WORKPACKAGE 4: MAPPING ON HEALTH AND VULNERABLE MIGRANTS AND REFUGEES - MYHEALTH
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WP4: Mapping on Health and VMR Security: PU 1/96
Author(s): RER, EIWH, Asserta, VHIR Version: 2.0
Models to engage Vulnerable Migrants and Refugees in their
health, through Community Empowerment and Learning
Alliance
Workpackage 4: Mapping on Health and Vulnerable
Migrants and Refugees
D4.2 Interactive map
V2.0
Health Unit HP-PJ-2016-738091© Copyright 2017 MYHEALTH Consortium
WP4: Mapping on Health and VMR Security: PU 2/96
Author(s): RER, EIWH, Asserta, VHIR Version: 2.0
Disclaimer
The content of this document represents the views of the author only and is his/her sole
responsibility; it cannot be considered to reflect the views of the European Commission and/or the
Consumers, Health, Agriculture and Food Executive Agency or any other body of the European
Union. The European Commission and the Agency do not accept any responsibility for use that may
be made of the information it contains.
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Author(s): RER, EIWH, Asserta, VHIR Version: 2.0
Executive Summary
This report presents the activities around developing a complete interactive map with the main
health issues, actors and stakeholders, reference sites dealing with vulnerable migrants and refugees,
legal and organisational aspects of health systems and available Information and Communications
Technology (ICT) tools in the European involved countries. This mapping exercise represents the very
first step of a social network analysis, and may well lay the foundation for subsequent, in-depth
explorations of the network. This document attempts to establish the purpose of this map, its final
target, and examine the available resources and networks to migrants, make a clear comparison
between what is already available on the net, and subsequently design a new platform to satisfy
emerging needs. Aim, targets, methods and preliminary results of the mapping process are
presented.
The map lays special attention on those actions that are directly related to health, but also on those
that modify the social determinants of health, particularly women and unaccompanied minors. The
multidisciplinary consortium that composes MyHealth project work group has intended to compile an
extensive range of tools to assist the most vulnerable segment of population that engages into the
migration process and faces difficulties in a mutable world. Migrants healthcare access is a very
sensitive subject from different points of view, not only due to aspects related to different systems
but due to cultural differences between the country of origin and the hosting country. All these
elements are important during the mapping exercise and an effort was made to take these aspects
into consideration while creating each product for each selected target.
During the second half of the project a collaboration with Mig-Healthcare, another European
healthcare migrants project, was developed to join efforts in raising awareness of the common need
all over Europe of a groundbreaking program to enhance migrants’ healthcare through a joint
mapping exercise, as well as a parallel effort to disseminate the results. Both projects aimed to reach
a reasonable amount of resources and stakeholders within their network to make these join the map
and increase the number of participants and the attention of European countries about different
aspects of the migration process.
Technology is a primary need and source of information support; however, fault finding in new
environments is common and more so when someone finds himself with foreign laws and systems.
This map attempts to simplify this exercise.
The present document enlightens the methodology and results of the mapping exercise, plus clarifies
all those thorny issues related to legislation in European countries related to migrants and access to
healthcare, explaining the basic information and the eligible condition to benefit local services.
In order to maintain the mapping platform up-to-date and ensure the accuracy of the available
information, a special update strategy is incorporated both internally and externally to the project.
MyHealth consortium is in charge of all the updates of information, all along the project and one year
after its end, and the stakeholders involved will be asked on a periodic basis of six months to
renovate all the data included upon their profile.
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Author(s): RER, EIWH, Asserta, VHIR Version: 2.0
Document Information
Grant Agreement Number Health Unit- 738091 Acronym MYHEALTH
Project full title: Models to engage Vulnerable Migrants and Refugees in their health,
through Community Empowerment and Learning Alliance
Project URL http://www.healthonthemove.net
EU Project officer Paola. D’ACAPITO / Paola.D'ACAPITO@ec.europa.eu
Deliverable Number D4.2 Title Interactive map
Milestone Number Title
Work package Number 4 Title Mapping on Health and VMR
Delivery date Contractual 30/06/2020 Actual 12/07/2020
Status Version 2.0 Final
Nature Report x
Dissemination Level Public x
Authors (Partner) RER, EIWH, Asserta, VHIR
Giovanni Ragazzi Email Giovanni.Ragazzi@regione.emilia-romagna.it
Kristin Semancik kristin@eurohealth.ie
Peggy Maguire peg@eurohealth.ie
Anais le Corvec anais.lecorvec@asserta.net
Responsible Author Nuria Serre nuria.serre@gencat.cat
Esperanza Esteban Serna esperanza.esteban@vhir.org
Eva Hajdok eva.hajdok@vhir.org
Daniela Poli danielleg.poles@gmail.com
Partner Asserta Phone 0039 0515277392
Description of the deliverable Interactive map, with main health issues, main actors and stakeholders,
reference sites dealing with VRM, legal and organisational aspects of
Health systems in the involved countries, and the ICT tools available.
Key words Mapping, migrant, resources, stakeholder, e-tools, local project
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Author(s): RER, EIWH, Asserta, VHIR Version: 2.0
MyHealth Consortium
This document is an output of a project grant (Grant Agreement nº: 738091) co-funded under the 3rd
Health Programme of the European Union by the Consumers, Health, Agriculture and Food Executive
Agency of the European Commission.
