Right to health and access to health-care services for refugees in Turkey

Abstract

Purpose This paper aims to provide a comprehensive understanding of factors that contribute to refugees’ exclusion from health-care services. More specifically, using institutional theory, this paper identifies regulative pillar-, normative pillar- and cultural/cognitive pillar-related challenges that result in refugees having limited or no access to health-care services. Design/methodology/approach The paper draws on both secondary research and empirical insights from two qualitative fieldwork studies totaling 37 semi-structured meso-level interviews, observations and focus groups in three Turkish cities (Izmir, Ankara and Edirne), as well as a total of 42 micro-level, semi-structured interviews with refugees and migrants in one large city (Izmir) in Turkey. Findings This study reveals that systematically stratified legal statuses result in different levels of access to public health-care services for migrants, asylum seekers or refugees based on their fragmented protection statuses. The findings suggest access to health-care is differentiated not only between local citizens and refugees but also among the refugees and migrants based on their legal status as shaped by their country of origin. Originality/value While the role of macro challenges such as laws and government regulations in shaping policies about refugees have been examined in other fields, the impact of such factors on refugee services and well-being has been largely ignored in service literature in general, as well as transformative service research literature in particular. This study is one of the first attempts by explicitly including macro-level factors to contribute to the discussion on the refugees’ access to public health-care services in a host country by relying on the institutional theory by providing a holistic understanding of cognitive, normative and regulative factors in understanding service exclusion problem.

Transformative service research methodologies for vulnerable participants

“…Importantly, gaining consent verbally is required as some cultures find signing documents problematic (Boenigk, Kreimer et al, 2021). Gokalp Aras et al (2021) used a combination of secondary data and in-depth interviews with Syrian refugees to investigate access to healthcare services. Interestingly, Kabadayi’s (2019) study of Syrian refugees in Turkey and service employees’ sabotage behaviour avoided primary data collection and relied on netnography of social media posts.…”

“…Service researchers have called for meaningful research into refugee related issues (Finsterwalder, 2017) and a growing TSR research strand focuses on improving the lives of refugees through transformative services (Boenigk, Fisk et al, 2021; Boenigk, Kreimer et al, 2021; Finsterwalder et al, 2021; Gokalp Aras, Kabadayi, Ozeren, & Aydin, 2021; Subramanian, Finsterwalder, & Hall, 2022).…”

Improving service interactions through inclusive language for Sindh’s Sheedis

“…Language plays a dominant role in the service sector (Holmqvist et al, 2017). Contemporary research on service interactions has assumed a value-based view of language use focusing either on the exclusion of vulnerable communities (Gokalp Aras et al, 2021) or on increasing the well-being of humans through inclusion in the service sector (Kabadayi et al, 2019). Language use, such as customers' language preference (Zolfagharian et al, 2018), language homophily between service providers and consumers (Pezzuti et al, 2018), language discrimination in the service sector (Seng et al, 2012), politeness in service encounters (David and Hei, 2012) and inclusive language in the service sector (Anderson, 2013) all conceptualize language interactions between service providers and customers.…”

Transformative service research: a conceptual framework based on consumer's perspective

“…Rahman et al, 2020;Tuzovic and Kabadayi, 2021), refugee crisis (i.e. Aras et al, 2021;Gross et al, 2021) and service design (Rosenbaum et al, 2021). More recently, some studies attempted to understand the impact of COVID-19 on wellbeing (i.e.…”