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Vol. 23. Num. 2. 2014. Pages 105-113

Transforming health policies through migrant user involvement:Lessons learnt from three European countries

[La transformación de las políticas sanitarias mediante la implicación de los usuarios inmigrantes: lecciones aprendidas de tres países europeos]

Cláudia de Freitas1 , Manuel García Ramírez2 , Arild Aambø3 , Sandra C. Buttigieg4

1Inst. Univ. Lisboa, Centre for Research and Studies in Sociology, Portugal ,2Univ. Sevilla, España ,3Oslo Univ. Hosp., Norwegian Centre for Minority Health Research, Noruega ,4Univ. Malta, Fac. Health Sciences, Dep. Health Services Management, Malta

Abstract

Designing and implementing equitable health policies requires the involvement of all stakeholders.However, disadvantaged groups are under-represented in European health participatory mechanisms.Migrants and ethnic minorities (MEMs), for example, are consistently left out of policy-making fora.Additionally, MEMs lack a voice on the programmes that are intended to benefit them. This can jeopardizethe responsiveness of health policies to MEM needs and undermine the development of diversity sensitivecare, making way for increased inequities in health. It is necessary therefore to investigate innovativestrategies capable of fostering MEMs' participation. Community psychology is particularly promising inthis respect as it aims to mobilize the resources that communities possess, rather than simply teachingpeople to use services developed by others. Moreover, it highlights collaborative/participatory researchapproaches, which privilege the involvement of all stakeholders. By employing a community psychologyapproach, this paper looks at three European countries -the Netherlands, Norway and Spain- andsummarizes lessons learnt from their experiences with migrant user involvement. The cases reportedaddress different aspects of involvement, including: community mobilization, sociopolitical development,and creation of community alliances and coalitions. Its analysis offers several insights that can transformpolicy-making into a more inclusive process. 

Resumen

Diseñar y poner en práctica políticas sanitarias justas precisa de la participación de todos los interesados. Noobstante, los grupos desfavorecidos están infrarrepresentados en los mecanismos europeos de participaciónsanitaria. Por ejemplo, los inmigrantes y minorías étnicas quedan sistemáticamente apartados de los foros dediseño de políticas. Además, estos grupos carecen de opinión sobre los programas pensados en su beneficio,lo cual impide una respuesta de las políticas sanitarias a sus necesidades a la par que frena el desarrollo deuna asistencia que tenga en cuenta la diversidad, dando origen a mayores injusticias en sanidad. Es necesariopues investigar en estrategias innovadoras que impulsen la participación de los inmigrantes y minorías étnicas.La psicología comunitaria es especialmente prometedora al respecto ya que busca movilizar los recursospropios de las comunidades más que enseñar a la gente a utilizar los servicios desarrollados por terceros.Además, recalca los enfoques de investigación colaboradores/participativos que privilegian la implicación delos interesados. A través de un enfoque de psicología comunitaria, este trabajo contempla tres países europeos-Holanda, Noruega y España- y resume las lecciones aprendidas de su experiencia con la participaciónde los usuarios inmigrantes. Los casos aportados abordan diversos aspectos de la participación, como la movilizacióncomunitaria, el desarrollo sociopolítico y la creación de alianzas y coaliciones comunitarias. El análisisofrece algunas ideas que pueden transformar el diseño de las políticas en un proceso más integrador. 

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