The partners in this project are:
Participant Partner's
Participant Legal Name Country
Nº Acronym
Fundacio Hospital Universitari Vall d’Hebron- Institut de
1 ES VHIR
recerca
2 Institute Catala de la Salut– Hospital Universitari Vall d’Hebron ES ICS
3 Syn Eirmos NGO of Social Solidarity Astiki Etairia E EL SYN-EIRMOS
4 Migrantas V.e. DE Migrantas
5 Consonant UK Consonant
6 European Institute of Women’s Health, CLG IE EIWH
7 University of Greenwich UK UoG
8 Asserta Global Healthcare Solutions ES Asserta
9 Fakultni Nemocnice U SV. Anny V Brne CZ FNUSA
Regione.Emilia-Romagna- Agenzia Sanitaria e Sociale
10 IT RER
Regionale
Hospital Charité, Universitaetsmedizin Berlin
11 DE CHARITE
A brief A brief description for every partner site is outlined in the Appendix 17: Error! No s'ha
trobat l'origen de la referència..
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Author(s): RER, EIWH, Asserta, VHIR Version: 2.0
ABBREVIATIONS
ICT Information and Communications Technology
NGO Non-Governmental Organisation
RER Regione Emilia-Romagna - Agenzia Sanitaria e Sociale Regionale
REF Reference
WP Workpackage
VMR Vulnerable Migrants and Refugees
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Author(s): RER, EIWH, Asserta, VHIR Version: 2.0
MyHealth Glossary
Asylum seeker A person who seeks safety from persecution or serious harm in a country other
than his or her own and awaits a decision on the application for refugee status
under relevant international and national instruments. In case of a negative
decision, the person must leave the country and may be expelled, as may any
non-national in an irregular or unlawful situation, unless permission to stay is
provided on humanitarian or other related grounds.1
Chronic disease No uniform definition of chronic disease exists. Some sources use the term
interchangeably with non-communicable diseases whereas others include
chronic conditions of infectious origin such as HIV or mental illness such as
Alzheimer. 2
Community The condition of sharing or having certain attitudes and interests in common.3
Community For MyHealth project: A pursuit of civic responsibility and of wanting or feeling
activity to do something to support one another and/or the wider society.
Community Health Community health agents are those who work in communities to strengthen
agent the links between the community and health services, usually not certified and
outside of national healthcare services. This also includes non-health agents
who work on the social determinants of health such as housing, inequalities,
education, employment or the environment.4
Community For MyHealth project: The process of engaging in discussion and collaboration
involvement with community members.
Community For MyHealth project: A meaningful active involvement of community members
participation in the design, development, implementation, delivery, as well as evaluation of
health services.
Country of origin The country that is a source of migratory flows (legal or illegal).1
Country of transit The country through which migratory flows (independent of administrative
status) move.1
Cultural mediator A cultural mediator is an individual who serves as a link between two or more
cultures and social systems. The essence of the mediating function is to shape
exchanges between the participating societies so that the contact will benefit
those cultures, on terms that are consistent with their respective value systems.
(b)
Family doctor The family doctor (FD) is the gatekeeper of the Primary Health Care system.
His/her role is to control the entry of people into the healthcare system, to
avoid unnecessary use, duplication and coordination of referrals to specialized
health care. (b)
General General practitioner (GP) treats all common medical conditions and refer
practitioner patients to hospitals and other medical services for urgent and specialized
treatment. They focus on the health of the whole person combining physical,
psychological and social aspects of care. (c)
Health Health is a state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity.5
Health champions People who, with training and support, voluntarily bring in their ability to relate
to people and their own life experience to transform health and wellbeing in
their communities.6
Health education Health education is any combination of learning experiences designed to help
individuals, groups, and communities improve their health, by increasing their
knowledge or influencing their attitudes.7
Health Needs For the MyHealth project: Deficiencies in health perceived by a stakeholder that
requires some intervention. The perceptions could be similar or different
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between them.
Health promotion Health promotion is the process of enabling people to increase control over,
and to improve, their health. It moves beyond a focus on individual 8behaviour
towards a wide range of social and environmental interventions. 8
Hospital Health For MyHealth project: The term refers to the healthcare structure where
Care patients are treated for more complex or rare diseases that could not be
managed by Primary Health Care.
Host Country The EU Member State / country in which a third-country national / non-national
takes up residence.9
Immigrant In the EU context, a person who establishes their usual residence in the
territory of an EU Member State for a period that is, or is expected to be, of at
least 12 months, having previously been usually resident in another EU Member
State or a third country.9 Any 3rd country national without an EU/EEA passport
arriving in the EU.
Infectious, or Defined as an illness caused by a specific infectious agent or its toxic product
communicable that results from transmission of that agent or its products from an infected
diseases person, animal, or reservoir to a susceptible host, either directly or indirectly
through an intermediate plant or animal host, vector or inanimate
environment.10
Integration As a state where an individual can maintain his or her own cultural identity
while at the same time becomes active participant in the host culture.11
International This term refers to a systematic consideration of all the factors that affect the
Health health of human population (genetic, cultural, natural environment, political,
economic, migration and violence). This term is historically related to tropical
diseases, sanitation, water, malnutrition, mother and child health; however,
many organizations includes broader range of subjects as chronic diseases. (d)
Irregular Someone who, owing to illegal entry or the expiry of his or her visa, lacks legal
(administrative) administrative status in a transit or host country. The term applies to migrants
migrant who infringe a country’s admission rules and any other person not authorized
to remain in the host country (also called clandestine/ illegal/undocumented
migrant or migrant in an irregular situation).1
Learning Alliance Innovative methodology seeking to re-think the utilisation, appropriation and
impact of research outcomes in the health services area in more integrated
ways. Formally defined, it is “a series of connected multi-stakeholder platforms
or networks (practitioner, researchers, policy-makers, service users) at different
institutional levels (local, national) involved in two basic tasks: knowledge
innovation and its scaling up.” 12
Mediator A person who usually belongs to the immigrant community or is familiar with
the cultural aspects of that immigrant community, translate (if necessary, adapt
the information), and facilitate liaison between two entities, for example a
hospital/institution and a service user.
