Results Background and objectives

A cross-sectional study was conducted from January to April 2012 in

Athens, Greece. The study population consisted of 191 recent

immigrants who were living in Greece for less than 10 years. We

developed a questionnaire that included information about

sociodemographic characteristics, health status, public health

services knowledge and utilization and difficulties in health services

access. To study the reliability of questionnaire, the internal

consistency coefficient Cronbach’s alpha was calculated and was

found equal to 0.7 indicating acceptable internal consistency.

Statistical analysis included Pearson’s x2 test, x2 test for trend,

student’s t-test, analysis of variance and Pearson’s correlation

coefficient. Face to face interviews were used for data collection.

Native speakers of the participants’ language were recruited in order

to eliminate misunderstandings. Country of origin of immigrants was

Albania, Georgia, Afghanistan, Philippines, Russia, Bulgaria, Nigeria

and Ghana (Chart 1).

Methods

Conclusions

Funding: This research has been co-financed by the European Union (European Social Fund-ESF) and Greek national funds through the Operational Program "Education and Lifelong Learning" of the National Strategic Reference

Framework (NSRF)-Research Funding Program: THALIS-UOA, MIS 377228

Funding: This research has been co-financed by the European Union (European Social Fund-ESF) and Greek national funds through the Operational Program "Education and Lifelong Learning" of the National Strategic Reference

Framework (NSRF)-Research Funding Program: THALIS-UOA, MIS 377228

Chart 2: Immigrants’ public health services knowledge and problems concerning health services

The increasing numbers of migrants and the challenges posed on the

healthcare systems of receiving countries have led to a growing

interest about the healthcare challenges faced by this population.

Greece was traditionally a country which sent immigrants to rapidly

developing countries. However, since the early ‘90s it has

transformed into a country which hosts immigrants, mainly from the

area of the Balkans. In 2009, 958.000 immigrants were estimated to

be living in Greece (including EU citizens) comprising 9% of the

population, 280.000 of which are estimated to be undocumented

migrants (Hellenic Statistical Service, 2011). Evidence shows that

migrants are more vulnerable to social and economic disadvantage,

something that affects health outcomes as well as access to care.

Although immigrants are considered as a high risk group, vulnerable

to poverty and social exclusion, there is a lack of an in-depth analysis

and documentation of the factors that lead to this situation.

This study aims to explore the perceived barriers to access

and utilization of healthcare services by migrants coming to

Greece (both documented and undocumented).

Mean age of the study population was 37.4 years (standard deviation,

10), while mean length of stay in Greece was 76.8 months (standard

deviation, 33.1). One hundred and twenty-seven (66.5%) of

immigrants were employed. Working population consisted of 60

(47.2%) blue-collar workers, 45 (35.4%) white-collar workers and 22

(17.4%) self-employed persons. Only 20.4% (n=39) of the

participants reported that they had a good or very good degree of

knowledge about public health services in Greece. Almost half of the

participants (n=95, 49.7%) used public health services in the last 12

months in Greece. A considerable proportion of the participants

(n=119, 62.3%), needed at least one time to use health services but

they could not afford it. The most important problems concerning

access to health services were: long waiting times in hospitals

(n=115, 60.2%), communication with health professionals (n=87,

45.5%), high cost of health care (n=74, 38.7%) and the system’s

complexity (n=65, 34%) (Chart 2). Increased ability to understand

(p<0.001) and speak (p<0.001) Greek as well as increased length of

stay in Greece (p<0.001) were associated with increased health

services knowledge. Increased family monthly income was associated

with less difficulties in accessing health services (p<0.001).

Based on our findings, the empowerment and facilitation of the health

care access and provision for migrants in Greece is necessary.

Depending on the needs of the migrant population, simple measures

such as information regarding access to the available health services

and the legal frame for this access, is an important step towards

enabling better access to needed services. Public health policy

measures related to appropriate coverage and adaptation of existing

best practices should be taken in order the system to be better able to

respond to increasing numbers of migrants and assist in their social

integration.

27%

22%14%

13%

12%

6%6%

Albania Georgia Afghanistan Nigeria, Ghana

Philippines Bulgaria Russia

20.4%

60.2%

19.4%

49.7%

60.2%

45.5%

38.7%34.0%

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

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degree of knowledge aboutpublic health services in

Greece

problems concerning healthservices

Chart 1: Country of origin of immigrants