Description
Adapting European health services to migration and cultural diversity is an unfinished business to date. Despite multiple initiatives, proposals, “calls for action” and programs for the last two decades, health systems and services are still far from adequately responding to the diverse cultural reality of contemporary European societies. In order to fight racism and structural health inequalities, health services in Europe are in need of being more culturally competent. Culture and cultural competence need to be understood within networks of social, political and economic determinants of health, and within power relations.
Meaningful participation of people with lived experiences of migration and forced displacement in health policy, service delivery and research, including people who may be marginalised, is imperative. Such grounded perspectives are key to ensure that including concepts of culture do not translate into stigmatising others, but rather engage with structural and social dimensions of health in the real world. Based on a purposeful review of academic literature from multiple disciplines, such as medical anthropology, public health, medical education, and humanitarian medicine, we aim to provide a critical synthesis of the main contributions, experiences, and persisting or newly defined challenges. The overall framework to guide our analysis was defined by the ethical commitment to health equity as well as the legal and conceptual components of the Right to Health, (UN. Committee on Economic, Social and Cultural Rights 2000) in correspondence with a “critical perspective on migrant health” (Castañeda 2022). This allows for addressing the social, political, and historical backgrounds that shape the ways in which the health of migrants is addressed in certain times and contexts, and what challenges, needs and barriers are perceived and addressed, or not.
This article includes three case studies (UK, Serbia, Spain, and Germany)
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