Mental health Mental health is defined by WHO as a state of well-being in which every
individual realizes his or her own potential, can cope with the normal stresses
of life, can work productively and fruitfully, and is able to make a contribution
to her or his community.13
Migrant At the international level, no universally accepted definition of migrant exists.
The term migrant is usually understood to cover all cases where the decision to
migrate is taken freely by the individual concerned for reasons of “personal
convenience” and without intervention of an external compelling factor. This
term therefore applies to persons, and family members, moving to another
country or region to better their material or social conditions and improve the
prospect for themselves or their family.1
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Migrant worker A person who is to be engaged, is engaged or has been engaged in a
remunerated activity in a State of which he or she is not a national.1
Migration A process of moving, either across an international border, or within a State. It
is a population movement, encompassing any kind of movement of people,
whatever its length, composition and causes; it includes migration of refugees,
displaced persons, uprooted people, and economic migrants.1
Minor In a legal context and in contrast to a child, a person who, according to the law
of their respective country, is under the age of majority, i.e. is not yet entitled
to exercise specific civil and political rights.9
MyHealth A transnational project co-funded by the health programme of the European
Union to develop and implement models of health network to reach out to
migrants and Ethnic minorities, in particular women and unaccompanied
minors.
Network A group or system of interconnected people, institutions or things.3
Non- Non-communicable diseases (NCDs), also known as chronic diseases, tend to be
communicable of long duration and are the result of a combination of genetic, physiological,
diseases environmental and 9behavioural factors. The major types include
cardiovascular diseases, cancer, chronic pulmonary disease, and diabetes.14
Pictograms Pictograms are the visual language of Migrantas. Their simple, universally
understandable images stir emotions: people from different backgrounds
recognize themselves in the representations, while others gain new insights or
modify their own perspectives.
Pilot For MyHealth project: is a test of a tool/method/instrument before introducing
it more widely.
Refugee A person who meets the eligibility criteria under the applicable refugee
definition, as provided for in international or regional refugee instruments,
under UNHCR’s mandate, and/or in national legislation.15
Primary Health Primary healthcare is an essential part of healthcare based on practical,
Care scientific and socially acceptable methods and technology made universally
accessible to individuals and families in the community through their full
participation. It is also made possible because the community and country can
afford to maintain at every stage of their development in the spirit of self-
reliance and self-determination. (a)
Social The social determinants of health are the conditions in which people are born,
determinants of grow, live, work and age.16
heath
Specialized For MyHealth project: These health professionals are trained to manage more
professionals complex or rare diseases (usually at Hospital Health Care settings) that could
not be managed by primary healthcare professionals.
Stakeholder For MyHealth project: A person, group or organization that has interest or
concern in the project. The general categorisation used in the project for
grouping stakeholders is: public sector, civil society, and private sector.
Third-country Any person who is not a citizen of the European Union within the meaning of
national (TCN) Art. 20(1) of TFEU and who is not a person enjoying the European Union right to
free movement, as defined in Art. 2(5) of the Regulation (EU) 2016/399
(Schengen Borders Code).9
Tool For MyHealth project: is an instrument (leaflet, training, game, workshop,
network...) or methodology that aids in accomplishing a particular objective or
task.
Trafficking in The recruitment, transportation, transfer, harbouring or receipt of persons, by
persons means of the threat or use of force or other forms of coercion, of abduction, of
fraud, of deception, of the abuse of power or of a position of vulnerability or of
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the giving or receiving of payments or benefits to achieve the consent of a
person having control over another person, for the purpose of exploitation. 1
Translator A person who provides translation services. Can be professional or informal
(such as family members).
Unaccompanied A minor who arrives on the territory of an EU Member unaccompanied by
minor the adult responsible for them by law or by the practice of the EU Member
State concerned, and for as long as they are not effectively taken into the care
of such a person; or who is left unaccompanied after they have entered the
territory of the EU Member State.9
Undocumented See irregular migrant
migrant
Vulnerable There is no internationally recognized definition. IOM proposes a model that
migrants (or defines vulnerability within a migration context as the diminished capacity of an
migrants in individual or group to resist, cope with, or recover from violence, exploitation,
vulnerable abuse, and violation(s) of their rights. It is determined by the presence,
situations) absence, and interaction of factors and circumstances that (a) increase the risk
of, and exposure to, or (b) protect against, violence, exploitation, abuse, and
rights violations .18
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References to the Glossary
1. IOM. Key Migration Terms [Internet]. Grand-Saconnex: International Organization for
Migration; 2018 [cited 2017 Sep 28]. p. 2. Available from: https://www.iom.int/key-migration-
terms
2. Bernell S, Howard SW. Use Your Words Carefully: What Is a Chronic Disease? Front Public
Heal [Internet]. 2016;4(August):2–4. Available from:
