Contributing to the Integration of Newly-Arrived Migrants and Refugees in the EU Member States’ Health Systems (Re-Health 2)

Objective: To support EU Member States in improving healthcare provision for migrants and integrating them into national healthcare systems.

Background

In line with the European Agenda on Migration, which foresees supporting the reception capacity to provide healthcare to newly arrived migrants and refugees to the EU Member States under particular migratory pressure, and to reinforce the need for a unified tool for a health assessment at the EU level that would allow to retrace the medical history of newly arrived migrants, facilitate the transit to destination countries and foster the integration in national health systems, the Migration Health Division of the International Organization for Migration’s (IOM) Regional Office in Brussels launched in February 2016 the Re-Health project – Support Member States under particular migratory pressure in their response to health-related challenges. The action is also in line with the Sustainable Development Goals: well-managed migration, Universal Health Coverage and Member stated commitments to “leave no one behind”.

Co-funded under the amended EU Third Health Programme (2014-2020) by direct grant agreement awarded to IOM by the European Commission’s Directorate-General for Health and Food Safety (DG SANTE), through the Consumers, Health, Agriculture and Food Executive Agency (CHAFEA), the action is a continuation of other EC funded projects implemented by IOM in the field of migration health, including PHBLM and Equi-Health. Re-Health aimed at improving the capacity of EU Member States under particular migratory pressure to address the health-related issues of migrants arriving at key reception areas while preventing and addressing possible communicable diseases and cross-border health events. The project was composed of three main components: electronic health database and its electronic Personal Health Record (e-PHR), exploratory phase, and piloting of the PHR/e-PHR in the field in different countries across Europe.

After the initial piloting phase of the e-PHR within Re-Health in Croatia, Greece, Italy, and Slovenia, and in line with the priorities and actions set out under the EU Public Health Work Programme 2017 to implement the third Programme of the Union’s action in the field of health (2014-2020), the Migration Health Division of the International Organization for Migration’s (IOM) Regional Office in Brussels is, under the current year 2017-2018, to implement and consolidate the use of the PHR as a single tool for health assessments in EU countries and to develop a revised version of the tool and its related electronic platform (e-PHR).

Under the project Re-Health 2 – Implementation of the Personal Health Record as a tool for integration of refugees in EU health systems, in line with the EU Migration Agenda, the New Skills Agenda for Europe - Commission Communication COM(2016) 381 in its part related to the integration of third-country nationals, IOM will carry out the implementing action with the overall objective to contribute to the integration of newly-arrived migrants and refugees, including those to be relocated, in the EU Member States’ health systems through the utilization of the PHR/e-PHR.

Electronic health database

Following the first phase of piloting of the PHR/e-PHR within Re-Health and the related electronic health database within the Re-Health project in Croatia, Greece, Italy and Slovenia, and according to findings and recommendations from the Feasibility/Transferability Study conducted within the pilot phase project, the PHR/e-PHR and related electronic platform will be revised to better meet the needs of stakeholders involved in the provision of health care to migrants and the general population (national and regional authorities, civil society organizations, etc.) as well as migrants/refugees’ needs. 

In line with the EU Directive 2011/24/EU on cross border health care, the data protection directive (95/46/EC2 and EC/2016/679) and IOM data protection principles, the revision will include - but will not be limited to - the following aspects:

• Automatic translation in a minimum of two languages according to geographic localization of the user; 
• More possibilities to upload and download documents, such as medical test results;  
• Additional spaces for follow-up exams and extra lab tests;  
• Additional search fields, etc.

Consolidation of the use of the PHR/e-PHR

To consolidate the use of the PHR/e-PHR with the view to demonstrate the feasibility and limitations of such a system, the Re-Health 2 action intends:

• The second phase of implementation in the countries participating in the first stage, within the Re-Health project, and in minimum three new sites;
• Promotion of the utilization of the PHR/e-PHR and similar system at local, national and EU levels; 
• Data collection on the use of the PHR/e-PHR to better assess the feasibility of such tool; 
• Further dissemination of the concept with the printing of the PHR for health assessment performed within the relocation  scheme;
• Data collection on migrants’ health status at the moment of relocation (conditional to an agreement with DG Home.

Two deliverables are directly related to the Implementation of the PHR:

• Report on the use of the PHR/e-PHR within the new and previously piloted countries.
• Health monitoring report out of the Health assessment done within the context of the relocation (conditional to agreement from DG Home).
• Four EU Member States, Croatia, Greece, Italy, and Slovenia as well as three new countries, Cyprus, Romania and Serbia, have committed in regards to the project implementation in this second phase. 

Capacity building

Building the capacity of health mediators is crucial to overcome the existing gap between people of different socio-cultural backgrounds and health professionals.

Within the Re-Health 2 action, health mediators, selected among the migrant/refugee population in targeted countries, will participate in capacity building activities in respect to migrants’/refugees’ health needs and the added value of the PHR/e-PHR, through:

• Organization of one face-to-face training session in each new implementing country at the beginning of the implementation phase as well as in new sites in previous countries when and where needed. 
• An online training course for health mediators. 

The specific deliverables related to this component are:

• Training sessions reports. 
• Online Training course. 

The European Commission and the International Organization for Migration’s (IOM) Regional Office in Brussels signed a Direct Agreement for the implementation of the project Re-Health 2  (July 2017- Sept. 2018) which aims to test the further use of the Personal Health Record - a tool designed to integrate migrants and refugees in EU health systems.

Re-Health 2 follows the Re-Health project which developed the electronic Personal Health Record (E-PHR) and platform and piloted it in four EU countries - Greece, Italy, Croatia and Slovenia (Feb. 2016- May 2017). Both projects are co-funded through the EU Health Programme 2014-2020.

Within the framework of the IOM/ EC Re-Health2 action “Implementation of the Personal Health Record as a tool for integration of refugees in EU health systems” co-funded under the EU Public Health Programme 2017 and productive cooperation within the IOM/EC Re-Health as well as with other migration health-related initiatives. Implementing sites: Cyprus, Croatia, Greece, Italy, Romania, Serbia and Slovenia.

The Personal Health Record (PHR) is an IOM tool created to foster appropriate health care provision to migrants during the reception process within and between countries and harmonize health assessment practices within the EU. The tool is in line with all the IOM internal security and legal components as well as EU and the Member States' legal and security requirements.

Funding

The project is co-funded by the Health Programme of the European Union and implemented by IOM 

Areas of action

Cyprus, Croatia, Greece, Italy, Romania, Serbia and Slovenia.

 

Related resources

For more information on the PHR/e-PHR and the related electronic health database, please see here. 

For more information, please visit this website.