Access to healthcare services for the Roma and undocumented migrants in the EU in light of the Covid-19 pandemic

Abstract

Background. The rising number of the EU Roma citizens from the CEE countries, non-EU Roma citizens from the Western-Balkans, and of undocumented migrants in the European Union makes it interesting to see that most of them face barriers when accessing health services [with a European Health Insurance Card (EHIC)] or have no health coverage at all [no legal entitlement]. European migrant health policies are seemingly well structured and responsive to the needs of migrants, however, results of recent studies raise the question whether the legislations are responsive enough to the needs of the Roma and undocumented migrants when accessing health services. Given the circumstances of the Covid-19 pandemic these groups are now at an increased risk and they might not be able to understand how the virus transmits and how they can protect themselves from it. 

Methods. Literature review focusing on the access to health services and migrant health policies in the EU and the UK was carried out. The target groups of this research were Roma citizens and third-country national undocumented migrants residing in the European Union.

Results. In theory the legal entitlement for accessing healthcare for migrants in general is satisfactory, while in practice these groups face difficulties, such as prejudice, discrimination and other barriers (language, logistical) when approaching health services. Migrants lack trust in the health system and the healthcare professionals, and are not aware of their fundamental rights to healthcare either. 

Conclusions. Legal entitlements for EU migrant citizens do not differ within EU countries but they significantly vary for undocumented migrants Europe-wide and there seems to be a mismatch between the legal entitlements for undocumented migrants in theory and their implementation in practice. Given the circumstances of the pandemic these groups are at an increased risk and therefore their health inclusion through health literacy programs should take place, as well as health workers should be trained on diversity in order to establish diversity adapted EU health systems. Seeking adaptive practices to establish cultural diversity within the healthcare settings, and introducing the universal health coverage scheme Europe-wide in order for undocumented migrants and EU citizens without employment to benefit from proper healthcare services is encouraged and necessary.