http://journal.frontiersin.org/Article/10.3389/fpubh.2016.00159/abstract
3. English Dictionary, Thesaurus, & grammar help | Oxford Dictionaries [Internet]. [cited
2018 Nov 27]. Available from: https://en.oxforddictionaries.com/
4. Lewin S, Munabi-Babigumira S, Glenton C, Daniels K, Bosch-Capblanch X, van Wyk BE, et al.
Lay health workers in primary and community health care for maternal and child health and the
management of infectious diseases. Cochrane Database Syst Rev [Internet]. 2010 Mar 17 [cited
2018 Nov 26];(3):CD004015. Available from: http://www.ncbi.nlm.nih.gov/pubmed/20238326
5. CONSTITUTION OF THE WORLD HEALTH ORGANIZATION 1 [Internet]. [cited 2018 Nov 26].
Available from: http://www.who.int/governance/eb/who_constitution_en.pdf
6. Health Champions - Altogether Better [Internet]. [cited 2018 Nov 27]. Available from:
http://www.altogetherbetter.org.uk/health-champions
7. WHO | Health education. WHO [Internet]. 2013 [cited 2018 Nov 26]; Available from:
http://www.who.int/topics/health_education/en/
8. WHO | Health promotion. WHO [Internet]. 2017 [cited 2018 Nov 26]; Available from:
https://www.who.int/topics/health_promotion/en/
9. | Migration and Home Affairs [Internet]. [cited 2018 Nov 26]. Available from:
https://ec.europa.eu/home-affairs/what-we-
do/networks/european_migration_network/glossary_en
10. Last JM, International Epidemiological Association. A dictionary of epidemiology. Oxford
University Press; 2001. 196 p.
11. Berry, J. W. (2001). a Psychology of Immigration | Prejudices | Immigration [Internet].
[cited 2018 Nov 26]. Available from: https://es.scribd.com/document/251351869/Berry-J-W-2001-
a-Psychology-of-Immigration
12. Moreno-Leguizamon CJ. Learning Alliance Methodology Contributions to Integrated Care
Research. Int J Integr Care [Internet]. 2018 Mar 12 [cited 2018 Nov 30];18(s1):125. Available from:
https://www.ijic.org/article/10.5334/ijic.s1125/
13. WHO | Mental health: a state of well-being. WHO [Internet]. 2014 [cited 2018 Nov 26];
Available from: http://www.who.int/features/factfiles/mental_health/en/
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14. Noncommunicable diseases [Internet]. [cited 2018 Nov 26]. Available from:
http://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
15. Refworld | UNHCR Master Glossary of Terms [Internet]. [cited 2018 Nov 26]. Available
from: https://www.refworld.org/docid/42ce7d444.html
16. WHO | About social determinants of health. WHO [Internet]. 2017 [cited 2018 Nov 26];
Available from: https://www.who.int/social_determinants/sdh_definition/en/
17. WHO | Screening. WHO [Internet]. 2017 [cited 2018 Nov 26]; Available from:
https://www.who.int/cancer/prevention/diagnosis-screening/screening/en/
18. Principles and Guidelines migrants in vulnerable situations [Internet]. [cited 2018 Nov 26].
Available from: https://www.ohchr.org/Documents/Issues/Migration/PrinciplesAndGuidelines.pdf
References to the new terms:
a) WHO. Declaration of Alma-Ata. International Conference on Primary Health Care, Alma-
Ata, USSR, 6-12 September 1978. http://apps.who.int/medicinedocs/en/m/abstract/Js21369en/.
Published 1978. Accessed March 15, 2019.
b) https://www.researchgate.net/publication/320191250_Interpreters_Cultural_Mediators
c) Saltman Ana Rico Wienke Boerma RB, Baker R, Bergman S-E, et al. www.openup.co.uk.
Accessed March 15, 2019.
d) General practice (GP) | Health Careers. https://www.healthcareers.nhs.uk/explore-
roles/doctors/roles-doctors/general-practice-gp. Accessed April 3, 2019.
e) Koplan JP, Bond TC, Merson MH, et al. Towards a common definition of global health.
Lancet. 2009;373(9679):1993-1995. doi:10.1016/S0140-6736(09)60332-9
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OVERVIEW ON THE INTERLINKAGES BETWEEN WORK PACKAGES WITHIN
MYHEALTH PROJECT
The project workload is distributed in 8 work packages (WPs): three transversal (WP1 Coordination and
Management, WP2 Evaluation and WP3 Communication and Dissemination) and four technical WPs (WP4
Mapping, WP5 Needs Assessment, WP6 Tools development and WP7 Pilots). This structure has been
defined with the scope of gathering all envisaged activities with their logical and temporal
interconnections.
Finally, a participatory and social innovative
approach is used to ensure that Vulnerable
Migrants and Refugees (VMR) take a central
role in the project (WP8 Community
involvement). This participatory and social
innovative approach guarantees a meaningful
active involvement of community members in
the design, development, implementation,
delivery and evaluation of healthcare services
(Figure 1).
Furthermore, the project MyHealth is using a
Learning alliance (LA) as an innovative methodology (details described in WP2). LA is a series of connected
multi-stakeholder networks or communities
(researchers, policy-makers, service providers and Figure 1: Structure of MyHealth Project and
service users) at different institutional levels (local, connections among its WPs
regional and international) with the aim of improving
the health conditions of VMR.
