Health care professionals’ experiences and views of sexual and reproductive health service provision to undocumented Roma women in Finland

Abstract

Aim: This qualitative study explores the sexual and reproductive health service provision offered to undocumented Roma women migrating to Finland and traces the major challenges in this regard through the experiences, the perceptions, and the views of Finnish health professionals.
Background: Sexual and reproductive health (SRH) of undocumented Roma women is of a particular concern since the lack of health insurance, their mobility, and disadvantaged educational, social, and economic level make them more vulnerable to health risks. In Finland, the provision of sexual and reproductive health services is limited and not equally distributed across the country, creating obstacles for these patients to address their health problems. Helsinki and few other cities have decided to extend the service provision to this population.
Methods: The applied analytical method is a qualitative manifest content analysis. 7 Finnish health professionals, providing care for undocumented migrants in Helsinki, Finland, were recruited for this study using a criterion sampling.
Main findings: Despite the overall improvement of SRH service provision; there is necessity to train health professionals in working with undocumented patients. There is a severe need of clear guidelines on service provision to this population, more precise definitions of ‘undocumented’, and current health policy’s further improvement in order to avoid inequity in accessing and receiving SRH services. Competent health professionals, smooth communication, successful delivery of patient education and building positive relationship to patients are key important for overcoming the existing barriers and hence, for the ensuring of continuance of care. SRH service provision at lower threshold with availability of Walk-in service proved crucial for improving approachability, accessibility, and provision of SRH health services to undocumented Roma women.
Conclusions: Health professionals, competent in working with undocumented migrants, are crucially important in the public sector’s primary healthcare for meeting this population’s sexual and reproductive health needs. Clear guidelines and straightforward definition of ‘undocumented’ status are required to help health professionals in SRH provision to undocumented patients. Sexual and reproductive health service provision at lower threshold is the instrument toward avoiding more costly medical care. Health policy revision toward unifying the SRH service provision at national level is necessary in order to secure the continuance of care for undocumented Roma women and undocumented migrants as a whole.

Popular Abstract

Throughout her lifetime every woman needs to take care of sexual and reproductive health. Every woman wishes to have a safe sexual life. One day she might want to become pregnant, and then - to give birth to her baby in the safest possible way. It is almost self-explanatory that women only need to book an appointment to the specialized clinic or the nearby health center, if they need a consultation about their child’s health problem or a visit to a doctor for resolving a gynaecological problem. And if we only imagine for a while that we do not have an access to a nurse, midwife or a physician, who would help us solve our health problem, how would it look like? Is it even possible in such a well-organized healthcare system? I wanted to search into this and found out that there are women, who do not have a complete or sometimes, any access to services related to sexual and reproductive health. They do not know how to get to such services and sometimes these services are not even offered to them. Have you heard of undocumented Roma women? They travel from a country to country in order to find economic means to survive and have a fairly harsh mobile life full of health risks. They do not have a residence, nor a social or health insurance at all. I decided to make conversations with health professionals who give care to undocumented Roma women and explore the services’ availability and accessibility in this regard, and look at the challenges involved in this process, set in the Finnish context.
With the help of the material from the interviews, I made certain conclusions. It is not quite clear who is undocumented. There are some general guidelines on care provision to undocumented, but not all sexual and reproductive health services are addressed there and the guidelines seem to be too broad. In Finland every municipality can decided on its own which health services to be available to undocumented. These problems cause confusion among the health professionals; they are not always sure how to approach the situation. Therefore, patients are left without care, due to these unclarities. Handling undocumented patients requires expertise, which not every professional possesses. The good news is that there are professionals in public and third sectors, who are experts and expand the professional knowledge on that. They found a way how to help undocumented Roma women to reach to sexual and reproductive services – they formed a specialized team with a separate Walk-in service, meant for undocumented patients only. The health professionals hope that legislation at a national level would favour undocumented women, so these patients can access sexual
and reproductive services more easily. If you want to learn all issues that they touched upon, you are welcome.

• author: Hristozova, Kalina Georgieva
• supervisor: Pia Svensson
• organization: Social Medicine and Global Health
• course: MPHN40 20221
• year: 2023
• type: H2 - Master's Degree (Two Years)
• subject: Medicine and Health Sciences
• keywords: undocumented Roma women, sexual and reproductive health, sexual and reproductive health service provision, health professionals' experiences
• language: English
• id: 9107272
• date added to LUP: 2023-01-17 12:06:52
• date last changed: 2023-03-07 11:06:32