Changes in health and primary health care use of Moroccan and Turkish migrants between 2001 and 2005: a longitudinal study

Background: Social environment and health status are related, and changes affecting social relations may also affect the general health state of a group. During the past few years, several events have affected the relationships between Muslim immigrants and the non-immigrant population in many countries. This study investigates whether the health status of the Moroccan and Turkish immigrants in the Netherlands has changed in four years, whether changes in health status have had any influence on primary health care use, and which socio-demographic factors might explain this relationship. Methods: A cohort of 108 Turkish and 102 Moroccan respondents were interviewed in 2001 and in 2005. The questionnaire included the SF-36 and the GP contact frequency (in the past two months). Interviews were conducted in the language preferred by the respondents. Data were analysed using multivariate linear regression. Results: The mental health of the Moroccan group improved between 2001 and 2005. Physical health remained unchanged for both groups. The number of GP contacts decreased with half a contact/2 months among the Turkish group. Significant predictors of physical health change were: age, educational level. For mental health change, these were: ethnicity, age, civil status, work situation in 2001, change in work situation. For change in GP contacts: ethnicity, age and change in mental and physical health. Conclusion: Changes in health status concerned the mental health component. Changes in health status were paired with changes in health care utilization. Among the Turkish group, an unexpected decrease in GP contacts was noticed, whilst showing a generally unchanged health status. Further research taking perceived quality of care into account might help shedding some light on this outcome.

Good practice in health care for migrants: views and experiences of care professionals in 16 European countries

<p>Abstract</p> <p>Background</p> <p>Health services across Europe provide health care for migrant patients every day. However, little systematic research has explored the views and experiences of health care professionals in different European countries. The aim of this study was to assess the difficulties professionals experience in their service when providing such care and what they consider constitutes good practice to overcome these problems or limit their negative impact on the quality of care.</p> <p>Methods</p> <p>Structured interviews with open questions and case vignettes were conducted with health care professionals working in areas with high proportion of migrant populations in 16 countries. In each country, professionals in nine primary care practices, three accident and emergency hospital departments, and three community mental health services (total sample = 240) were interviewed about their views and experiences in providing care for migrant patients, i.e. from first generation immigrant populations. Answers were analysed using thematic content analysis.</p> <p>Results</p> <p>Eight types of problems and seven components of good practice were identified representing all statements in the interviews. The eight problems were: language barriers, difficulties in arranging care for migrants without health care coverage, social deprivation and traumatic experiences, lack of familiarity with the health care system, cultural differences, different understandings of illness and treatment, negative attitudes among staff and patients, and lack of access to medical history. The components of good practice to overcome these problems or limit their impact were: organisational flexibility with sufficient time and resources, good interpreting services, working with families and social services, cultural awareness of staff, educational programmes and information material for migrants, positive and stable relationships with staff, and clear guidelines on the care entitlements of different migrant groups. Problems and good care components were similar across the three types of services.</p> <p>Conclusions</p> <p>Health care professionals in different services experience similar difficulties when providing care to migrants. They also have relatively consistent views on what constitutes good practice. The degree to which these components already are part of routine practice varies. Implementing good practice requires sufficient resources and organisational flexibility, positive attitudes, training for staff and the provision of information.</p

Social Support and Access to Justice at the Kitchen Table? An Assessment of the Legal Capabilities of Community Social Care Professionals in the Netherlands

This research examines the legal capabilities of social care practitioners involved in a new decision-making process, ‘the kitchen table conversation’, used since the introduction of the 2015 Social Support Act in the Netherlands. This law delegates social care allocation to the local authorities, who employ social care practitioners to assess and decide upon the needs of applicants for personalised services. Dit onderzoek focust op de juridische competenties van sociale professionals die betrokken zijn bij het ‘keukentafelgesprek’, een manier van werken die is geïntroduceerd met de transities in het sociaal domein. Sinds de implementatie van de Wet maatschappelijke ondersteuning (Wmo 2015) zijn Nederlandse gemeenten verplicht onderzoek te doen naar de persoonlijke situatie van mensen die zich melden met een ondersteuningsvraag. De wet delegeert de toekenning van maatschappelijke zorg aan de lokale overheden, die sociale professionals inzetten om de behoeften aan maatschappelijke ondersteuning van cliënten te onderzoeken

