Health and social needs of unprotected unaccompanied minors in Paris in the context of COVID-19

Abstract

Background Unaccompanied minors (UMs) are children under 18 settling in foreign countries without the care of a guardian. Host countries' governments are responsible for the care of UMs. In France, UMs theoretically receive child protection. However, assessment systems frequently deny their protection because of minority status rejection. As a result, they navigate through social precarity and have limited access to healthcare services. In Paris, the non-governmental organisation Médecins du Monde (MdM) offers them medico-psycho-social care. In March 2020, lockdown measures to contain COVID-19 further reduced unprotected UMs' access to social and healthcare services. This critical situation prompted MdM to adapt their care provision to the pandemic. In this research, we sought answers to the following research question: what were unprotected UMs' social and healthcare needs during lockdown and what was MdM's response? Methods First, we estimate the evolution of social and healthcare needs of a cohort of 58 unprotected UMs during the eight-week lockdown using secondary data. Second, using interview data with MdM volunteers and staff (n = 15) we further explore UMs' needs and document the experience of phone consultations with this cohort of UMs. Preliminary Results Time series show a constant increase of UMs' needs through time. MdM's new form of care provision may have contributed to alleviate their feeling of isolation. It also had unintended consequences. Conclusions In light of the alarming healthcare status of unprotected UMs, we recommend that France implements the public health authorities' recommendation to provide appropriate shelter to UMs regardless of their status, at least during health crises. Key messages This study fills a research gap related to a pressing political and public health issue. This study advances evidence-informed debates debates on the influence of models of care provision on UMs’ social and healthcare needs during health crises.