Refugees' access to and utilization of health services: challenges and solutions in Turkey

Kaya, Edip; Çaman, Özge Karadağ; Kılıç, Cengiz; Üner, Sarp

doi:10.1093/eurpub/cky214.273

Cited by 6 publications

(9 citation statements)

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“…41 Another study illustrated that language barriers among Syrian refugees who do not live in camps have caused inadequate access to healthcare. 42 The government of Jordan and the United Nations are currently implementing CBR programs within refugee camps. 43 Several case studies point out the importance of simultaneous provision of health insurance coverage as well as need-based services to improve refugees' health.…”

Section: Discussionmentioning

confidence: 99%

Refugees and Sustainable Health Development in Iran

et al. 2021

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Background: Refugees’ access to quality healthcare services might be compromised, which can in turn hinder universal health coverage (UHC), and achieving Sustainable Development Goal (SDG), ultimately. Objective: This article aims to illustrate the status of refugees’ access to healthcare and main initiatives to improve their health status in Iran. Methods: This is a mixed-method study with two consecutive phases: qualitative and quantitative. In the qualitative phase, through a review of documents and semi-structured interviews with 40 purposively-selected healthcare providers, the right of refugees to access healthcare services in the Iranian health system was examined. In the quantitative phase, data on refugees’ insurance coverage and their utilization from community-based rehabilitation (CBR) projects were collected and analyzed. Results: There are international and upstream policies, laws and practical projects that support refugees’ health in Iran. Refugees and immigrants have free access to most healthcare services provided in the PHC network in Iran. They can also access curative and rehabilitation services, the costs of which depend on their health insurance status. In 2015, the government allowed the inclusion of all registered refugees in the Universal Public Health Insurance (UPHI) scheme. Moreover, the mean number of disabled refugees using CBR services was 786 (±389.7). The mean number of refugees covered by the UPHI scheme was 112,000 (±30404.9). Conclusion: The United Nations’ SDGs ask to strive for peace and reducing inequity. Along its pathway towards UHC, despite limited resources received from the international society, the government of Iran has taken some fundamental steps to serve refugees similar to citizens of Iran. Although the initiative looks promising, more is still required to bring NGOs on board and fulfill the vision of leaving no one behind.

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Section: Discussionmentioning

confidence: 99%

Refugees and Sustainable Health Development in Iran

et al. 2021

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“…Mobile mental health is a promising way to reach a large portion of this vulnerable population; since most refugees have smartphones, the accessibility of a mobile app technology is feasible for usage. Additionally, mental health services in general that have been culturally, religiously and linguistically adapted to refugees in the Levantine region (Syria, Lebanon, Palestine) have been met with overwhelmingly positive results [13,15,16,37]. Therefore, the ideal mMHealth platform would incorporate linguistic, cultural and religious adaptations.…”

Section: Discussionmentioning

confidence: 99%

“…A review of health system utilization by Sarria-Santamerra et al discusses the general lack of utilization of health services by immigrant populations in a variety of host nations and conclude that further studies are needed to evaluate patterns of health resource usage among these populations [12]. A study from Ankara, Turkey identified language as a major barrier for utilization of health services [13]. The Turkish Ministry of Health is now employing Syrian Health Workers to improve access to Syrians living in Turkey [14].…”

Section: Study Motivationmentioning

confidence: 99%

Utilization of Mobile Mental Health Services among Syrian Refugees and Other Vulnerable Arab Populations—A Systematic Review

Ashfaq

Esmaili

Najjar

et al. 2020

IJERPH

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The global refugee crisis is at its most critical state in history; Syria alone has produced 12 million internally displaced persons, with another 5 million refugees seeking protection across the globe. Faced with the heavy burden of mental distress carried by a massive refugee influx, many host nations lack the service capacity to respond adequately. While mobile mental health (mMHealth) applications and platforms have the potential to augment screenings and interventions for vulnerable populations, an insufficient gender and cultural adaptation of technology may drastically hamper its uptake in Arab refugees. Reporting only papers originating from Middle Eastern and/or Arab nations or refugee host nations, this systematic review evaluates the available literature published between 2000 and 2019 on the usage acceptability of mMHealth in Syrian refugees and other vulnerable Arab populations. We conducted a systematic review in PubMed, PsychInfo, Association of Computing Machinery (ACM) and the Directory of Open Access Journals (DOAJ) using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to identify studies that addressed mMHealth implementation in these populations; of a total of 607 articles identified, only 10 (1.6%) available, unique articles met our search criteria. These studies discussed the feasibility and efficacy of mMHealth applications and the barriers to their uptake. The few existing studies show positive impacts of mMHealth on the access to services and on treatment outcomes but also reveal a paucity of literature on mMHealth for vulnerable Arab populations. These findings indicate a critical need for research on the barriers to mMHealth uptake, to bolster service capacity in the Arab Region and in the refugee diaspora of other, non-Arab host countries.

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“…The most common barriers to mental health care were language problems and lack of knowledge about existing services. From the service providers' and policy makers' point of view, the reasons for low utilization of mental health services were refugees' higher prioritization of daily life challenges and physical health problems and their low level of awareness on available services [18][19][20][21].…”

Section: Methods and Key Findingsmentioning

confidence: 99%

Challenges and lessons learned in mental health research among refugees: a community-based study in Turkey

et al. 2021

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Background Turkey hosts nearly four million refugees and 99% live in urban areas. Research in urban settings pose different challenges and opportunities than research in refugee camps. In this article, we aimed to share the challenges and experiences we encountered in a mixed-methods study to assess mental health problems and barriers to accessing mental health care among refugees in urban areas of Turkey. Discussion In our case, the main challenges in conducting research with refugees were collecting data from a highly traumatized population, difficulties with contacting undocumented asylum seekers including trust issues and the fear of deportation, the risk of secondary traumatization among data collectors, and the bureaucracy during study approval processes. Targeting a representative sample was not feasible, because of the lack of publicly available demographic data on a district level, presence of undocumented asylum seekers and high mobility among the refugees. Although respondents with significant psychological symptoms were routinely referred to available mental health services, we were able to do less for unregistered refugees with problems in accessing health care. Language/alphabet differences and differing dialects of Arabic posed another challenge in both translation and administration of the scales. Based on cultural characteristics, a gender-balanced team was used and the interviewers were gender-matched whenever needed. Also, the research team had to work after work hours and during weekends to be able to interview male refugees, since most refugee men were at work during working hours and most days of the week. Conclusions The research team’s experience showed that refugee population characteristics including level of trauma, language, culture, gender, legal status, and urban setting characteristics including places of living, mobility, availability of publicly available demographic data, and outreach-related barriers lead to different challenges and ethical responsibilities of researchers and affect the research costs in terms of time, human resources and finance. Even in a host country with geographical, religious and cultural proximity to the refugees, profound challenges exist in conducting mental health research in urban settings. Learning from previous experience and collaborating with local researchers and institutions are vital for better public health research and practice outcomes.

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Refugees' access to and utilization of health services: challenges and solutions in Turkey

Cited by 6 publications

References 0 publications

Refugees and Sustainable Health Development in Iran

Refugees and Sustainable Health Development in Iran

Utilization of Mobile Mental Health Services among Syrian Refugees and Other Vulnerable Arab Populations—A Systematic Review

Challenges and lessons learned in mental health research among refugees: a community-based study in Turkey

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