Accessibility in maternal health services: a case study of refugee population in hospitality structure of fillipiada
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School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Publication date: 2023-10-24
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Despoina Kostakioti   

School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Eur J Midwifery 2023;7(Supplement 1):A144
Refugee asylum seekers have the right to free access to Public Health Facilities and are entitled to nursing and medical care. Pregnant refugees face a variety of linguistic, cultural, geographical, administrative, etc. barriers. Inadequate access to health services is a brake that affects all aspects of their lives.

Material and Methods:
The research was chosen to be qualitative, where individuals and phenomena are studied in their natural environment. It is characterized as an participatory observational study since the research team participated in the activities being studied trying to facilitate women's access to obstetric services. The research took place at the Refugee and Immigrant Reception Center from July 2020 to July 2021. The communication was made through certified cultural interpreters of the service/organization in two languages. Arabic and Farsi. The data collection method was (34) structured interviews that included eleven questions, categorized according to the type of accessibility studied (social, geographical and organizational). The results of the interviews were audio recorded and transcribed.

All the women who participated in the survey chose a public hospital. This was an option that was 100% economical. Each respondent visited the doctor from only once to once a month with 50% visiting the hospital 2-3 times. Half of the women answered that they did not need more visits. The problems that most of them faced during the journey to the hospital were difficulties in transportation and the cost of it. The largest percentage (62%) say they did not have any problems with the use of the services. A large percentage (62%) believe that they were not confronted with racist behavior. 21% of women report offensive behavior by staff. Women faced various bureaucratic problems with their social security number, prescription and certificate of marital status. In the process of admission to childbirth, 65% reported various problems regarding the distance of the hospital from the place of residence and the cost of transportation. Women make very positive feedback on the support they received after pregnancy, and only two make negative feedback. The largest percentage of respondents (91%) recognize communication as the biggest obstacle and emphasize the need for a translator in every health service.

The most important problems that arise regarding the accessibility of refugee women to health services are language, geographical and bureaucratic barriers. It is necessary to take the required measures in order to provide satisfactory maternal care within the geographical boundaries of the region without presenting the need to change the place with the accompanying problems that this entails. Health care providers must also recognize, respect and respond to the cultural beliefs and practices of the people they serve. This can be achieved through training programs both at the workplace (hospital, health center, etc.) and at the university (intercultural training). The most important issue that emerges from the literature and is confirmed by the research is the urgent need to provide interpretation services in the health system. Finally, the responsible bodies are required to do their utmost so that the already established mechanisms operate in an organized manner without delays and deficiencies to avoid bureaucratic problems as well as to establish new interventions that cover the geographical and linguistic needs of the population in order to provide refugees with an equal access to health services in general and obstetrics in particular.

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