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Health care for irregular migrants: pragmatism across Europe. A qualitative study

Marie Dauvrin12*, Vincent Lorant2, Sima Sandhu3, Walter Devillé4, Hamidou Dia5, Sónia Dias6, Andrea Gaddini7, Elisabeth Ioannidis8, Natasja K Jensen9, Ulrike Kluge10, Ritva Mertaniemi11, Rosa Puigpinós i Riera12, Attila Sárváry13, Christa Straßmayr14, Mindaugas Stankunas1516, Joaquim JF Soares1718, Marta Welbel19, Stefan Priebe3 and the EUGATE study group

Author Affiliations

1 Fonds de la Recherche Scientifique-FNRS, rue d'Egmont 5, 1000 Bruxelles, Belgium

2 Institute of Health and Society IRSS, Université catholique de Louvain, Clos Chapelle aux Champs 30 B1.30.15, 1200 Bruxelles, Belgium

3 Unit for Social and Community Psychiatry, London and the Barts School of Medicine and Dentistry, Queen Mary University of London, Newham Centre for Mental Health, London E13 8SP, UK

4 International and Migrant Health, NIVEL (Netherlands Institute for Health Services Research), Otterstraat 118-124, PO Box 1568, 3500, BN Utrecht, The Netherlands

5 Etablissement public de santé Maison Blanche, 3-5 rue Lespagnol, 75020 Paris, France

6 Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Rua da Junqueira, 96, 1349-008, Lisbon, Portugal

7 Laziosanità ASP Public Health Agency for the Lazio Region, Via S. Costanza 53, 00185 Rome, Italy

8 Department of Sociology, National school of Public Health, 196 Alexandras avenue, Athens 11521, Greece

9 Danish Research Centre for Migration, Ethnicity and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark

10 Clinic for Psychiatry and Psychotherapy, Charité - University Medicine Berlin, CCM, Charitéplatz 1, 10117 Berlin, Germany

11 Department for mental health and substance abuse services, National Institute for Health and Welfare (THL), P.O.B. 30, FIN-00271 Helsinki, Finland

12 Agency of Public Health of Barcelona, Pça. Lesseps, 1, 08023 Barcelona, Spain

13 Faculty of Health, University of Debrecen, Sóstói út 2-4, 4400 Nyíregyháza, Hungary

14 Ludwig Boltzmann Institute for Social Psychiatry, Lazarettgasse 14A-912, 1090 Vienna, Austria

15 School of Public Health, Griffith University, Gold Coast Campus, Southport, Queensland 4222, Australia

16 Department of Health Management, Lithuanian University of Health Sciences, A. Mickeviciaus 9, Kaunas 44307, Lithuania

17 Department of Public Health Sciences, Section of Social Medicine, Karolinska Institutet, SE- 171 76 Stockholm, Sweden

18 Department of Public Health Sciences, Mid Sweden University, SE-851 70 Sundsvall, Sweden

19 Institute of Psychiatry and Neurology, Ul. Sobieskiego 9, 02-957 Warsaw, Poland

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BMC Research Notes 2012, 5:99  doi:10.1186/1756-0500-5-99

Published: 16 February 2012



Health services in Europe face the challenge of delivering care to a heterogeneous group of irregular migrants (IM). There is little empirical evidence on how health professionals cope with this challenge. This study explores the experiences of health professionals providing care to IM in three types of health care service across 16 European countries.


Semi-structured interviews were conducted with health professionals in 144 primary care services, 48 mental health services, and 48 Accident & Emergency departments (total n = 240). Although legal health care entitlement for IM varies across countries, health professionals reported facing similar issues when caring for IM. These issues include access problems, limited communication, and associated legal complications. Differences in the experiences with IM across the three types of services were also explored. Respondents from Accident & Emergency departments reported less of a difference between the care for IM patients and patients in a regular situation than did respondents from primary care and mental health services. Primary care services and mental health services were more concerned with language barriers than Accident & Emergency departments. Notifying the authorities was an uncommon practice, even in countries where health professionals are required to do this.


The needs of IM patients and the values of the staff appear to be as important as the national legal framework, with staff in different European countries adopting a similar pragmatic approach to delivering health care to IM. While legislation might help to improve health care for IM, more appropriate organisation and local flexibility are equally important, especially for improving access and care pathways.

Irregular migrants; Europe; Qualitative method; Health services; Accessibility