The Role of the Social Network in Access to Psychosocial Services for Migrant Elderly—A Qualitative Study

Abstract: Background: Despite high prevalence of mental problems among elderly migrants in The Netherlands, the use of psychosocial care services by this group is low. Scientific evidence points at the crucial role of social support for mental health and the use of psychosocial services. We therefore explored the role of social networks in the access to psychosocial care among elderly migrants in The Netherlands. Methods: A qualitative study was conducted using semi-structured group interviews and individual interviews. The eight group and eleven individual interviews (respectively n = 58 and n = 11) were conducted in The Netherlands with Turkish, Moroccan, Surinamese, and Dutch elderly. The data were analysed through coding and comparing fragments and recognizing patterns. Results: Support of the social network is important to navigate to psychosocial care and is most frequently provided by children. However, the social network of elderly migrants is generally not able to meet the needs of the elderly. This is mostly due to poor mental health literacy of the social network, taboo, and stigma around mental illness and the busy lives of the social network members. Conclusions: Strategies to address help-seeking barriers should consider mental health literacy in elderly migrants as well as their social networks, and counteract taboos and stigma of mental health problems

Met recht een zorg: Lokale sociale professionals als poortwachters van de Wet maatschappelijke ondersteuning 2015

Op basis van een casestudy gaat dit artikel in op de mate van juridische kennis van lokale sociale professionals in een wijkteam in Amersfoort over de Wet maatschappelijke ondersteuning 2015 (Wmo 2015). Daarnaast worden knelpunten besproken die zij ervaren in de uitvoering van de juridische procedure. Onder mandaat van de gemeente bereiden zij een besluit voor over een maatwerkvoorziening terwijl zij hier niet per se voor zijn opgeleid. Onbekend is of zij zich bewust zijn van de juridische aspecten. Vanaf oktober 2016 tot februari 2017 zijn drie keukentafelgesprekken geobserveerd tussen sociale professionals van dit wijkteam met mensen met een beperking. Daarnaast is één casusoverleg geobserveerd en zijn zes professionals geïnterviewd. Vier keukentafelgesprekken zijn geobserveerd met mensen met een cognitieve beperking en hun belangenbehartigers in andere Utrechtse gemeenten.1 De resultaten worden besproken in dit artikel nadat we het besluitvormingsproces op papier beschrijven. In de laatste paragraaf worden onbedoelde consequenties van de rol van het wijkteam in kaart gebracht. Ook worden er aanbevelingen gedaan om de kwaliteit van besluitvorming te verbeteren zodat de rechtspositie van mensen met een beperking sterker gewaarborgd kan worden

Hulp en recht aan de keukentafel: De toegang tot de Wet maatschappelijke ondersteuning volgens lokale professionals

Dit rapport verkent juridische kennis, vaardigheden en houdingsaspecten van lokale sociale professionals bij het vormgeven van de toegang tot de Wet maatschappelijke ondersteuning (Wmo 2015). Sinds de wet in werking is getreden, op 1 januari 2015, is de gemeente verplicht onderzoek te doen naar de persoonlijke situatie van mensen die zich melden met een ondersteuningsvraag. Uit dat onderzoek, bekend geworden als het ‘keukentafelgesprek’, moet blijken of een cliënt zijn beperkingen het hoofd kan bieden met algemeen toegankelijke voorzieningen (bijvoorbeeld activiteiten in een buurthuis) en de inzet van gebruikelijke hulp van familie, vrienden en kennissen. Als dit niet afdoende is, kan hij een aanvraag doen voor een maatwerkvoorziening zoals huishoudelijke zorg, een woningaanpassing of specialistische begeleiding