Health System Response during the European Refugee Crisis: Policy and Practice Analysis in Four Italian Regions

Leonardo Mammana, Chiara Milani, Paola Bordin, Lorenzo Paglione and Chiara Salvia
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Leonardo Mammana: Department of Biomedical and Neuromotor Sciences, University of Bologna, 40121 Bologna, Italy
Chiara Milani: School of Specialization in Hygiene and Preventive Medicine, University of Florence, 50134 Florence, Italy
Paola Bordin: Postgraduate School of Hygiene and Preventive Medicine, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35128 Padova, Italy
Lorenzo Paglione: Department of Civil, Building and Environmental Engineering, Sapienza University of Rome, 00184 Rome, Italy
Chiara Salvia: Local Health Unit of Modena, 41124 Modena, Italy

IJERPH, 2020, vol. 17, issue 15, 1-22

Abstract: The decentralization of the provision of health services at the subnational level produces variations in healthcare offered to asylum seekers (ASs) across the different Italian regions, even if they are entitled to healthcare through the national health service. The present study aims to map the healthcare path and regional policies for ASs upon arrival and identify challenges and best practices. This is a multicentric, qualitative study of migrant health policies and practices at the regional level within four Italian regions. For the analysis, a dedicated tool for the systematic comparison of policies and practices was developed. The collection and analysis of data demonstrated the presence of many items of international recommendations, even if many gaps exist and differences between regions remain. The analysis of practices permitted the identification of three models of care and access. Some aspects identified are as follows: fragmentation and barriers to access; a weakness in or lack of a governance system, with the presence of many actors involved; variability in the response between territories. The inclusion of ASs in healthcare services requires intersectoral actions, involving healthcare sectors and other actors within local social structures, in order to add value to local resources and practices, reinforce networks and contribute to social integration.

Keywords: asylum seeker; health policy; regional differences; health system; primary healthcare; vulnerability; NGOs; governance; barriers in access to care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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