MyHealth project comes to answer, by developing and implementing models based on the knowhow of a European multidisciplinary network, the need to reach out Vulnerable Migrants and Refugees (VMR) on their Health. In particular, women and Unaccompanied minors as one of the most vulnerable group.
It has been reported that, as local population, this very heterogeneous group is facing challenges in health related issues.
The main aim of MyHealth is to improve the healthcare access of vulnerable immigrants and refugees newly arrived to Europe, by developing and implementing models based on the knowhow of a European multidisciplinary network.
Secondary objectives:
1. Develop a complete interactive map, with main health issues, main actors and stakeholders, reference sites dealing with MREM, legal and organisational aspects of Health systems in the involved countries, and the ICT tools available.
2. To define more clearly the current health problems of migrants treated in our health centres.
3. Define and develop health intervention strategies in Mental Health/Communicable and non communicable diseases, based on the community health approach.
4. Develop and ICT based platform to support new tools, enhance Health applications development and health information
5. To implement the defined strategies and models in pilot over the hospital participating in the consortium.
6. To ensure training and involvement of all the key actors in the Health system value chain. From users to management.
7. Ensure a sound management and communication strategy for MyHealth.
Outcomes:
Interactive map available online.
Pilot survey on current health status and concerns conducted.
Health promotion best strategies identified.
Pilot Models successful evaluated.
Existence of guide for integration of ICT Solutions for VMR.
MyHealth project comes to answer, by developing and implementing models based on the knowhow of a European multidisciplinary network, the need to reach out Vulnerable Migrants and Refugees (VMR) on their Health. In particular, women and unaccompanied minors as one of the most vulnerable group. It has been reported that, as local population, this very heterogeneous group is facing challenges in health related issues.
The main aim of MyHealth is to improve the healthcare access of vulnerable immigrants and refugees newly arrived to Europe, by developing and implementing models based on the knowhow and shared learning of a European multidisciplinary network.
Secondary objectives:
1. Develop a complete interactive map, with main health issues, main actors and stakeholders, reference sites dealing with VMR, legal and organizational aspects of health systems in the involved countries, and the ICT tools available.
2. To identify more clearly the current health problems of migrants treated and/or diagnosed and/or consulted in our health centers in Barcelona, Berlin and Brno.
3. Define and develop health intervention strategies in Mental Health/Communicable and non communicable diseases, based on a community health approach.
4. Develop and ICT based platform to support new tools, enhance Health applications development and health information
5. To implement the defined strategies and models in pilot over the hospital participating in the consortium.
6. To ensure training and involvement of all the key actors in the Health system value chain: from users to management.
7. Ensure a sound management and communication strategy for MyHealth.
The European Commission emphasized its willingness to support effective responses to communicable diseases as well as cooperation in relation to health promotion, disease prevention and improving the response to chronic diseases and mental health issues in vulnerable migrants and refugees. This action aims to support activities in view of the development of models to improve health care access of vulnerable migrants and refugees.
More particularly in the Migrant’s health, two key aspects are:
● To identify innovative ways of reducing inequalities in access and provision of health services, and promote social inclusion through care models that support reorientation of specialists to general practitioners and strengthen culturally competent healthcare in primary care settings.
● To compile best practices in care provision for vulnerable migrants and refugees (including pregnant women, children and older persons), with a focus on psycho-social aspects, acute and chronic diseases, including communicable diseases.
Myhealth project, through the development of models based on a community health approach and the different dissemination actions will fulfil two of the four main objectives of the Health Workplan:
● to identify and develop tools and mechanisms at the European Union level to address shortages of resources to facilitate the uptake of innovations in public health interventions and prevention strategies.
● to increase access to medical expertise and information for specific conditions also beyond national borders, facilitating the application of the results of research and developing tools for the improvement of healthcare quality and patient safety.
