareness, a better understanding of asylum issues, and stronger community support are essential to addressing inequalities experienced by this vulnerable population.

UCRAID (Ukrainian Citizen and refugee electronic support in Respiratory diseases, Allergy, Immunology and Dermatology) action plan

“…16 Medical help is made difficult by the lack of patient health records and communication issues caused by the language barrier. 13,17 Assessing patients by medical history and physical examination requires good communication between the patient and the physician and is severely hindered when they do not understand each other. 17 Physicians are often on the frontline in providing care for these unassisted, vulnerable and often misunderstood population groups.…”

“…16,17,21 Efforts aimed at improving the medical care for Ukrainian refugees should include (i) collecting robust data for health and disease monitoring and surveillance, (ii) providing health care to refugees and developing cost-effective and sustainable ways of financing this within and across recipient countries, (iii) improving the mobility and transferability of patients' health records and (iv) facilitating good communication between patients and physicians. 12,13,16 According to the UNHCR (United Nations, refugee agency), the number of forcibly displaced and stateless people in Europe rose suffer from allergic diseases, asthma and/or urticaria and that over 100,000 of them may have a severe disease. However, due to the stressful conditions, this number could be higher.…”

“…Among the most challenging are chronic non‐communicable diseases including mental disorders, which require continuous long‐term care and access to medicines 12 . Obtaining health care in recipient countries can be difficult for Ukrainian refugees 13 who are frequently unassisted, vulnerable and misunderstood 14 . Many Ukrainian refugees are not insured, need to pay for their health care out of pocket and cannot afford medication 15 .…”

“…Ukrainian refugees may not know where to go when they need medical help and may have substantial and diverse informational needs (legal advice, transport and accommodation issues, accessing services and health care) 16 . Medical help is made difficult by the lack of patient health records and communication issues caused by the language barrier 13,17 . Assessing patients by medical history and physical examination requires good communication between the patient and the physician and is severely hindered when they do not understand each other 17 .…”

“…Potential solutions include involving professional and volunteer translators, web sites providing information in Ukrainian, as well as the use of QR codes and smartphone applications to enable translations and interpretations 16,17,21 . Efforts aimed at improving the medical care for Ukrainian refugees should include (i) collecting robust data for health and disease monitoring and surveillance, (ii) providing health care to refugees and developing cost‐effective and sustainable ways of financing this within and across recipient countries, (iii) improving the mobility and transferability of patients' health records and (iv) facilitating good communication between patients and physicians 12,13,16 …”