Background: European Member States are facing a challenge to provide
accessible and effective health care services for immigrants. It remains
unclear how best to achieve this and what characterises good practice in
increasingly multicultural societies across Europe. This study assessed
the views and values of professionals working in different health care
contexts and in different European countries as to what constitutes good
practice in health care for immigrants.
Methods: A total of 134 experts in 16 EU Member States participated in a
three-round Delphi process. The experts represented four different
fields: academia, Non-Governmental Organisations, policy-making and
health care practice. For each country, the process aimed to produce a
national consensus list of the most important factors characterising
good practice in health care for migrants.
Results: The scoring procedures resulted in 10 to 16 factors being
identified as the most important for each participating country. All 186
factors were aggregated into 9 themes: (1) easy and equal access to
health care, (2) empowerment of migrants, (3) culturally sensitive
health care services, (4) quality of care, (5) patient/health care
provider communication, (6) respect towards migrants, (7) networking in
and outside health services, (8) targeted outreach activities, and (9)
availability of data about specificities in migrant health care and
prevention. Although local political debate, level of immigration and
the nature of local health care systems influenced the selection and
rating of factors within each country, there was a broad European
consensus on most factors. Yet, discordance remained both within
countries, e. g. on the need for prioritising cultural differences, and
between countries, e. g. on the need for more consistent governance of
health care services for immigrants.
Conclusions: Experts across Europe asserted the right to culturally
sensitive health care for all immigrants. There is a broad consensus
among experts about the major principles of good practice that need to
be implemented across Europe. However, there also is some disagreement
both within and between countries on specific issues that require
further research and debate