Vulnerable Migrants and refugees are often exposed to specific health risks, such as those resulting from precarious conditions during the migration path, exploitative working conditions or precarious housing. As EU Member States, faced with an ageing population and the repercussions of a global economic crisis, struggle to contain public health expenditure, the right to health for all-regardless of legal status must remain a key concern. Vulnerable migrants and refugees face legal, economic and practical obstacles in accessing healthcare. This project adds high value at EU level in the field of public health since aims to devel
The project workload is distributed in 8 work packages (WPs). These have been defined by the consortium with the scope of gathering all envisaged activities by accounting for their logical and temporal interconnections. The first three WP are transversal: WP1 Coordination, WP2 Dissemination and WP3 Evaluation. Four technical WPs form the core of the project: WP Mapping, WP5 Needs Assessment, WP6 Tools development and WP7 Pilots. Finally, we will use a participatory and social innovative approach to work, ensuring vulnerable migrants and refugees are at the centre of the project, and all the relevant stakeholders are involved. The awareness and capacity building across partners and rest of stakeholders will allow the adaptation of the models to different scenarios. This creates a spillover effect in which change management and community participation take a central role (WP8 Community involvement). All these work packages and their related tasks are well detailed in the WorkPlan.
The WP4 is devoted to Mapping the existing initiatives on Health for WUM-MREM, and the main actors involved in migrants and refugees’ health in order to come up with an interactive map (and database) with key referents sites (refugee camps, NGOs offices etc) to provide support to migrants and refugees limited to the network and opened for inputs from other countries. The maintenance for the interactive map will be ensured for at least 4 years after the project. Within this WP, we do not intend to duplicate existing initiatives, but make the information available on an interactive format.
In WP5 a pilot survey to collect information on physical and mental health status will be carried out giving qualitative insight on the current health status of migrants and refugees, together with quantitative indications from literature. It aims to assess the needs and raise awareness of difficulties that migrants face in terms of access and utilization of healthcare services and which are directly linked between the social determinants of health and the barriers to the traditional health system.
Tool development will be the central part of WP6. The aim of this WP is to develop or identify existing tools to improve the health care access of vulnerable immigrants and newly arrived refugees. This WP will allow identifying concerns and needs, regarding health, as perceived by the target groups, and the best screening and community health strategy for mental health disorders and infectious diseases in primary health care. We will introduce the referent figures in Health and migration at community levels, linked to primary care and hospital, so to work in networks.
Finally, Pilots will be carried out in WP7. Once the best community health models are identified, these will be put in place and monitored throughout the project. Three pilots, one each in Spain, Germany and Czech Republic will be carried out in order to test its adaptability in terms of people’s needs, expectations, economic and social sustainability and in terms of replicability in other domains and countries.
Besides the current monitoring and evaluation of the project MyHealth will use a learning alliance (LA) as an innovative methodology that will contribute to articulate the work of the different work packages by
(1) promoting the involvement of collaborating stakeholders (including policy makers) in the field of VRM health and the institutionalization of learning alliance outcomes,
(2) ensuring capacity building strategies for the models to be adapted,
(3) emphasizing documentation and dissemination as innovative practices among stakeholders, including academics, civil society organizations, planners, and health practitioners, and
(4) strengthening the network capacity of the community in VRM health’s to guarantee the sustainability of the project.
The use of this innovative methodology will ensure that vulnerable migrants and refugees are being included within the models to be adapted a
In accordance with the contractual requirements written in the Grant Agreement between MyHealth consortium and European Commission, the following deliverables and milestones were provided during the reporting period:
-MS1, MS4 Committees formed, Consortium agreement: Three committees were formed for acting as reference points for all stakeholders involved in MyHealth: Scientific Steering Committee (SC), Ethics Committee (EthC) and Advisory Board (AB). WPs leaders formed the SC which is the major management authority of MyHealth. The kick-off meeting took place in May 2017 in Luxembourg and the 1st SC already took place in Barcelona (10.2017). The Consortium Agreement was signed by all the partners. The EthC was formed by 4 representatives of the different participating partners and supervised by an external expert, member of the collaborating partners to ensure the independence for all ethical-related decisions. EthC is responsible for the implementation of all consent procedures, personal information related instructions and ethical guidelines. The AB is in charge to set up strategies to extend MyHealth far beyond the current involved countries, its members are part of the collaborating stakeholders. Furthermore, virtual MyHealth coordination team conferences had took place 7 times during the reporting period.
