Monitoring equity in the delivery of health services: a Delphi process to select healthcare equity indicators.

Aims Of The Study: Health equity is a key component of quality of care and an objective for a growing number of quality improvement projects for deontological, ethical, public health and economic reasons. To monitor equity in the delivery of health services in Switzerland, there is a need to implement valid, measurable and actionable equity indicators, along with vulnerability stratifiers such as migrant status, which could lead to differences in quality of care. The aim of this study was to develop a set of healthcare equity indicators and stratifiers targeting inpatient and outpatient populations and to test their feasibility.

Recruitment and Attrition for Panel Surveys of Hard-to-reach Populations: Some Lessons from a Longitudinal Study on Undocumented Migrants.

Conducting research among hard-to-reach populations is a difficult endeavor because some of their characteristics are known to be associated with survey nonresponse and panel attrition. In the case of the Parchemins study, which followed undocumented migrants over their process of regularization and during the first years of regularized life in Geneva, we underscore the difficulties in recruiting and keeping respondents who come from such a hard-to-reach population. Factors hindering their participation include the fear of being denounced as undocumented, missing time due to high workload, health issues, or language problems.

Chagas disease is a low health priority among high-risk Latin American migrants in Geneva, a qualitative study.

This qualitative study of the situation of Latin American migrants with Chagas Disease in Geneva analyses how precarious migration-related socioeconomic conditions determine health priorities and disease perception. The study was conducted between 2016 and 2019 and is based on survey data collected in three Chagas-related community events, as well as on open-ended interviews with Bolivian migrants. This research contributes to more appropriate development of public health policies for migrants, as well as to a more nuanced and culturally sensitive understanding of how precarity affects the delivery of, and access to, healthcare in Western Europe.

Working Conditions and Self-Reported Health Among Undocumented and Newly Regularized Migrants in Geneva: A Cross-Sectional Study.

Most undocumented migrants are employed in so-called "dirty jobs" or "3D jobs" (dangerous, dirty and degrading) due to their lack of legal status. This study aimed to describe the self-reported health of undocumented and newly regularized migrants in relation to their working conditions. A cross-sectional study was conducted using data collected during the first phase of the study (2017-18), a survey that monitors the socioeconomic and health impact of a regularization scheme for undocumented workers in Geneva, Switzerland.

[Eco-competences for a sustainable medical practice].

Climate and environmental changes require primary care physicians to adapt their practices. This article presents resources and actions contributing to reduce the impact of medical practice by implementing the CanMEDS competences in an environmental perspective.

[Research about vulnerable populations: challenges and opportunities].

There is an important gap in health knowledge about vulnerable and hard-to-reach groups. The development of research projects and the implementation of interventions require strategies adapted to the particularities of these groups. This article reviews some of the main issues through the lens of recent projects conducted in French-speaking Switzerland.

[Health equity: an often misused concept].

The use of the concept "health equity" is more and more widespread. It is often considered as a major objective in health policies aimed at improving healthcare for populations in a vulnerable situation. However, the understanding of "health equity" is often subject to confusion and it can be misinterpreted with the concept of "health equality".

Impact of legal status regularization on undocumented migrants' self-reported and mental health in Switzerland.

Undocumented migrants face cumulative difficulties like precarious living and working conditions or exclusion from health services that might negatively influence their health. Little is known about the evolution of undocumented migrants' self-reported health (SRH) and mental health after they get documented. This study aims to observe the effect of legal status regularization on SRH and mental health in a cohort of migrants undergoing regularization in Geneva, Switzerland.

Learning from the COVID-19 pandemic response to strengthen undocumented migrant-sensitive health systems: case studies from four countries.

Undocumented migrants are a vulnerable population group in the context of the COVID-19 pandemic due to increased risk of infection, severe morbidity, and mortality. In this Personal View, we analyze the COVID-19 pandemic responses, particularly vaccination campaigns, vis à vis undocumented migrants, and discuss lessons learned. Our empirical observations as clinicians and public health practitioners in Italy, Switzerland, France, and the United States are supplemented by a literature review, and presented through country case studies focusing on Governance, Service Delivery, and Information.

New metabolic signature for Chagas disease reveals sex steroid perturbation in humans and mice.

The causative agent of Chagas disease (CD), , claims thousands of lives each year. Current diagnostic tools are insufficient to ensure parasitological detection in chronically infected patients has been achieved. A host-derived metabolic signature able to distinguish CD patients from uninfected individuals and assess antiparasitic treatment efficiency is introduced.

[Management of chronic heart failure: updates and implications for the primary care physician].

The latest recommendations of the European Society of Cardiology on chronic heart failure published in 2021 propose several new concepts. The main changes include a revision of the classification but most importantly modifications in the therapeutic management, especially concerning the first-line treatment of heart failure with reduced ejection fraction. Since heart failure affects approximately 2% of the general population, these new recommendations will have a definite impact on the practice of primary care physicians.

