WHO-HPH TF MFCCH Task Force on Migrant-Friendly and Culturally Competent Health Care

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WHO-HPH TF MFCCHTask Force on Migrant-Friendly
andCulturally Competent Health Care

• EVOLUTION TOWARDS MIGRANT FRIENDLY HEALTH CENTERS

Méndez, Elvira. General Director Asociación Salud
y Familia
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• This is a collaborative project developed during
  2003-2007 by the Asociación Salud y Familia (ASF)
  and the public health care system (PHC) in
  Catalonia (Spain). ASF is a non-governmental,
  non-profit-making organisation which designs and
  promotes models for improved accessibility to and
  use of health services, targeting vulnerable
  groups as immigrants, in social and cultural
  disadvantaged positions.

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ORGANIZATIONAL OBJECTIVES (I)

• Improve general conditions for the provision of
  healthcare to the immigrant population.
• Increase the availability of culturally adapted
  services.
• Improve communication by breaking down language
  and cultural barriers between healthcare staff
  and immigrants.

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ORGANIZATIONAL OBJECTIVES (II)

• Reduce unnecessary burdens on workload through
  reduction of intercultural conflict.
• Increase appropriate use of services and the
  level of satisfaction among patients from the
  immigrant population.

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GENERAL OBJECTIVES (I)

• To describe the effects of a stable collaboration
  framework between the public health system and
  the ASF, an expert body working independently
  within the sphere of immigration.
• To describe the quantitative and qualitative
  development of the various activities carried out
  in the health centres by the intercultural
  mediators.

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GENERAL OBJECTIVES (II)

• To analyse those factors which change the way in
  which health centre staff use intercultural
  mediation services.
• To analyse what impact a stable intercultural
  mediation program has in improving cultural
  competencies of staff and health organisations.

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ORGANIZATIONAL METHODS

• Broad availability of intercultural mediation
  services to provide support to immigrants and
  healthcare staff.
• Identifying the needs for intercultural
  adaptation of the hospitals services, products
  and routines.
• Joint leadership between PHC and ASF to encourage
  collaboration and the sharing of knowledge,
  expertise and innovation.

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GENERAL METHODS

• The sources used are computerised records of the
  activities performed as well as the
  characteristics of the immigrants attended to by
  intercultural mediators in the health centres
  participating in the collaborative project.
• Other notable sources are the periodical advisory
  sessions which ASF holds within the various
  health centres with the goal of fostering and
  improving the effectiveness of the collaborative
  project.

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ORGANIZATIONAL RESULTS (I)

• The PHC is actively using the services of 37
  intercultural mediators provided by ASF, covering
  the areas of America Latina, North Africa,
  Pakistan, Rumania, Ucrania and Xina and giving
  direct support to 95.094 immigrant patients
  (2003-2007).
• The PHC is developed in 5 hospitals and 30
  primary health centers.

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ORGANIZATIONAL RESULTS (II)
INTERCULTURAL MEDIATION FROM COMPATRIOT TO COMPATRIOT
Immigrants Immigrants
2003-2004 2.278 () 1.794
2005 27.930 457
2006 27.680 484
2007 33.930 541
Subtotals 91.818 3.276
TOTAL 95.094 95.094
() The intercultural mediation programme begun
in February 2004.
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ORGANIZATIONAL RESULTS (III)

• The PHC is adapting, interculturally, numerous
  information and health education materials.
• The PHC has initiated a revision process for
  procedures that generated intercultural conflict.
• Intercultural organisational development has
  become part of PHC agenda.

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GENERAL RESULTS (I)

• The activities carried out by the intercultural
  mediators (providing information, support and
  intercultural mediation) have advanced rapidly.
  The variety of functions performed by the
  intercultural mediators has multiplied in tandem
  with an important rise in the number of immigrant
  patients attended (8.492 in year 2005 and 28.335
  in year 2006).
• The health centre staff members who use the
  intercultural mediation services with greatest
  frequency are doctors and nurses, followed quite
  far behind by the administrative staff working in
  patient reception and planning.

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GENERAL RESULTS (II)

• The factors which contribute most to staffs use
  of intercultural mediation services are the
  presence of an active immigrant-friendly policy
  promoted by health centre management, the
  availability of stable intercultural mediators,
  and the external advisory sessions with ASF which
  foster a process of continual improvement.
• There has been a notable increase in
  intercultural continued training and in
  intercultural adaptation of informative and
  educational materials in the health centres
  participating in the project.

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CONCLUSIONS (I)

• The experience of PHC in collaboration with ASF
  provides a feasible and innovative model of good
  intercultural practice which can be expanded and
  adapted to other hospitals and health centers.

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CONCLUSIONS (II)

• The availability of permanent intercultural
  mediators within a stable Migrant Friendly
  Health Centres collaborative project offers
  immediate improvements in the care given to
  immigrant patients while simultaneously
  facilitating a specific and substantial
  development in staff members cultural
  competencies through daily exposure and continued
  intercultural training.

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HEALTH CENTRES COLLABORATORS

• HOSPITALS
• Hospital del Mar de Barcelona
• Centre Pere Camps de Barcelona
• Hospital Clínic. Maternitat de Barcelona
• Hospital Clínic de Barcelona.
• Hospital Arnau de Vilanova de Lleida
• Hospital Josep Trueta de Girona

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HEALTH CENTRES COLLABORATORS

• PRIMARY CARE CENTRES - BARCELONA CIUTAT
• CAP Drassanes
• CAP Raval Nord
• CAP Les Hortes
• CAP Besós Mar
• CAP Casc Antic
• CAP Poble Nou
• CAP Poble Sec
• CAP Besós
• CAP Manso
• CAP Fondo
• CAP Sant Joan
• PASSIR Manso
• PASSIR Santa Coloma de Gramanet
• PRIMARY CARE CENTRES - BAIX LLOBREGAT
• CUAP Sant Ildefons

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HEALTH CENTRES COLLABORATORS

• PRIMARY CARE CENTRES - LLEIDA
• CAP Balaguer
• CAP Rambla Ferran
• CAP Aitona
• CAP Tàrrega
• CAP Mollerussa
• SASSIR Prat de la Riba
• CAP Cervera
• CAP Alcarràs
• CAP Serós
• CUAP Rambla Ferran
• PRIMARY CARE CENTRES - GIRONA
• CAP Can Gibert del Pla.
• CAP Celrà

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• THANKS !
• E.mail saludyfamilia_at_saludyfamilia.es
• Web www.saludyfamilia.es