Access to health care for undocumented migrants in Belgium: SWOT analysis of the procedure of urgent medical aid

This project aimed at providing an in-depth analysis of the current practice of Urgent Medical Aid (UMA) for Undocumented Migrants (UM) in Belgium. The specific objective was to identify strengths, weaknesses, opportunities and threats (SWOT) of the current procedures for granting undocumented migrants access to health care, with three sub-questions as per terms of reference:

What are the difficulties for UM getting UMA approval (at the levels of health care providers and CPAS/OCMW)?
Are there difficulties for UM getting access to health care under UMA?
Does UMA generate major difficulties for health care services or administrative services?

Upon a quick introductory literature review, 33 in-depth interviews were conducted with undocumented migrants, 6 focus groups with health care professionals and managers and 3 brainstorming and evaluating sessions with key informants were held. This latter group also acted as the overall advisory board for the study. The information collected from the three groups of participants were analysed in three separate SWOT analyses, indicating the ‘Strengths’, ‘Weaknesses’, ‘Opportunities’ and ‘Threats’ related to the procedure of Urgent Medical Aid for undocumented migrants in Belgium. We subsequently compared the three SWOT matrices for each of the subthemes of the legal and political framework and procedures on the one hand, and of the provision and quality of urgent medical aid for undocumented migrants on the other hand. When analysing the SWOT matrices of our different participants, four key themes emerged which are cutting across the legal and political frameworks as well as across the quality elements of the provided care. We consider them to be the key bottlenecks linking the most important problems and challenges in the current implementation of urgent medical aid for undocumented migrants in Belgium, namely (1) definition of urgent medical aid, (2) information and communication, (3) application of procedures, and (4) decision-making process.

At the end of December 2015, the report was issued by KCE and can be downloaded from their site: click here. The recommendations made are taken further by different political parties in 2016.