Access for Public Health Care of refugees and migrants in Rabat, Morocco 2018

  • Public health surveillance
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Background:
International migrations have become subject of interest worldwide. As Morocco has become a migration host country, with around 40 000 migrants and refugees, and has developed a migrant health strategy since 2014. The obligation to reach the right to health for migrants has often been overlooked. This study aims to measure access of migrants and refugees to healthcare structures and the encountered issues in area of Rabat in Morocco.

Methods:
A cross sectional Study was conducted between January and June 2018. All migrants located in Rabat City who gave their consent and attending the three active local NGOs in Rabat city were included. Information regarding socio-demographic status and access to different levels of healthcare facilities were collected by face-to-face questionnaire.

Results:
A total of 204 migrants participated in the study. Average age was 28.7±9 years. Gender ratio Men/Women: 1.9/1. The half of migrants is from Guinea Conakry, Democratic Republic of Congo and Cameroon. Health insurance coverage was 2%. More than 90% of migrants asked for care in health facilities, 76.6% of them were assisted by an association. They practiced self-medication in 28.9%. The access was different at the 3 levels; 81.4% accessed to primary level, 24.5% to secondary level and 41.7% to tertiary level. According to the perception of migrants; 62.1% of the participants declared that the right of access to healthcare facilities was very limited. Communicational problems with facilities staff (51/67) In Primary level and the payment of services (15/32) in tertiary level were the main problems that migrants faced.

Conclusion:
To access at health care, the migrants and refugees still face many constraints related to the communication and the payment of benefits at secondary and tertiary levels. It’s recommended to implement an agreement framework of health coverage with the participation of different stakeholders’, to train health professionals on the specific migrants take in care and inform the migrants on their right to access to healthcare facilities.

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