The following reports represent the outcomes of the tasks carried out under WP2 Evaluation:
D2.1 Evaluation plan
D2.2 Interim and Final Evaluation reports
In WP3, Communication and Dissemination tasks are carried out in order to communicate and disseminate
project results and activities for raising awareness among stakeholders and general public. The following
report summarized the outcomes of the tasks carried out under this WP:
D3.1 Dissemination package
The WP4 is devoted to Mapping the existing initiatives on Health for VMR. The tasks carried out under this
WP are included in these reports:
D4.1 Data collection tool and protocol to gather reference sites, projects and ICT tools
dealing with migrant population
D4.2 Interactive map available online with the different exposed components (country
health facts, reference sites, the available ICT tools, etc) and existing initiatives
The overall aim of WP5 Needs analysis is to collect information on physical and mental health status of the
VMR. The following reports are developed as the outcomes of the tasks carried out under this WP:
D5.1 Methodological approach for needs assessment in Health access for Migrants and
refugees in Europe
D5.2 Needs and capacity assessment report
Tools development is the central part of WP6 and it is based on the needs assessment’s scientific results
carried out under WP5. In this WP tools able to improve the health care access of VMR are identified or
developed. The following reports summarized the outcomes of this WP:
D6.1 Report on defined models and consequent tools
D6.2 Web platform-based tools
Pilots are carried out in WP7 where the preliminary versions of tools identified under WP6 are tested in the
clinical sites (Spain, Germany and Czech Republic). The following reports summarize the tasks carried out
under this WP:
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D7.1 Report on Economic analysis of comparative models
D7.2 Evaluation report of the models
Lastly, the outcomes of the tasks carried out under WP8 Community Involvement are described in the
following reports:
D8.1 Model for Community Participation
D8.2 Final health-educative suitcase for the informative sessions
Where are we? The present report corresponds to WP4.
Timeline and connections among WPs of MyHealth are outlined in the following chart:
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User Guide
The content of the present report can be grouped under three main sections.
The first section outlines the basis for the creation of the interactive map together with the
methodology followed for its creation, and concludes summarizing the main results from this
process of creating the map.
The second section presents the overview, methodology, results and conclusions of the search,
performed under this deliverable, of the current legal and health system organisation
characteristics of each of the countries participating to both MyHealth and Mig-Healthcare
projects.
Finally, the last chapter describes the characteristics of the information on stakeholders and
resources collected for the interactive map by June 2020.
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Contents
Executive Summary .................................................................................................................... 3
ABBREVIATIONS ......................................................................................................................... 6
Contents .................................................................................................................................. 16
Index of Figures and Tables ...................................................................................................... 18
Introduction ............................................................................................................................. 19
Interactive Map........................................................................................................................ 20
1. Objectives and Methodology for the data collection of the interactive map ........................ 20
2. The Map .................................................................................................................................. 23
Legal Map ................................................................................................................................ 26
1. Overview of the legal mapping ............................................................................................... 26
2. Methodology of the legal mapping......................................................................................... 26
3. International and EU Migrant Health Policy Summary ........................................................... 27
a. Health as a Basic Right ............................................................................................................ 27
b. EU Level Health Policy ............................................................................................................. 27
c. EU Migrant Health Policy ......................................................................................................... 29
4. National Legal and Health Organisational Overview .............................................................. 31
5. Health Entitlements of Migrants per Country of MyHealth Consortium ............................... 34
a. Czech Republic (CZ) .................................................................................................................. 34
b. Germany (DE) .......................................................................................................................... 37
c. Greece (EL) ............................................................................................................................... 39
d. Italy (IT).................................................................................................................................... 42
e. Ireland (IE) ............................................................................................................................... 44
f. Spain (ES) .................................................................................................................................. 48
g. United Kingdom (UK) ............................................................................................................... 52
6. Health Entitlements of Migrants per Countries of Mig-Healthcare Consortium ................... 55
a. Austria (A) ................................................................................................................................ 55
b. Bulgaria (BG) ........................................................................................................................... 55
c. Cyprus (CY) ............................................................................................................................... 56
d. France (FR) ............................................................................................................................... 57
e. Malta (MT)............................................................................................................................... 58
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f. Sweden (SW)............................................................................................................................. 58
7. Summary and Conclusions of the legal mapping .................................................................... 60
Data Analysis and Report ......................................................................................................... 61
References ............................................................................................................................... 64
Annex 1 – MyHealth Mig-Healthcare collaboration contract ..................................................... 68
Annex 2 – European Countries Legal Mapping ............................................................................ 1
Annex 3 – Sustainability Plan ...................................................................................................... 1