[Teaching planetary health in pregraduate medical curriculum in Switzerland].

Environmental degradation, including climate change, is causing increasing threats to human health. To address these issues, health professionals, including future physicians, need to be educated in planetary health and sustainable healthcare. This article discusses possible content for pre-graduate education in planetary health and methods of implementation in the curriculum.

Association Between Residence Status Regularization and Access to Healthcare for Undocumented Migrants in Switzerland: A Panel Study.

Background: Switzerland has a universal healthcare system. Yet, undocumented migrants face barriers at different levels that hinder their access to healthcare services. The aim of this study is to assess whether undocumented migrants' healthcare utilization improves with residence status regularization.

COVID-19 vaccine hesitancy among undocumented migrants during the early phase of the vaccination campaign: a multicentric cross-sectional study.

Study Objectives: The marginalisation of undocumented migrants raises concerns about equitable access to COVID-19 vaccination. This study aims to describe migrants' hesitancy about the COVID-19 vaccination during the early phase of the vaccination campaign.

Setting: This multicentric cross-sectional survey was conducted in health facilities providing care to undocumented migrants in the USA, Switzerland, Italy and France in February-May 2021.

The well-being of newly regularized migrant workers: Determinants of their satisfaction with life as compared to undocumented migrant workers and regular local residents.

Subjective assessments of well-being are becoming routine indicators, considering that material resources are insufficient to capture people's satisfaction with life. Examining the unique situation of undocumented migrant workers, driven by aspirations for a better life but constrained by their limited rights in the country of destination, we assess their satisfaction with life and the factors that matter in their evaluations. Data were collected in Geneva (Switzerland), in a study comparing those who have just received a residency permit or about to obtaining it after submitting a regularization request ( = 195) with those who were still undocumented and/or had not submitted a regularization request at the time of our study ( = 231).

Equity in access to COVID-19 testing for undocumented migrants and homeless persons during the initial phase of the pandemic.

Introduction: The COVID-19 pandemic has excessively affected socially and economically deprived groups of population. There is a dearth of empirical evidence about the effect of policies regulating access to care for such groups. This study aims to document the impact of an equity-based strategy to facilitate access to COVID-19 testing during the initial phase of the pandemic.

Vulnerable patients forgo health care during the first wave of the Covid-19 pandemic.

During the first wave of the Covid-19 pandemic, access to health care was limited, and patients encountered important delays for scheduled appointments and care. Empirical data relying on patients' reports of forgoing health care are scarce. This study investigated Covid-19-related self-reports of forgoing health care in a sample of vulnerable outpatients in Geneva, Switzerland.

Self-rated health among undocumented and newly regularized migrants in Geneva: a cross-sectional study.

Background: In Europe, knowledge about the social determinants of health among undocumented migrants is scarce. The canton of Geneva, Switzerland, implemented in 2017-2018 a pilot public policy aiming at regularizing undocumented migrants. We sought to test for associations between self-rated health, proven eligibility for residence status regularization and social and economic integration.

Mental health of undocumented migrants and migrants undergoing regularization in Switzerland: a cross-sectional study.

Background: Undocumented migrants live and work in precarious conditions. Few studies have explored the mental health consequences of such environment. The objective of this study is to describe the mental health of migrants at different stages of a regularization program.

[Vulnerable populations and COVID-19 : need for innovation and cooperation to address health and social needs].

The COVID-19 crisis has rapidly increased the vulnerability of groups of population already facing precarious living conditions. The emergence of food and housing insecurity have forced health and social actors along with the local authorities to implement innovative responses in order to respond to these unmet needs. This article presents some of these responses, such as an interdisciplinary mobile COVID-19 screening team, an emergency housing program and a large-scale food assistance program.

[Integrative and complementary primary care medicine: new evidence in 2020].

Integrative medicine proposes a coordinated approach to conventional medicine and complementary treatments. This approach is of particular interest in the field of prevention and in comprehensive primary care. This article presents some key studies published in 2020, which highlight the potential benefits of an integrative approach in primary care medicine.

The Impact of the Covid-19 Pandemic and the Lockdown on the Health and Living Conditions of Undocumented Migrants and Migrants Undergoing Legal Status Regularization.

Undocumented migrants are at high risk of adverse consequences during crises because of a lack of access to essential securities and sources of support. This study aims to describe the impact of the COVID-19 crisis on the health and living circumstances of precarious migrants in Switzerland and to assess whether those undergoing legal status regularization fared better than undocumented migrants. This cross-sectional mixed methods study was conducted during the COVID-19 lockdown in April-May 2020.