Forschung Migration und Gesundheit im Rah - Bundesamt für ...

Introduction
Rahel Gall Azmat, Federal Office of Public Health (FOPH)
A proportion of the migrant population is exposed to substantial
health risks. It is also often additionally disadvantaged in
terms of prevention and healthcare provisions, compared to
the native population. 13 For this reason, and in accordance with
the Health 21: The health for all policy framework for the WHO
European Region 14 , the national Migration and Public Health
Strategy 2002–2007 15 was drawn up. The Federal Office of
Public Health (FOPH) was mandated to implement the Strategy,
which will constitute a significant step towards solidarity
and equality of opportunity for all people in the Swiss healthcare
system. The long-term objective is to provide a health
system that takes account of a society that has been altered
through migration and is characterised by diversity, and which
is appropriate to diverse different needs. To move one step
closer to this goal, the federal Migration and Public Health
Strategy will implement measures in the following five areas
of intervention:
1. Education
2. Public information, prevention and health promotion
3. Healthcare provision
4. Therapy and care facilities for traumatised asylum seekers
5. Research
Although research in the field of migration and health has increased
over recent years, there are still important gaps in
the knowledge obtained from scientific studies. Part of the
Strategy will involve research projects to address these gaps
in concrete ways. A study was first commissioned to identify
the knowledge gaps, using a literature review and discussions
with leading experts. The reports serve as a starting point to
indicate subject areas in which research projects should be
promoted:
12
How do origin and social factors (e.g. gender, residence
status, social position) influence diagnosis, treatment and success
of treatment, and the quality of interaction and communication
between patient and professional? What are the criteria
determining the quality of their relationship, and how does it
influence diagnosis, treatment and success of treatment?
n What structures and institutional and organisational factors
in health care affect the content and quality of communication
and treatment?
What relationship is there between healthcare provision for
migrants (access to it, success of treatment) and their legal situation
(residence status, insurance, social and political rights,
level of institutional and social discrimination)?
What concepts of transcultural competence exist, and how
can they be conveyed to members of different health care professions?
What effect do they have on the quality of treatment
and on satisfaction with treatment?
What health resources do the migrant themselves have
(e.g. social networks, traditional methods of treatment, psychological,
religious and emotional resources), and how can
they be utilised in treatment?
What criteria can be used to evaluate the quality of intercultural
interpreters, and what is their effect on the quality of
treatment? 16
Although the studies presented in this collection, which are
supported by the Migration and Public Health Strategy, cannot
answer all these questions, they go some way towards doing
so.
The article by Gajo addresses the issue of how transcultural
competence can be conceptualised, and how it is understood
and implemented by members of different professional groups.
Following this, Hudelson describes her project to develop an
instrument and use it to evaluate transcultural competence in
doctors.
Kamm and Kaya investigate the (hitherto unused) resources of
non-Swiss hospital staff, and how a hospital can promote and
use them. The contributions by Büchi and Obrist and by Achermann
and Chimienti also address the question of resources,
but in terms of migrants. The first essay examines the health
resources of people from the south of the Sahara and discusses
what affects their availability and use. The second article
presents the health risks to which people with a precarious
residence status are exposed, and what resources they can
fall back on.
13 See e.g. Weiss, Regula, 2003: Macht Migration krank? Eine transdisziplinäre Übersicht
über die Gesundheit von Migrantinnen und Migranten. Zurich: Seismo.
14 http://www.euro.who.int/document/health21/wa540ga199heeng.pdf
15 Federal Office of Public Health, 2002: Migration and Public Health. The
Confederation’s strategic orientation 2002–2006. In May 2005 the Federal Council
extended the Strategy to the end of 2007. Further information on www.bag.admin.
ch/themen/gesundheitspolitik/00394/00395/00396
16 Maggi, Jenny, with Sandro Cattacin, 2003: Needed Basic Research in Migration
and Health 2002–2006 in Switzerland. Research report 29/2003 of the Swiss
Forum for Migration and Population Studies. Neuchâtel: SFM.