Annex 4 - Description of MyHealth Partners ............................................................................... 1
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Index of Figures and Tables
Figure 1: Structure of MyHealth Project and connections among its WPs 13
Figure 2. MyHealth Mig-Healthcare Interactive Map functionalities (filters and search bar). ......... 23
Figure 3 MyHealth Mig-Healthcare Interactive Map appearance. .................................................... 24
Figure 4 MyHealth Mig-Healthcare Interactive Map example of an information pop up window for
one of the registered stakeholders/resources. ................................................................................. 25
Table 1: Healthcare Access for Categories of People under EU Secondary Law 28
Table 2: Summary of Health Entitlements of Migrants in an Irregular Situations ............................ 31
Table 3: Healthcare System Financing in Selected EU Member States ............................................. 34
Table 4: Summary of Health Entitlements of Migrants in Czech Republic ........................................ 34
Table 5: Summary of Health Entitlements of Migrants in Germany ................................................. 37
Table 6: Summary of Health Entitlements of Migrants in Greece ..................................................... 39
Table 7: Summary of Health Entitlements of Migrants in Italy ......................................................... 42
Table 8: Summary of Health Entitlements of Migrants in Ireland ..................................................... 44
Table 9: Summary of Health Entitlements of Migrants in Spain ....................................................... 48
Table 10: Summary of Health Entitlements of Migrants in United Kingdom .................................... 52
Table 11: Summary of Health Entitlements of Migrants in Austria ................................................... 55
Table 12 Summary of Health Entitlements of Migrants in Bulgaria .................................................. 55
Table 13: Summary of Health Entitlements of Migrants in Cyprus ................................................... 56
Table 14: Summary of Health Entitlements of Migrants in France ................................................... 57
Table 15: Summary of Health Entitlements of Migrants in Malta ..................................................... 58
Table 16: Summary of Health Entitlements of Migrants in Sweden ................................................. 58
Table 17. Organizations or services involved ..................................................................................... 61
Table 18. Primary country .................................................................................................................. 61
Table 19. Primary targets ................................................................................................................... 61
Table 20. Gender for whom was directed ......................................................................................... 62
Table 21. Age for whom was directed ............................................................................................... 62
Table 22. Cost of the service .............................................................................................................. 62
Table 23. Languages ........................................................................................................................... 62
Table 24. Main Target ........................................................................................................................ 63
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Introduction
This report reveals the results and objectives of the Interactive map and the review of the current
legal health of the countries participating to MyHealth and Mig-Healthcare project at the date of
release of this document.
The Interactive Map is product of the data collection (Mapping process) process based on the four
questionnaires available on MyHealth’s Website:
Migrant Resources Mapping
Stakeholders Mapping
App e-Tools Mapping
Current Studies and Projects Mapping
Regarding the legal mapping, as part of the Interactive map, MyHealth partners reviewed the
current legal and health system organizational aspects of each of the seven EU countries were the
project works. From these reviews, a short description for each country’s health system was made
available on the map, following the task ‘T4.3 Map the legal, organisational and institutional
environment across the EU’ of the project. The seven Member States included are:
1. Czech Republic (CZ)
2. Germany (DE)
3. Greece (EL)
4. Italy (IT)
5. Ireland (IE)
6. Spain (ES)
7. United Kingdom (UK)
In 2019 six European countries were added to the legal mapping and the resources information,
after the approval by the EC of a joint action with Mig-Healthcare project. The two projects
involved centers from thirteen different European countries from which four were shared among
both projects (Spain, Italy, Germany and Greece). After the amendment was approved, the
following partner countries were added to the map:
1. Austria (A)
2. Bulgaria (BG)
3. Cyprus (CY)
4. France (FR)
5. Malta (MT)
6. Sweden (SE)
These legal status summaries were reviewed by the project partners, who are national level
stakeholders in the seven involved countries above. These summaries will be adapted and added
onto the map to provide with the main legal information of this countries health systems (main
issues on access, rights, and first point of contact) in an-easy-to-understand language.
In 2019, a collaboration with another Consumers, Health, Agriculture and Food Executive Agency
(CHAFEA) financed project named Mig-Healthcare Project was approved (Annex 1). The reson for
this colaboration was that both consortiums (MyHealth and Mig-Healthcare) had the common
need to map resources for migrant health and social care available on the European territory and
to improve access to health care for vulnerable migrants and refugees, while promoting health
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and well-being of members in the community and providing wider ownership of health services,
increasing engagement and embracing the skills that migrants bring to the health sector.
The two project consortiums jointly involved centers from thirteen different European countries.
four of which were shared among both projects and six countries were added to the ones already
listed as part of MyHealth project: Austria, Bulgaria, Cyprus, France, Malta and Sweden.
Both projects spread among their stakeholders and contacts the same online questionnaires to be
filled with migrant centers, resources and projects information. These surveys were collected and
added to an online database and identified with different icons depending on the services offered
by the collected item. The result from this data collection tasks is available online for free and
accessible from any device.
Interactive Map
1. Objectives and Methodology for the data collection of the interactive map
Work Package (WP) 4 main objective: Develop a complete interactive map, with the main health
issues, actors and stakeholders, reference sites dealing with vulnerable migrants and refugees,
legal and organizational information on healthcare systems of the involved countries, and the
Information and Communications Technology (ICT) tools available in them.
(The team leading the coordination of these mapping tasks is Regione Emilia-Romagna - Agenzia
Sanitaria e Sociale Regionale [RER])
Mapping is mainly a descriptive account of the network of services/projects/communication and
information e-tools, but is also, and primarily conceived to be, a process. The final output will be a
shared database; however, every MyHealth and Mig-Healthcare partner should be able to benefit
locally from this process and use it to strengthen (or build) relations and awareness within each
local network. Getting in contact with other people and organizations that could know about other
reference sites or services is important not only to collect information, but also to build relations
and (re)organize work.