-D2.1, MS5 Evaluation plan: The roadmap identified objectives and goals to setting up a timeline for evaluation activities. The evaluation plan presented the aim, evaluation questions, targets, methods and results (outputs and outcomes) and timing of the evaluation of the EC funded project, “MyHealth”. It is the general objective of MyHealth to improve the healthcare access of vulnerable Migrants and Refugees (VMR) newly arrived to Europe by developing and implanting models based on the knowhow of a European multidisciplinary network. MyHealth is being funded by the EU Consumers, Health, Agriculture and Food Executive Agency (CHAFEA) under the framework, Migrant’s Health: Best Practices in Care Provision for Vulnerable Migrants and Refugees (PJ--01--2016). The evaluation plan delineates the steps to be followed to assess the process and results (outputs and outcomes) of MyHealth. It is a flexible tool compiled with inputs from all WP leaders; and it is updated on an ongoing basis as needed to reflect project priorities and changes over the three years (2017--2020) of implementation.
- MS7 Dissemination plan: guidance and tools were provided to the Project partners on how to inform and stimulate broader debate with and amongst specific target groups; disseminate and promote the progress of the project, events, results, and findings; Strengthen the cooperation and collaboration dialogue between research/healthcare professionals and policymakers; disseminate and promote project deliverables; utilize project findings to develop communications messages that are relevant, easy to understand and drive behavior change; utilize consistent messaging, branding, imagery and language (Plain English standard) so that project recommendations/findings are understood and can be acted upon by the key stakeholders. Furthermore leaflet, public website was provided.
-D4.1 Report about health status on vulnerable migrants: The objective of this report is to present the activity about developing a complete interactive map, with main health issues, main actors and stakeholders, reference sites dealing with vulnerable migrants and refugees, legal and organizational aspects of Health systems in the involved countries, and the Information and Communications Technology (ICT) tools available. The starting point was the definition of the target (focus on vulnerable migrants), the processes and boundaries of the mapping (health, social and support services in the city or region). Variables of interest have been discussed and defined, an online questionnaire has been created to collect data about public and private organizations that
VMR are MyHealth service users’ target group, but it is a very heterogeneous group. For this reason, and because some VMR are particularly vulnerable, we are focusing on women and unaccompanied minors (from now on in the text UM) newly arrived in Europe (less than 5 years). The approach used by Myhealth partners to reach the target group is made by building networking with social private entites (NGO or Fundations) and social public entities (settle centers for unaccompanied minors) that focus their activities on VRE, always supported by the health community workers. To reach out, we used the sound expertise of member of the consortium, and a targeted dissemination strategy. For UM: extended network of social centres hosting UM, new technology appeal, we are already working with these groups (ICS, CHARITE, FNUSA, SYN-EIRMO) For Women: extended network of hospitals and obstetrics departments, family health appeals, we are already working with these groups (ICS, CHARITE, FNUSA) in the different pilot sites. A specific WP on Community involvement is also included. In the project description, we will use the term VRM, for the whole group, and WUM-VRM for our concrete target group. Within the different phases of the project, we will have the following groups involved, in order to ensure we can clearly optimize the response:
i) VRM, all acting as participants; motivated by the anticipated increase in the knowledge and management of their health.
ii) Patients’ and advocacy groups (e.g. patients’ associations; immigrant associations) to promote dissemination of the project in lay terms. Advocacy groups will provide essential feedback for service provision, links to policy makers, and involvement of our service users.
iii) Health professionals, participating as data contributors given that they will work on improving the understanding of the main VRM health concerns, learn from the VRM concerns themselves, participate in pilots wherever possible, follow and participate in trainings related to the developed models and strategies
iv) Governments and international health agencies, being involved as sponsors and recipients of information, contributing to the understanding of the VRM Health situation and concerns, monitoring safety of pilots, evaluating cost-effectiveness and political importance of Health for VRM.
v) Social researchers: by using the learning alliance methodology, as well as getting in the field of social innovation, we want to make sure that social sciences researchers are involved and aware of the project.
The preliminary report of the needs analysis provided a background from which to develop a survey that can be disseminated electronically to stakeholders to gain quantitative data concerning the extent to which the needs identified in the analysis are. Mapping Online interactive map will be online by the end of March 2018. In order to guarantee its use, it will be necessary to plan an information campaign that advertises the site and the smartphone app. In the meantime, the mailing list of stakeholders that represent the network of services for vulnerable migrants is in continuous expansion.
