progetto speciale immigrati dott.ssa giovanna v. dallari
TRANSCRIPT
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PROGETTO SPECIALE IMMIGRATIPROGETTO SPECIALE IMMIGRATI
Dott.ssa Giovanna V. DallariDott.ssa Giovanna V. Dallari
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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.
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• 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
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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
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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
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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
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• 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
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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
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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
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• 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)
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Particular relevance…
1. Benchmarking
2. Liaison officer (intercultural mediators) and free line
3. Web site
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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
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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
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Health For
EveryoneHealth Promoting Hospitals
Intercultural Hospital Project
Multi Lingual•Free Line•Information Service
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the aim of the multi lingual information service
to solve Immigrants’ Problems in Health and Social Services access
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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
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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
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3) The web site
Health’s colours
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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
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Future plans
• Cross-culture communication enhanced by use of translated information cards and pictorial aids, also useful for illiterate people.
• Diverse spiritual care.
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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
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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
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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.
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• 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.
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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