Health care for immigrants in the context of economic crisis : the perceptions and experiences of health professionals in Greece

Milionis, Charalampos and Popay, Jennie and Holland, Paula (2019) Health care for immigrants in the context of economic crisis : the perceptions and experiences of health professionals in Greece. PhD thesis, Lancaster University.

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Abstract

Background: Greece, alongside other European countries, is facing constant immigration inflow. Rising immigration creates unprecedented pressures on local health systems. This situation is aggravated by the current circumstances of economic recession in Greece. Health professionals are at the coal face of health care, being in constant clinical contact with immigrants. This study explored Greek health professionals’ perspectives on, and experiences of, caring for the various categories of immigrants in the context of economic crisis. Methods: A theoretical framework, consisting of political and economic theories about the provision of health care and concepts of culturally competent care, served as a tool to explore and interpret issues in the provision of care to immigrants from health professionals’ perspective. A qualitative study was conducted based on 20 interviews with health workers of various professional identities and experiences who were practicing in public health care services in Attica and Central Greece. The participants were recruited via purposeful sampling. Interview data were analysed using thematic analysis. Results: Interviewees highlighted problems relating to the social status of immigrant populations, the impact of the current economic crisis, the existing legislation regulating access to health care and the utilisation of health services by immigrants. Reported organisational difficulties were related to health system deficiencies and shortfalls in culturally competent care. The participants’ accounts revealed problematic staff attitudes towards immigrants, cultural differences between staff and the immigrants they cared for, and failures in communication with immigrant patients. Measures to improve health care for immigrants are suggested. Conclusions: The provision of health services to immigrants is a challenging task. Problems were found to be interrelated and their effects determine health outcomes. Managing the identified problems with appropriate health policies and practices should be prioritised in order to protect both immigrants’ and non-immigrant public health.