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  • 1. Pérez-Urdiales, Iratxe
    et al.
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    ¿Cómo acceden las mujeres inmigrantes a los servicios sanitarios en el País Vasco?: Percepciones de profesionales sanitarias2018In: Atención Primaria, ISSN 0212-6567, E-ISSN 1578-1275, Vol. 50, no 6, p. 368-376Article in journal (Refereed)
    Abstract [en]

    Objective: To determine the perception of health professionals working in alternative health centres on the barriers and facilitators in the access by immigrant women to general public health services and sexual and reproductive health in the Basque Country.

    Location: Basque Country.

    Design: Analysis of qualitative content based on 11 individual interviews. Participants: Health professionals working in alternative health centres of Primary Care and sexual and reproductive health.

    Method: Data collection was performed between September and December 2015 in four alternative health centres. After transcription, the units of meaning, codes and categories were identified.

    Results: Four categories emerged from the analysis, which represented how the characteristics of immigrant women (Tell me how you are and I will tell you how to access), the attitude of the administrative and health staff ("When they are already taken care of"), the functioning of the health system (Inflexible, passive and needs-responsive health system), and health policies ("If you do not meet the requirements, you do not go in. The law is the law") influence access to health services of immigrant women.

    Conclusions: This study shows that there are a considerable number of barriers and few facilitators to the access by immigrant women to public health and sexual and reproductive health services in the Basque Country. The alternative health centres were presented as favouring the improvement of the health of the immigrant population and in their access.

  • 2.
    Pérez-Urdiales, Iratxe
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Epidemiology and Global Health.
    How do immigrant women access the public healthcare services in the Basque Country (Spain)?2017In: European Journal of Public Health, ISSN 1101-1262, E-ISSN 1464-360X, Vol. 27, no Suppl_3, p. 477-478Article in journal (Other academic)
    Abstract [en]

    Background: Immigrant women face diverse barriers in order to access the public healthcare services in Spain. Furthermore, in 2012, a legislative change made the access conditions more difficult to fulfil for immigrants. Besides the public healthcare system, “free clinics” exist, which provide health attention to immigrant men and women who are not eligible for accessing it.

    Objective: To explore the perception of healthcare professionals working in free clinics in regards to the barriers and facilitators that immigrant women face to access the public healthcare general services and sexual and reproductive health services in the Basque Country (Spain).

    Methods: Qualitative study based on 11 individual interviews with healthcare professionals working in four different free clinics. A qualitative content analysis was done identifying meaning units, codes and categories.

    Results: Four categories emerged from the analysis that represent how the personal characteristics of the immigrant women (Tell me who you are and I will let you know how you will access); the attitude of the staff at the healthcare system (“Once they have been attended, everything is fine. The problem is with the administrative staff”); the organization of the healthcare system (The healthcare system is bureaucratic and passive), and health policies (“If you do not fulfil the requirements, you are just out. The law is the law”) influence the access of immigrant women to the public healthcare services.

    Conclusions: The results of this study show that there are a great number of barriers and few facilitators for the access of immigrant women to the public healthcare general services and sexual and reproductive health services in the Basque Country. The barriers based on the personal characteristics of the immigrant women, which vary based on their origin, were the most largely recognized, whereas the legal barriers were considered the most restrictive ones and difficult to overcome.

    Key messages:

    • Immigrant women face personal, institutional and legal barriers to access public health services.
    • Legal requirements are considered the main barriers to access public health services.
  • 3.
    Pérez-Urdiales, Iratxe
    et al.
    Department of Nursing I, University of the Basque Country (UPV/EHU), Biscay, Spain.
    San Sebastian, Miguel
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health. Department of Nursing I, University of the Basque Country (UPV/EHU), Biscay, Spain.
    Goicolea, Isabel
    Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
    Free clinic utilisation by immigrants after the introduction of a restrictive health policy in the Basque Country (Spain)2018In: Public Health, ISSN 0033-3506, E-ISSN 1476-5616, Vol. 163, p. 9-15Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Policies restricting healthcare access for immigrants were applied in times of reduced public funding for welfare in Spain. This study aimed to assess the impact of the implementation of a more restrictive health policy in the Basque Country region, Decree 114/2012, on the number of consultations attended at a free clinic, where the majority of patients are undocumented immigrants.

    STUDY DESIGN: Interrupted time series.

    METHODS: A negative binomial regression model was applied in two phases to the number of healthcare consultations during the period 2007-2017 (n = 9272) to estimate the level and trend changes associated with the implementation of the policy. Data were analysed separately by sex and adjusted for consultations' seasonality and unemployment rate and the sex-specific percentage of migrant population in Biscay province as confounding factors.

    RESULTS: Different trends of attendance between men and women were observed during the whole period, constituting 76.94% and 23.06% of all consultations, respectively. After the implementation of the decree, the number of consultations for women per trimester decreased and increased for men by 1%, although it was not statistically significant in either of the trends.

    CONCLUSIONS: No clear relationship between the implementation of the Basque Decree 114/2012 and an increase in the attendance of immigrants in a free clinic during the studied period was found.

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