Which factors promote and deter the implementation of migrant-sensitive health care?: Exemplary focus group discussions with staff in rehabilitative care

Abstract

Background Despite a higher need for rehabilitation, migrants are less likely to use rehabilitative care than non-migrants and have poorer rehabilitative care outcomes. Migrant-sensitive health care strategies, which consider migrants' needs and expectations, can contribute to reducing barriers that migrants encounter in the health system. Currently, only few hospitals in Germany employ such strategies. The present study aims to explore factors promoting and deterring their implementation in medical rehabilitation from the perspective of health care staff. Methods Eight qualitative focus group discussions with a total of 50 employees from different professions have been conducted in orthopedic rehabilitation hospitals in the federal states of North Rhine-Westphalia and Schleswig-Holstein. Employees were interviewed with respect to barriers and promoting factors regarding the implementation of migrant-sensitive health care strategies. Results The health care staff considers migration-sensitive rehabilitative care to be necessary and is highly motivated to implement services accordingly. Factors deterring the implementation of migrant-sensitive services are considered to be the lack of financial and personnel resources, e.g., needed to employ additional multilingual staff. Further potential for improvement is reported with respect to a limited migrant-sensitivity among funders of health care. Conclusion Barriers identified need to be overcome in order to promote the implementation of migrant-sensitive health care services. They can be the starting point for a diversity-sensitive health care which also takes into account the role of other diversity characteristics.