Abstract:

An estimated 362,000 refugees and migrants risked their lives crossing the Mediterranean Sea in 2016, with 181,400 people arriving in Italy and 173,450 in Greece. During 2017 over 105,000 refugees and migrants entered Europe (1). Rates of depression, anxiety and poor well-being are at least three times higher among refugees than the general host-country's population (2). Forced migration might cause challenges for both the host countries and for the individual refugee with regard to well-being, adaptation and integration into the society (3) and therefore there is a need for adequate reception and support, as the procedures, legislation, systems and culture may be significantly different, with no exception from the healthcare organization. Providing healthcare for refugees may range in different levels, from giving first-aid at points of arrival, to ensure access to health care at refugee accommodation centres, to provide health care for refugee pupils in school and to deal with long-term health issues such as post-traumatic stress (4).

Comprehensive action plans for long-term solutions to the complex issues of mixed migration and addressing its root causes are required. Health systems may differ considerably from those that refugees are used to, resulting in difficulties accessing healthcare and a lack of understanding of how health services are provided. A lack of proper “health integration” can cause serious problems both for the refugees themselves but also for the health system who may have to treat them at a later stage of a disease, or for the whole society in cases for non-immunization and spread of previously considered eradicated communicative diseases.

The ReHIn project – Refugees’ Health Integration – an ERASMUS+ Strategic Partnership for Adults aims to create digital learning resources including Reusable Learning Objects (RLOs) and a Massive Open Online Course (MOOC) in order to raise awareness and refugees’ knowledge that may foster their health integration.

In order to systematically identify and prioritize the content of digital learning resources, we conducted a workshop in Sweden in November'19, at Karolinska Institutet, where we explored the stakeholders’ opinions. This study involved 15 stakeholders that represented non-governmental organizations (NGOs), policy makers, governmental organizations and researchers in this field. The input of the participants was gathered through questionnaires and focus groups.

The results revealed that the topics considered most important by the participants were: access to the healthcare system; knowledge of rights; women's rights and reproductive health; health literacy and empowerment; rights according to different types of status as migrant; unmet expectancies; and conflicts of interest.

In this study we have collected input from some of the key organizations engaged in refugees’ health issues in one European country. Nevertheless, the study is limited and only covers a small subset of all stakeholders. The involved organizations seemed however to agree on the produced list of prioritized topics as crucial for refugees’ health integration. Further research is required including a cross-European sample representing the different needs of the refugees in different countries.

Keywords:

Refugee health, digital learning resources, health integration.