Study investigates the obstacles faced by undocumented immigrants in accessing health services

A study by the UPV/EHU has found that undocumented immigrants encounter structural and individual barriers linked to their social vulnerability when accessing public health services in the Basque Autonomous Community. They have difficulties in meeting the conditions to access the services and are at greater risk of poorer health. In order to bring about a more inclusive health system, their legal access to healthcare must be guaranteed, and rights-based care must be promoted among health workers.

Immigrants face all kinds of barriers when trying to access health services in host countries. Among other things, undocumented immigrants have more restricted conditions for legally accessing public health services. Women are also more likely to seek healthcare and face gender-based factors that hinder their access to it.

Iratxe Pérez-Urdiales, lecturer in Nursing I at the UPV/EHU, has investigated the obstacles encountered by undocumented immigrants and immigrant women in accessing public health services in the Basque Autonomous Community. The researcher indicates that when trying to access public health services, "undocumented immigrants and immigrant women face difficulties for various reasons, such as the characteristics of the immigrants themselves (origin, language, culture…), the way the health system functions (bureaucracy), legal requirements (documented or undocumented) or the stereotyped and poor view held by society and health center staff regarding immigrants (the behavior of those who attend to them in the health center is very important)".

To reach these conclusions, the researcher analyzed data going back several years of the free clinic run by the NGO Médecins du Monde Euskadi, which treats immigrants who end up outside the public health system, and assessed the experiences and perceptions of immigrants and health professionals who work in these free clinics.

Two executive orders that came into force in 2012 imposed stricter conditions on the right of undocumented immigrants to access standardized healthcare. In this respect, Pérez-Urdiales analyzed the data of this free clinic before and after that year, and concluded that "no clear link has been found between the application of more restrictive legal conditions to access public health services and the tendency of immigrants to go to a free health center".

Healthcare for the whole population

The research reveals that in the case of documented immigrants, both men and women face similar obstacles, except in the case of women victims of gender-based violence: "We have seen that women are the ones that resort to the health system most. But regardless of their administrative status, women who suffer gender-based violence find it very difficult to access services or they avoid attending health centers. What is more, undocumented immigrants "are afraid to go to public health centers and decide to go to free clinics, where they are provided with basic healthcare", she said.

Pérez-Urdiales explained that free health services, in addition to providing healthcare to immigrants, play a crucial role in defending their right to health, and "the outcome of this research provides cogent scientific reasons to defend access to health services for immigrants". The study concludes that, in addition to guaranteeing the legal right to healthcare for these people, culturally appropriate care is needed. To this end, it is essential to have cultural mediators, to reinforce the values of non-discrimination and to create more accessible and multilingual sources of information for immigrants.

Our society regards healthcare as a privilege, but it is a fundamental right per se. A new perspective has to be fostered both in society and among health workers."

Iratxe Pérez-Urdiales, Lecturer in Nursing I, UPV/EHU