There are many ways to start mapping. As discussing tools devoted to a specific target, a needs-
based approach is advisable; that is, starting from the list of needs that typically characterize
newcomer migrants, and possibly considering their various and peculiar degrees of vulnerability
(women, unaccompanied minors, individuals with psychological disorders or disabilities, etc.). This
approach will allow identifying the most needed services and information for each specific target.
Some examples of organizations and services to map (as resources or stakeholders) are those who
provide: healthcare, social care, legal assistance, general living information, cultural support and
social integration (e.g., mediation, translation, advising/orientation, support groups, etc.),
education, learning (e.g., language courses), recreational/cultural/sport activities, employment
and employment training services, housing, shelter, essential goods (food, clothes...), etc. In more
operational terms, the mapping activity can start from what every organisation (hospital, NGO…)
knows better because of closeness or because of previous knowledge (bottom-up approach); or
we could start from the institutional level (top-down approach) by revising laws and organizational
protocols about migrants and identifying who is responsible for which service. All of these
approaches are useful and they should be integrated to assure a good resolution of the final map.
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MyHealth together with Mig-Healthcare aims to map: (a) current studies and projects at the local
level and involving communities (T4.1); (b) key actors both institutional and non-institutional
(T4.2), and stakeholders (T3.2) involved in supporting vulnerable migrants and refugees (from
health, social, community, cultural, and political points of view); (c) ICT tools currently available in
Europe and in the rest of the world (T4.4). It was decided to use online and paper format
questionnaires for mapping data collection.
From the ‘target’ point of view MyHealth focuses on vulnerable migrants and refugees, and in
particular women and unaccompanied minors. From a geographical point of view, an approach
based on feasibility has been selected so that each partner could opt for mapping the city,
province or region, according to their resources, organizational position and role within the
network.
In order to maintain the platform up-to-date and ensure the accuracy of the available information,
a special update service is incorporated. We are putting emphasis on that the stakeholders’
entities are participating on a voluntary basis while showing their willingness in getting involved
and make their organizational data appearing
at the interactive map. From all of the data received throughout the questionnaires, an
automated reminder email is sent every 6 months to the contact person who registered the
initiative. This email will allow the update of the initiatives’ details. With the interactive map being
now public and available on MyHealth and Mig-Healthcare websites
(http://www.healthonthemove.net/ and https://www.mighealthcare.eu/), a feature in both
websites will enable new initiatives to continue to be registered. Once new initiatives are
collected, these will be reviewed by a mixed team made by the coordination team of the project
and Asserta to ensure consistency, and will be added to the online platform on a monthly basis.
Finally, once the project is over, these mechanisms (updated and new initiatives) will be
maintained by Asserta, on a minimum timeline of 1 year after the project termination. Part of the
sustainability plan that will be developed towards the end of the project will enable the possibility
of finding sponsorship to maintain the map live and updated for a longer period of time.
For each of the 4 mapping activities the following variables have been defined (SurveyMonkey
link):
T4.1 Current Studies and Projects Mapping variables:
Name of the Organisation/Service that manages the Study/Project,
Type of Organisation/Service that manages the Study/Project,
Name of the Study/Project,
Brief description (max 144 characters) of the Study/Project,
Other organisations / associations / services involved in the Study/Project,
Primary country of the Organisation/Service,
Level of action of the Study/Project,
Primary target(s) of the Organisation/Service's activities,
Gender targeting (if applicable), Adults/minors targeting (if applicable),
Main activities of the Organisation/Service,
Specific requirements to access,
Cost,
Spoken languages,
Head office address and contact information,
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Additional contact information,
Website, Opening hours, Other study/project contact , Comments
(Link: https://it.surveymonkey.com/r/H2RQ78D)
T4.2 Migrant resources mapping variables:
Name of the Organisation/Service,
Type of Organisation/Service,
Brief description (max 144 characters) of the Organisation/Service,
Primary country of the Organisation/Service,
Primary target(s) of the Organisation/Service's activities, Gender targeting (if applicable),
Adults/minors targeting (if applicable),
Main activities of the Organisation/Service,
Specific requirements to access,
Cost,
Spoken languages,
Head office address and contact information, Additional contact information, Website,
Opening hours, Other organization/service contact, Comments
(Link: https://it.surveymonkey.com/r/XL7T5KL)
T4.4 App/eTools Mapping variables: *
Name of the App/Website/E-tool,
Link,
Brief description (max 144 characters) of the App/Website/E-tool,
Year of creation,
Store,
Cost,
Main target(s) of the App/Website/E-tool, Gender targeting (if applicable), Adults/minors
targeting (if applicable),
Type of informations provided by the App/Website/E-tool,
Available languages,
Geographical scope of the App/Website/E-tool, Other App/Website/E-tool information,
Comments
(Link: https://it.surveymonkey.com/r/H23ZRQC)
T3.2 Stakeholders Mapping variables:
Name of the Organisation/Service,
Type of Organisation/Service,
Brief description (max 144 characters) of the Organisation/Service,
Primary country of the Organisation/Service,
Primary target(s) of the Organisation/Service's activities, Gender targeting (if applicable),
Adults/minors targeting (if applicable),
Main activities of the Organisation/Service,
Head office address and contact information, Additional contact information, Website,
Other organization/service contact , Comments
(Link: https://it.surveymonkey.com/r/HYZQ69Z)
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2. The Map
Figure 2. MyHealth Mig-Healthcare Interactive Map functionalities (filters and search bar).
