PROGETTO SPECIALE IMMIGRATIPROGETTO SPECIALE IMMIGRATI

Dott.ssa Giovanna V. DallariDott.ssa Giovanna V. Dallari

THE MULTICULTURAL HOSPITAL = A HOSPITAL FOR EVERYONE

BENCHMARKING, INTERCULTURAL MEDIATION AND WEB SITE: THREE USEFUL

INSTRUMENTS TO IMPROVE COMMUNICATION, HEALTH SERVICES

REENGINEERING AND HEALTH PROMOTION IN

A MULTI-ETHNIC SOCIETY.

• 900,000 emigrated in 1913

• 60 million people of Italian descent worldwide

• 1973 was the first year of balance between emigration/immigration

ITALY: A COUNTRY OF MIGRANT PEOPLE

2004 Migrant population

in Italy

• 2,470,000 • 4.2 % of the Italian

population• 190 nationalities

in Bologna

• 22,663• M 11,013• F 11,650• more than 130 ethnic

groups• Most used services:

obstetrics & gynaecology

First 10 nationalities in Bologna10 Largest National Groups In The City Of Bologna

(31/12/2003)

2769

2507

158714751424

854 814 769 727 691 616 533

0

500

1000

1500

2000

2500

3000

Nu

mb

er

of

peo

ple

fro

m e

ach

co

un

try

Foreign Population of Bologna by age-band and sex at 31/12/2003

0

500

1,000

1,500

2,000

2,500

3,000

3,500

0-4 5-9 10-14 15-19 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90-94

Femmine

Maschi

• It’s impossible to satisfy the needs of each ethnic group

• Bologna’s LHU has implemented a set of services, focused on individual needs and on the reengineering of health services which are

• more accessible, appropriate and sensitive to every patient and service user

whether Italian or not

Progetto Speciale ImmigratiProgetto Speciale Immigrati MISSION

Improve access for immigrants to all the health services in Bologna by working in partnership with all relevant agencies in all sectors.

The unit is supported by a The unit is supported by a networknetwork involving involving volunteers associations, public and private sectorvolunteers associations, public and private sector Institutions

Actions and Instruments (1)

• Analysis of the law, medical literature and experiences at local, national and international level

• involvement of all stakeholders in the community• a comprehensive health programme and monitoring

process• specific training for socio-health and administrative

staff• patient education programmes • intercultural mediators (liaison officers) training

course• analysis of quality perception in different health

services

• multicultural menu• a web site showing all the information tools, documents, projects,

laws, activities, news, links, etc. related to immigrants’ social and health care

• informative brochures in different languages

• intercultural liaison officers to help bridge the cultural and linguistic divides between patient and healthcare professional – eight

languages • free telephone line and information centre

– offers counselling and information on health services in eight languages to support foreign citizens and socio-health professionals

– a consultative instrument which enables users to contribute effectively to service development

Actions and Instruments (2)

Particular relevance…

1. Benchmarking

2. Liaison officer (intercultural mediators) and free line

3. Web site

1) Benchmarking

Continuous improvementContinuous improvement

To be as good as the bestTo be as good as the best

Work with exemplars in Italy and EuropeWork with exemplars in Italy and Europe

2) Liaison Officers (intercultural mediators)

• In 1998 the Regional Government organized for the first time an EU funded a 700 hour training course for liaison officers (350 + 350 hours)

• Later on…Liaison officers created AMISS (Associazione Mediatrici Interculturali Socio - Sanitarie), the Socio-Health Liaison officers organization

Health For

EveryoneHealth Promoting Hospitals

Intercultural Hospital Project

Multi Lingual•Free Line•Information Service

the aim of the multi lingual information service

to solve Immigrants’ Problems in Health and Social Services access

Objectives

• To ensure equal access to Health and Social Services in the Province of Bologna

• To help in the reengineering of the hospital organization, structure and activities

• To implement communicational and educational activities, to protect migrants from social and cultural differences

To achieve better access and better health

Main Activities

• Information about health assistance rights

• Information about the correct use of services offered by the health service and social services offered by local government

• Contribution to the reengineering of the hospital and ward services

• Connection with volunteer services

• Set up innovative activities

• Teaching in the Multicultural Course for health and social services professionals

3) The web site

Health’s colours

Objectives• To create a reference point for institutions

charged with improving access to Health Services

• To facilitate dissemination of best practice

• To create a network of public and private institutions to monitor and improve access opportunities for migrant citizens

Scientific Committee & Local, Regional, National and international contributors

Future plans

• Cross-culture communication enhanced by use of translated information cards and pictorial aids, also useful for illiterate people.

• Diverse spiritual care.

TOTAL NUMBER OF ITALIAN CITIZENS RESIDENT IN BOLOGNA 01/01/2003 355,785

MALE ITALIAN CITIZENS 165,249

FEMALE ITALIAN CITIZENS 190,478

TOTAL NUMBER OF FOREIGN RESIDENTS 17,807

MALE FOREIGN RESIDENTS 8,876

FEMALE FOREIGN RESIDENTS 8,931

% FOREIGNERS 4.77

% MALE FOREIGNERS 5.1

% FEMALE FOREIGNERS 4.48

Az. Di ricovero EsteroAltre

Regioni Bo sud Bo nord Bo città Totale

Bo sud 60 1.898 11.611 458 2.073 16100

Bo nord 40 587 999 19.462 1.399 22487

Bo città 487 11.888 16.546 5.764 34.882 69567

Az OSP Bo 1.656 10.874 12.806 5.955 34.333 65.624

IOR 161 9.629 1.269 759 2.351 14.169

Totali Bologna 2404 34.876 43.231 32398 75.038 187.947

Provenienza

Health promotion is a global socio – political process based on:

•empowerment of people, to enable them to take care of their own wellbeing and health determinants•also based on actions aimed to make changes in social, economical and ecological environment, to reduce their impact on health.

• Among the reasons for migration is to look for better job opportunities, therefore a form of natural selection takes place in their own countries

healthy migrant effecttherefore migrant workers were mainly

healthy young men.

The ten largest national groups in RER

30%

11%

7%

5%

5%

4%4% 4%

8%

22%

Morocco

Albania

Tunisia

Romania

China

Senegal

Philippine

Pakistan

Ghana

India