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Angela Genova Fondazione Brodolini

BETTER HEALTH FOR BETTER INTEGRATION Building capacities to improve health equality for ethnic minorities women ITALY. Angela Genova Fondazione Brodolini. STRUCTURE OF PRESENTATION. Introduction: EMW? Health system EMW health needs Policies for EMW health services Good practices

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Angela Genova Fondazione Brodolini

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  1. BETTER HEALTH FOR BETTER INTEGRATION Building capacities to improve health equality for ethnic minorities womenITALY Angela Genova Fondazione Brodolini Peer review, Ancona 27 October 2011

  2. STRUCTURE OF PRESENTATION Introduction: EMW? • Health system • EMW health needs • Policies for EMW health services • Good practices • Comments Peer review, Ancona 27 October 2011

  3. STRUCTURE OF PRESENTATION Introduction: Ethnic minorities in Italy: according to language and territorial dimension. Ethnic Minorities Women (EMW): immigrant women (regular – irregular). We also briefly looked at Roma women living in camps (Roma) because of their condition of deprivation. Peer review, Ancona 27 October 2011

  4. INTRODUCTION • Immigration recent phenomena => ’70s • 4.563.000 foreign people. 7,5% population • 22% > 18 years old • 14% of total births • Different ethnic minorities • Different migration projects Peer review, Ancona 27 October 2011

  5. Foreigners residents in Italy on 1st January 2010 according to the first 20 citizenship countries Source: Istat 2011 Peer review, Ancona 27 October 2011

  6. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 Foreigners residents in Italy on 1st January 2010 according to the first 20 citizenship countries • Over 60% of immigrants lives in Northern Italy, • 25% in the Centre and 13% in the South. • About ¼ of all immigrants live in Lombardy, mainly in Milan province (about 1/10 of all Italian immigrants). • Most of immigrants lives in urban area. Source: Istat 2011 Peer review, Ancona 27 October 2011

  7. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 Foreigners residents in Italy on 1st January 2010 according to the first 20 citizenship countries • In Marche 138.994 immigrants • Country of provenience: • Romania (16%) , • Albania (16%), • Morocco (10%), • China (6%), • Ukraine (3 %). Source: Istat 2011 Peer review, Ancona 27 October 2011

  8. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 1. HEALTH CARE SYSTEM • Tax funded universal health care system • Since 1992 regionalisation process • Health inequalities not really a priority (just LEA) • No attention to gender • Regional dimension crucial for health policies and services Peer review, Ancona 27 October 2011

  9. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 1. HEALTH CARE SYSTEM Source:WHO, health for all, 2011 Peer review, Ancona 27 October 2011

  10. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 2. EMW HEALTH NEED, SOCIO DETERMINANTS, OUTCOMES DATA from Caritas, ISS, ISTAT, CMM and Minister • Immigrants do not present pathologies that are very different from those of Italians according to age populations. • Foreigners’ access to primary care presents many critic aspects: immigrants access later to primary care, or do not use at all primary care accessing directly emergency services (such as first aid services in hospital) Peer review, Ancona 27 October 2011

  11. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 2. EMW HEALTH NEED, SOCIO DETERMINANTS, OUTCOMES • Inequalities related to maternal/reproductive health; • Health inequalities related to the occupational status (care-workers); • Health inequalities of Roma people and other resident minorities groups • Inequalities related to long term care for elderly migrant women. Peer review, Ancona 27 October 2011

  12. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 2. EMW HEALTH NEED, SOCIO DETERMINANTS, OUTCOMES • Inequalities related to maternal/reproductive health. Pre- post natal assistance All indicators (examinations, ultrasounds exams, gestational age at first examination) show worst results for EMW, presenting more difficult access to pre-natal care for EMW. Public family services are the point of reference for EMW, while private services for DCW. 18% of women have their first pre-natal examinations after the third months, compared to 4% of Italians. ISS 2009: foreign women seem to lack necessary information and are less able to take advantage of assistance opportunities (ISS). Peer review, Ancona 27 October 2011

  13. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 2. EMW HEALTH NEED, SOCIO DETERMINANTS, OUTCOMES Source:La salute della popolazione immigrata, 2009 Peer review, Ancona 27 October 2011

  14. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 2. EMW HEALTH NEED, SOCIO DETERMINANTS, OUTCOMES Source: la salute della popolazione immigrata2009 Peer review, Ancona 27 October 2011

  15. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 3. EMW HEALTH SYSTEMS Synthetic index of socio-employment integrations territorial potentiality Source: Caritas 2010 Peer review, Ancona 27 October 2011

  16. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 3. HEALTH CARE SYSTEM AND EMW Marche: La legge regionale n.13/2009 “Disposizioni a sostegno dei diritti e dell'integrazione dei cittadini stranieri immigrati” Regional law on immigrations Source: Caritas 2010 Peer review, Ancona 27 October 2011

  17. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 3. HEALTH CARE SYSTEM AND EMW Regional immigration three-year or one year plans Source: Caritas 2010 Peer review, Ancona 27 October 2011

  18. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 3. HEALTH CARE SYSTEM AND EMW Focus on immigrants health needs in health or socio –health local plans Source: Caritas 2010 Peer review, Ancona 27 October 2011

  19. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 3. HEALTH CARE SYSTEM AND EMW Focus on women immigrated health. Source: Caritas 2010 Peer review, Ancona 27 October 2011

  20. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 3. HEALTH CARE SYSTEM AND EMW Source: Caritas 2010 Peer review, Ancona 27 October 2011

  21. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 3. GOOD PRACTICES • Emilia Romagna (Antonio Brambilla, Clara Curcetti, Camilla Lupi, M.Giovanna Caccialupi) • Piedmont (Luisa Mondo, Pietro Ferrero) • Lombardy (Coop Crinali S.Carlo, S. Paolo) (Sabina dalVerme) • Roma community in Rome and Marche (Sinti) (ComunitàdiSant’Egidio, Barbara Giacconi) • Caritas in Rome • Jesi • Fabriano • Ancona • Senigallia • Pesaro – Urbino (Naa) • Freewomen Ancona Source: Caritas 2010 Peer review, Ancona 27 October 2011

  22. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 5. SOME COMMENTS At national level: • Regional highly differentiated policies and services for EMW. • The crucial role of third sector organizations in collaboration with public actors. • Linguistic and cultural mediation as the main services offered to overcome inequality in accessing health services. Source: Caritas 2010 Peer review, Ancona 27 October 2011

  23. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 5. SOME COMMENTS Marche region: • High differentiation of services to tackle inequalities in access to health services for EMW at local level. • Fragmentation of third sectors organisation in offering linguistic and cultural mediation to support EMW access to health services. • Weakness in the relationship between public and third sectors organisation offering linguistic and cultural mediation. Source: Caritas 2010 Peer review, Ancona 27 October 2011

  24. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 6. Questions to be discussed with partners • EMW in Italy are mainly immigrants and Roma. What are the target groups selected in other state /region in Sweden, UK, Romania ? • In Italy EMW access health services mainly for pre and post natal services. What are the main EMW health needs in Sweden, UK, Romania? • Italy presents highly differentiated services and policies at regional /local level. What is the situation in Sweden, UK, Romania ? • What are the main services and good practices in EMW services in Sweden, UK, Romania, Italy( with specific focus on pre and post natal health services, if pertinent)? Source: Caritas 2010 Peer review, Ancona 27 October 2011

  25. BETTER HEALTH FOR BETTER INTEGRATION. Building capacities to improve health equity for ethnic minorities women PROGRESS VP/2010/006 Thank you ! Peer review, Ancona 27 October 2011

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