Overall, MyHealth Interactive Map links geolocation data with the other information obtained
throughout the four questionnaires mentioned above, including the following items for each point
of the map:
• Name (of program, initiative, resource, stakeholder, app, etc.)
• Address
• Phone
• Keywords
• Description (no more than 3 lines)
• Website link
The MyHealth interactive map is responsive to the user interface and correctly adapts to mobile
phones since it is expected to receive more visits from this type of devices. However, its navigation
through desktop browsers is also perfectly usable. The database collection is strictly linked to
community involvement and participation on a voluntary basis as the potential and targeted
stakeholders are deciding upon filling in the accompany questionnaires to be included it in the
interactive map.
All the information of the centers is available in 2 languages (and sometimes with a 3rd optional
language):
Local Language. (Official language of the country or region where the center is located).
English.
The map consists of two main parts:
An administration backend managed by the project work team.
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A consultation application that end users use to locate the different service centers
registered to the database.
Next, the functionality of each of the parts is listed.
Administration Backend
It is a management application that is and will be accessed by Asserta/or accredited staff members
to manage the information that appears in the application and is accessible to end users.
It consists of the following features:
• Login. screen where technicians must identify themselves.
• Inputs management (program, initiative, resource, stakeholder, app). From this section,
authorized staff can manage the new inserted data and perform the following operations:
Add a new center to the application.
Edition: Change the information within a new register.
Elimination: Delete an application input.
Import data from new registries: This functionality will allow to automatically load data
entries automatically in case they are already compiled in some specific document format
of the types such as: CSV, Excel, Open Data, etc.(i.e. import data from MigHealthCare
project entries).
Interacive Map public map
This is the web to which end users access and has the following features:
• Main screen. Screen to which the user accesses when entering the application which directly
displays the map and / or information to locate service centers.
Figure 3 MyHealth Mig-Healthcare Interactive Map appearance.
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Display by Map.
▪ A map shows the location for each of the inputs registered in the platform with different label
point shapes depending on the nature of each stakeholder or resource.
▪ There is a search field that allows to directly search by stakeholder or resource name (just like
Google Maps works, with filters such as Type of input; targeted public; type of Centre; etc)
▪ If the user selects a label point icon, more information about the selected registry pops up in a
window.
Figure 4 MyHealth Mig-Healthcare Interactive Map example of an information pop up window for
one of the registered stakeholders/resources.
Display by Listing.
▪ A filter pane is available on the left of the screen to select by different elements within the broad
groups of services offered, targeted public; country and host language. (But it will appear empty
until the user does a search).
▪ If the user selects a filter all points which are not under the selected category will disappear.
Sustainability and up-to-date information
Once registered, each entity available on the map will receive a user code, and an automatic
“update your info” email every 6 months. , With these updates, the project ensures that the data
available on the website remains up to date, and that the owners of the data keep engaged and
act as initiatives/projects themselves.
Once MyHealth project comes to an end, the map will be active and monthly updated for 1 year,
ensuring the continuous update of the information (Sustainability Plan – annex 3).
In order to obtain more entries, the link to the surveys are highly visible both on MyHealth and
Mig-Healthcare websites, and distributed via various communication platforms and resources
(newsletter, social media, etc.).
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Legal Map
1. Overview of the legal mapping
In 2015, about 2.7 million people migrated to the twenty-eight European Union Member States
(EU-28) from non-member countries (Eurostat, 2017). Of these migrants, about 1.5 million were
fleeing countries affected by war, conflict and/or economic crisis (European Parliament, 2016). As
of January 2016, 35.1 million living in the EU-28 had been born outside of the European Union (EU)
(Eurostat, 2017).
Although most migrants start their journey in good health, their experiences prior to departure
and the journey itself can affect their health. The rising number of migrants, asylum seekers and
refugees has health repercussions for the EU. Member States are faced with challenges of meeting
migrant healthcare needs, adding pressure to already heavily burdened national healthcare
systems. Healthcare needs must be met on migrant arrival, including injuries, infectious diseases,
chronic diseases and mental health conditions. Migrant women and children in particular can have
unique health needs. In addition, the World Health Organization (WHO) recommends systems to
be equipped to meet the long-term health needs of migrants by integrating them into the national
system (WHO Europe, 2018; European Parliament, 2016; Smith et al, 2016; IOM, 2009).
The right to health of migrant populations, whether they are foreign nationals, asylum seekers or
refugees, is embedded in international human rights treaties. The effectiveness of the
implementation of this right to health is in national legal frameworks. Based on studies from the
past five years and research projects, a short summary of the current legal and health system
organisation aspects of each of the seven selected Member States as well as at EU level has been
generated as part of the MyHealth Project, a project funded under the European Union’s Health
Programme (2014-2020).
2. Methodology of the legal mapping
This task reviews the current legal and health system organisational aspects in each of the seven
case countries and at EU level. The seven Member States include:
1. Czech Republic (CZ)
2. Germany (DE)
3. Greece (EL)
4. Italy (IT)
5. Ireland (IE)
6. Spain (ES)
7. United Kingdom (UK)
In 2019 six European countries were added to the legal mapping and the resources information,
after the approval by the EC of a joint action with Mig-Healthcare project. The two projects
involved centers from thirteen different European countries from which four were shared among
both projects (Spain, Italy, Germany and Greece). After the amendment was approved, the
following partner countries were added to the map:
7. Austria (A)
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