Migrant-friendly hospitals

The project

The project Migrant-friendly hospitals aimed to improve the quality of care and access to services by supporting the hospitals of the Reggio Emilia (RE) province in becoming a culturally sensitive reality and by empowering TCNs. This was reached though the production of informative materials in different languages, the introduction of intercultural mediation in hospitals and primary health care services, capacity building activities on intercultural competencies for the health service personnel, the strengthening of the cultural sensitivity of the hospitals, informing migrants regarding their rights and the health services available. The activities contributed also to increasing effective collaboration between patients and healthcare professionals. This approach improved migrants’ capacity to become an active part in the health care system, and contributed to filling the gaps identified in the needs assessment carried out.  

The project was implemented with a multi-level and multi-stakeholder approach. As a matter of fact, the Local Health Authority of Reggio Emilia (AUSL RE) covers urban as well as rural areas; this permitted to adopt the migrant-friendly strategy into Hospitals, primary health services and clinics in the territory. The implementation of the activities involved top management levels of Emilia Romagna Region, as well as Hospital Directors, Local Health Department coordinators and health staff representatives, reaching all levels in a capillary way.  

The initiative proved to be sustainable by becoming part of the overall organization policy of the AUSL RE: the involvement of managers and decision makers was fundamental in assuring the embracement of the initiative as a general approach, to assure continuity and effectiveness. Another key element that supported the sustainability of the project was the integration of the strategy among public health policies process, hospitals and primary health care services, guaranteeing the collaboration among institutions, services and policy makers. Moreover, a co-design strategy was put in place, involving the AUSL RE and social cooperatives operating in the territory. In addition, the model was built according to the Italian structure of health services provision, so that the model could be easily adapted to the structure of other Region Local Health Authorities and so transferred.  Finally, the interventions involved the main health services for migrants, with special attention to women health services and pediatric ones. 

The impact of the good practice

The implementation of a comprehensive approach proved to have a positive impact on the provision of health service for TCNs, empowering the migrants, the health staff and as well as the whole community, with a view to overcome cultural barriers and boost the integration process. The coverage of intercultural mediation increased and became available in almost all health services of the province (in 2016 the cultural mediation services increased from an estimation of 7.000 to a total of 13.000). In line with this intervention, migrants were empowered with information on access to health services, and health staff increased their knowledge regarding the importance and the technique for a more inclusive health service performance (800 staff were trained, corresponding to the 20% of the total). 

These interventions contributed to improving the quality of care experienced by TCNs in the province. In a long run, it can be deducted that this element contributed to increasing the participation of migrants in prevention programs and their faith in the health system, as well as decreasing the access to the emergency department, and by so contributing to the improvement of public health. The access to healthcare improved also for the irregular migrants, guaranteeing 3.500 visits every year to migrants at risk of exclusion because of lack of legal status, through the establishment of the center for migrant family health (CSFS). The participation to this project empowered the AUSL RE even in terms of project management and policy making regarding migrant inclusion.