Infectious disease health services for refugees and asylum seekers during a time of crisis. A scoping study of six European Union countries

Bozorgmehr K, Samuilova M, Petrova-Benedict R, Girardi E, Piselli P, Kentikelenis A. Infectious disease health services for refugees and asylum seekers during a time of crisis. A scoping study of six European Union countries. Health Policy. 2018;123(9):882-887

Infectious disease health services for refugees and asylum seekers during a time of crisis: a scoping study of six European Union countries

Background Systematic information on infectious disease services provided to refugees and asylum seekers in the European Union (EU) is sparse. We conducted a scoping study of experts in six EU countries in order to map health system responses related to infectious disease prevention and control among refugees and asylum seekers. Methods We conducted 27 semi-structured in-depth interviews with first-line staff and health officials to collect information about existing guidelines and practices at each stage of reception in first-entry (Greece/Italy), transit (Croatia/Slovenia), and destination countries (Austria/Sweden). Thematic coding was used to perform a content analysis of interview material. Results Guidance on infectious disease screening and health assessments lack standardisation across and—partly—within countries. Data collection on notifiable infectious diseases is mainly reported to be performed by national public health institutions, but is not stratified by migrant status. Health-related information is not transferred in a standardized way between facilities within a single country. International exchange of medical information between countries along the migration route is irregular. Services were reported to be fragmented, and respondents mentioned no specific coordination bodies beyond health authorities at different levels. Conclusion Infectious disease health services provided to refugees and asylum seekers lack standardisation in health assessments, data collection, transfer of health-related information and (partly) coordination. This may negatively affect health system performance including public health emergency preparedness

Infectious-disease Screening and Vaccination for Refugees and Asylum Seekers Entering Europe in 2015–16: A Scoping Study of Six European Union Countries

Piselli P, Samuilova M, Bozorgmehr K, et al. Infectious-disease Screening and Vaccination for Refugees and Asylum Seekers Entering Europe in 2015–16: A Scoping Study of Six European Union Countries. Journal of Refugee Studies. 2019;32(Special Issue 1):i92-i104.Abstract In 2015, more than 1 million asylum seekers and refugees arrived in Europe. Information on how European countries addressed the prevention and control of infectious diseases among these populations during and after this period is limited. This study is based on 27 semi-structured interviews conducted with first-line staff and health officials in May–June 2016 in first-entry countries (Greece/Italy), transit countries (Croatia/Slovenia) and destination countries (Austria/Sweden). Characteristics of health-service provision for infectious diseases at each stage of reception, with a focus on tuberculosis, viral hepatitis, intestinal parasites and human immunodeficiency virus infections, were investigated. No major differences in the provision of services in accordance with migration status (asylum seekers vs refugees) were reported. At arrival, interventions were focused on addressing emerging health needs and no major barriers to accessing acute hospital care for infectious diseases were reported. There were shortcomings in interventions to tackle medium- to long-term needs with respect to infectious diseases, including screening for chronic treatable infections and adult vaccination. European evidence-based guidance highlighting the most relevant interventions for infectious diseases during the reception process is needed.</jats:p