Primary Health Care for refugees and other migrants (EUR-HUMAN workflow chart)
Primary health care settings for refugees/migrants
Within the EUR-HUMAN project a flowchart was developed to show the ideal process/workflow of health care for refugees and other migrants when they approach a respective country. In this workflow three domains of contact with the primary health care system are depicted (see the figure attached). Within each domain the most relevant steps, assessments and tools are described to be able to provide person-centred, integrated, compassionate and multifaceted primary health care best possible. In addition, it is highlighted that primary care teams are best fit to provide this multifaceted care.
At the beginning of each module of this EUR-HUMAN course it is described for which domain(s) of this workflow the related module fits best.
The whole flowchart can be used as process template when organizing a health care structure for refugees and other migrants.
The three domains are organized differently in the different European countries. Following, the three levels are described for Austria.
- Level: Triage
a) Triage only is provided in initial reception centres (for asylum seekers who are not admitted to the asylum process in Austria – Dublin III) to identify refugees and other migrants with urgent and acute needs.
b) Triage and initial health assessment is provided to asylum seekers who are admitted to the asylum process in Austria (in distribution centres, federal refugee centres with specific focus on unaccompanied minor refugees, and in additional Red Cross units). The initial health assessment is a standardized assessment procedure including anamnesis, x-ray of the lung (obligatory) and (voluntary) vaccination (Po-Di-Te & Ma-Mu-Rö). Details will follow in module 2.If the content of a course module is relevant for primary care providers who work in this domain with refugees and other migrants, this is indicated at the beginning of the module.
- Level: First contact with the primary health care system for asylum seekers who are admitted to the asylum process in Austria (General Practitioners (GPs))
If in the initial health assessment a (sub-) acute disease is diagnosed where no hospital admission is needed the asylum seekers are recommended to contact a GP or another primary health care facility for further treatment. All other refugees will have their first contact with the GP only if they are sick, thus asylum seekers have access to the conventional primary health care system in Austria. At this level, it is besides the treatment of the acute complain additionally important to assess the health needs of refugees again very carefully with special respect to vaccination coverage, mental health, chronic conditions, sexual and reproductive health as well as children´s health (since the initial health assessment in the triage setting is quite limited and with a focus on urgent and acute needs).If the content of a course module is relevant for family doctors/physicians/health care worker who work in this domain with refugees and other migrants, it is indicated at the beginning of the module.
- Level: Long-term primary health care In this domain the focus should be – besides the continuous treatment of the diseases – on health literacy, empowerment, and enhancing coping strategies.If the content of a course module is relevant for family doctors/physicians/health care worker who work in this domain with refugees and other migrants, it is indicated at the beginning of the module.