Abstract

Intercultural mediators are employed to resolve linguistic and cultural barriers in a variety of health-care contexts. This report examines the main roles performed by intercultural mediators in health care across the WHO European Region and analyses evidence on their effectiveness in improving accessibility and quality of care for refugees and migrants, and the factors that enable them to have a positive impact. The beneficial impact of intercultural mediators is hindered by a lack of professionalization, insufficient training and the non-systematic and inconsistent implementation of intercultural mediation programmes. Developing training programmes and accreditation systems, further research into the effectiveness of intercultural mediators in health care, and the development of strategies that guarantee access to intercultural mediators in health care wherever and whenever needed will enormously improve the quality of health care for refugees and migrants.

Contents

• ABBREVIATIONS
• CONTRIBUTORS
• SUMMARY
• 1. INTRODUCTION
  • 1.1. Background
  • 1.2. Methodology
• 2. RESULTS
  • 2.1. Roles of intercultural mediators in health care
  • 2.2. Training, accreditation and deployment
  • 2.3. Contributions and effectiveness of intercultural mediators in health care
  • 2.4. Factors facilitating the performance of intercultural mediators
• 3. DISCUSSION
  • 3.1. Strengths and limitations of the review
  • 3.2. Development of intercultural mediation as a fully integrated health profession
  • 3.3. Further research
  • 3.4. Policy considerations
• 4. CONCLUSIONS
• REFERENCES
• ANNEX 1. SEARCH STRATEGY
• ANNEX 2. MAIN DIFFERENCES BETWEEN INTERPRETERS AND INTERCULTURAL MEDIATORS IN HEALTH CARE

Suggested citation:

Verrept H. What are the roles of intercultural mediators in health care and what is the evidence on their contributions and effectiveness in improving accessibility and quality of care for refugees and migrants in the WHO European Region? Copenhagen: WHO Regional Office for Europe; 2019 (Health Evidence Network (HEN) synthesis report 64).

The Health Evidence Network

The Health Evidence Network (HEN) is an information service for public health decision-makers in the WHO European Region, in action since 2003 and initiated and coordinated by the WHO Regional Office for Europe under the umbrella of the WHO European Health Information Initiative (a multipartner network coordinating all health information activities in the WHO European Region).

HEN supports public health decision-makers to use the best available evidence in their own decision-making and aims to ensure links between evidence, health policies and improvements in public health. The HEN synthesis report series provides summaries of what is known about the policy issue, the gaps in the evidence and the areas of debate. Based on the synthesized evidence, HEN proposes policy considerations, not recommendations, for policy-makers to formulate their own recommendations and policies within their national context.

The Migration and Health programme

The Migration and Health programme, formerly known as Public Health Aspects of Migrants in Europe (PHAME), was established in 2011 to support Member States of the WHO European Region to strengthen the health sector's capacity to provide evidence-informed responses to the public health challenges of refugee and migrant health. The programme operates under the umbrella of the European health policy framework Health 2020. The programme provides support to Member States under four pillars: technical assistance; health information, research and training; partnership building; and advocacy and communication. The programme promotes a collaborative intercountry approach to migrant health by facilitating cross-country policy dialogue and encouraging homogeneous health interventions along the migration routes to promote the health of refugees and migrants and protect the health of the host community.

Evidence for health and well-being in context

The Evidence for health and well-being in context project was initiated by the WHO Regional Office for Europe in response to Members States' demand for more locally relevant health information. As part of this project, a specific initiative examines the cultural contexts of health and well-being. Awareness of cultural contexts has always been central to the work of WHO, and the importance of cultural contexts is increasingly being recognized, whether in investigating the attitudes that determine the success or failure of immunization programmes as part of the European Vaccine Action Plan or in understanding community resilience and well-being in the face of poor health and economic hardship. The initiative aims to take a more systematic approach to investigating how culture affects the perceptions of, access to and experiences of health and well-being in order to help to improve health interventions and health policy-making. Supported by an expert group, the project works horizontally within WHO Regional Office for Europe and provides technical assistance to various programmatic areas by drawing on scholarship from the humanities and social sciences to promote a more nuanced, contextual understanding of a variety of public health challenges.

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Suggested citation. Verrept H. What are the roles of intercultural mediators in health care and what is the evidence on their contributions and effectiveness in improving accessibility and quality of care for refugees and migrants in the WHO European Region? Copenhagen: WHO Regional Office for Europe; 2019 (Health Evidence Network (HEN) synthesis report 64).

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