For reaching the targeted population, we have outlined the following plans for community involvement across the work packages: Advisory board: One leader from the immigrant community will be members of the Advisory Board. (WP1) Coordination Team meetings, a community health agent and 1-2 member of the immigrant community (both genders if possible) will join monthly this meetings. (WP1) A Community Steering Group will be set up with members of diverse communities and professionals working with vulnerable immigrants. (WP1) The Learning Alliance methodology will consult and gather the views of all the stakeholders involved in MyHealth Project as well as women and children (unaccompanied). (WP2) Dissemination materials will be distributed and made available to the communities and target groups serviced by the project. (W
We are in the process of establishing a European networking including all actors involved in improving general health situation of vulnerable migrants. At the end of project, we will have: i) a representative report on immigrants’ and refugees' perceptions of their health priorities and needs ii) Digital and interactive map of Health and VRM in Europe, including reference sites, health legal and organizational details iii) main issues for WUM-VRM in Mental Health, infectious diseases and non-communicable diseases iv) appropriate screening and treatment strategies for our three key areas in primary health are based on community health strategies vi) versatile ICT (Information and Communication Technology) based platform on WUM-VRM health, including the interactive map, general information, contact, and health apps vii) Recommendations and innovative tools.
The mapping activity highlighted some difficulties in involving non-governmental organizations.
Also, with regard to public services, the online search response rate is still quite low. Dissemination activities within the networks and an automatic recall pan are being planned in order to increase response rates and ensure greater and ever wider coverage. All partners have helped collate information for the mapping process by inviting partners, organizations and individuals know to us to participate in the mapping process. All of this information is feeding into the pan-European mapping exercise .
We have successfully completed the process of documenting the community participation strategy to be used in this project. All partners were able to successfully contribute to the development of this strategy. We will be delivering training on it to all partners involved at our next partnership meeting and looking in more detail at how we can implement it more widely over the next two years.
In Berlin, we have planned psycho educational groups for female refugees which will start in April 2018. Topics will be health literacy, mental health care system, school system, employment system as well as housing problems.
The communication and dissemination activities began at the start of the project to ensure these efforts were systematically integrated into project activities. The central aim of WP3, communication and dissemination, is to effectively communicate and disseminate of project findings to a broad audience of relevant European stakeholders at local, national and European levels, a key project objective to promote the translation of project findings into practice.
The communication and dissemination plan were developed in the first months of the project. All partners inputted into the document, which was finalized for the end of M3. The strategy outlines how results will be disseminated and stakeholders engaged and will be used as the basis for communication and dissemination activities throughout the project. The plan outlines objectives, project image and diction as well as requirements, such as EU funding and content statements.
In addition, various other project materials were developed in the first three months for communication and dissemination. A project leaflet (two versions—long and abbreviated) were developed. Also, a project power point was created. A press release was written and disseminated for the project kick off. All materials are written in basic and accessible English. Partners have the option to translate into their native language as they see fit and needed.
Administratively for the work package, a photo and video release form was generated. A six month tracker for communication and dissemination activities was created for partner institution completion every six months. Also, a communication request form was created so partners can put in requests to post content on the project website and social media accounts. The website and social media accounts were set up including the website, Twitter and Facebook accounts. The website content was first written in basic and accessible English. A TC was held for the WP during the first three months. The WP activities are discussed in monthly meeting to integrate with and to support other WP activities.
A social media strategy has also been written for the project. Partners have been asked to complete a social media survey for their institutions in order to integrate partner social media and online efforts with those of the project. Partners have been asked to complete request forms for social media and other communication and dissemination activities.
Partners have also begun to communicate project objectives and activities at meetings and conferences, such as DG Sante’s communication event and European conferences. All partners will complete an activity tracker every six months from M6 of the project to track all of their organization’s communication and dissemination activities for the project to track all relevant activities. Activities to communicate in year 2 are beginning to be planned .
For M12, a newsletter is being generated to propagate project results, which will include profiling the online tool set to go live. The external stakeholder list will also be created for M12 for distribution and dissemination purposes.