International organizations and migrant health in Europe

Kentikelenis, Alexander; Shriwise, Amanda

doi:10.1186/s40985-016-0033-4

Cited by 11 publications

(7 citation statements)

References 47 publications

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“…Furthermore, our data indicate a growing need to increase psychosocial training for healthcare providers [ 21 ] and to strengthen referral mechanisms for mental healthcare and GBV support services as health services transition to local authorities. Strategic communication and coordination is also needed between NGOs [ 33 ] and Greek health authorities [ 31 ] to facilitate the transition of health service provision to the Greek healthcare system and improve access and quality of care for refugees. The refugee population should be informed of locations and means to access to local health services, standards and processes in the Greek healthcare system, and availability of medical interpreters during service delivery.…”

Section: Discussionmentioning

confidence: 99%

“The needs have clearly evolved as time has gone on.”: A qualitative study to explore stakeholders’ perspectives on the health needs of Syrian refugees in Greece following the 2016 European Union-Turkey agreement

Hémono

Relyea²,

Scott

et al. 2018

Confl Health

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BackgroundBy 2017, more than 500,000 Syrian refugees had passed through Greece seeking safety and asylum. Understanding how their health needs evolved over the refugee crisis in Greece and in relation to changing migration policy, and exploring the challenges involved in delivering their healthcare is timely as non-governmental organizations (NGOs) transition health service provision to the Greek health authorities.MethodsWe conducted a qualitative study to explore stakeholders’ perspectives on delivering health services to Syrian refugees over the course of the humanitarian response in Greece from 2015 to 2017. Twenty-five in-depth interviews were conducted face-to-face or by Skype with healthcare providers, NGO staff, and organizational and government representatives involved in coordinating and managing healthcare for the Syrian refugee population in Greece. Following informed consent, interviews were audio-recorded or detailed summaries were manually recorded. Data were coded inductively to identify emerging themes.ResultsFollowing the implementation of the European Union-Turkey agreement in 2016, healthcare providers in refugee camps reported a shift from acute physical health issues to mental health disorders, and heightened risks of gender-based violence among Syrian refugees. Key challenges to service delivery included a narrow model of healthcare provision and insufficient referral mechanisms for social support and mental health services. Language and gender differences between refugees and healthcare providers, and a lack of privacy and space in clinics impeded the quality of care. Stakeholders observed deterioration in refugees’ mental health in relation to longer periods spent in the camps. Many also emphasized that services for gender-based violence and mental health should be prioritized.ConclusionThis study provides stakeholders’ perspectives on changes in refugee health needs over the course of the humanitarian response in Greece. With protracted encampment resulting from migration policy, addressing mental health disorders and gender-based violence should be prioritized, including psychosocial training for healthcare providers and strengthening referral mechanisms for specialized care. The findings also emphasize the importance of providing human-centered care and gender concordant services by incorporating female healthcare providers and interpreters into medical teams. Strategic communication and coordination is needed between NGOs and Greek health authorities to facilitate the transition of health service delivery to the Greek healthcare system and to improve access and quality of care for refugees.

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Section: Discussionmentioning

confidence: 99%

“The needs have clearly evolved as time has gone on.”: A qualitative study to explore stakeholders’ perspectives on the health needs of Syrian refugees in Greece following the 2016 European Union-Turkey agreement

Hémono

Relyea²,

Scott

et al. 2018

Confl Health

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show abstract

“…by developing migrant health clinics that specialises to handle the health care needs of this diverse group as is seen for instance at the Odense University Hospital in Denmark [ 65 ]. This will help to strengthen the efforts already taking place in the receiving countries’ health care system and by a number of NGOs [ 3 , 66 ]. The ECDC has developed a handbook for clinicians for health assessment of refugees and migrants in the EU/EEA [ 67 ].…”

Section: Discussionmentioning

confidence: 99%

Review of infectious diseases in refugees and asylum seekers—current status and going forward

2017

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An unprecedented rise in the number of asylum seekers and refugees was seen in Europe in 2015, and it seems that numbers are not going to be reduced considerably in 2016. Several studies have tried to estimate risk of infectious diseases associated with migration but only very rarely these studies make a distinction on reason for migration. In these studies, workers, students, and refugees who have moved to a foreign country are all taken to have the same disease epidemiology. A common disease epidemiology across very different migrant groups is unlikely, so in this review of infectious diseases in asylum seekers and refugees, we describe infectious disease prevalence in various types of migrants. We identified 51 studies eligible for inclusion. The highest infectious disease prevalence in refugee and asylum seeker populations have been reported for latent tuberculosis (9-45%), active tuberculosis (up to 11%), and hepatitis B (up to 12%). The same population had low prevalence of malaria (7%) and hepatitis C (up to 5%). There have been recent case reports from European countries of cutaneous diphtheria, louse-born relapsing fever, and shigella in the asylum-seeking and refugee population. The increased risk that refugees and asylum seekers have for infection with specific diseases can largely be attributed to poor living conditions during and after migration. Even though we see high transmission in the refugee populations, there is very little risk of spread to the autochthonous population. These findings support the efforts towards creating a common European standard for the health reception and reporting of asylum seekers and refugees.

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“…As a result of these effects on health systems, non-state actors have often sought to fill the gaps in healthcare provision left by retreating state services. In particular, international or nongovernmental organizations often step in to offer health services to vulnerable groups-sometimes bypassing governments (Kentikelenis and Shriwise, 2016;Sridhar and Woods, 2010). Even though some evidence points to improved health outcomes following these interventions (J. M. Shandra et al, 2010), they have been linked to coordination problems, limited range and quality of services, prolonged weak state capabilities in health policy (Kentikelenis et al, 2014b;Ravindran, 2010;Sridhar and Woods, 2010).…”

Section: Direct Effects On Health Systemsmentioning

confidence: 99%

Structural adjustment and health: A conceptual framework and evidence on pathways

Kentikelenis

2017

Social Science & Medicine

Self Cite

110

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Economic reform programs designed by the International Monetary Fund and the World Bank-so-called 'structural adjustment programs'-have formed one of the most influential policy agendas of the past four decades. To gain access to financial support from these organizations, countries-often in economic crisis-have reduced public spending, limited the role of the state, and deregulated economic activity. This article identifies the multiple components of structural adjustment, and presents a conceptual framework linking them to health systems and outcomes. Based on a comprehensive review of the academic literature, the article identifies three main pathways through which structural adjustment affects health: policies directly targeting health systems; policies indirectly impacting health systems; and policies affecting the social determinants of health. The cogency of the framework is illustrated by revisiting Greece's recent experience with structural adjustment, drawing on original IMF reports and secondary literature. Overall, the framework offers a lens through which to analyze the health consequences of structural adjustment across time, space and levels of socioeconomic development, and can be utilized in ex ante health impact assessments of these policies.

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International organizations and migrant health in Europe

Cited by 11 publications

References 47 publications

“The needs have clearly evolved as time has gone on.”: A qualitative study to explore stakeholders’ perspectives on the health needs of Syrian refugees in Greece following the 2016 European Union-Turkey agreement

“The needs have clearly evolved as time has gone on.”: A qualitative study to explore stakeholders’ perspectives on the health needs of Syrian refugees in Greece following the 2016 European Union-Turkey agreement

Review of infectious diseases in refugees and asylum seekers—current status and going forward

Structural adjustment and health: A conceptual framework and evidence on pathways

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