Italian asylum reception system and health challenges: The Apulian case

This research investigates the health and migration nexus regarding service provision and migration governance, particularly asylum seekers’ health access. We decided to analyse the case of the Apulia Region, one of the main Mediterranean routes for asylum seekers heading for Europe and representing an exception in the Italian national territory, extending the medical treatments and services provided for Italians and regular migrants to those irregular ones. The analysis relies on the data collected within a research project that aims to create an integrated system of prevention, diagnosis, treatment, and rehabilitation of asylum seekers and holders of international protection on the regional territory. It is mixed-method research based on (1) quantitative data from an ad hoc field survey organised in the reception centres and drafted to retrieve information unavailable in other databases and distributed to, and (2) qualitative data collected through semi-structured interviews with local policymakers, representatives of reception centres, and NGOs. Our results highlight that in the reception process, the medical service appears decisive, and the absence of constant control of health status can cause the worsening of not visible symptoms, creating further psycho-physical problems. Another essential aspect is the importance of the communication: the diffusion of the information and the role of competent intercultural mediators in the outpatient visits in the first-level reception centres, especially during the certification and treatment of violence, torture, or other severe forms of physical, psychological, or sexual violence. Some best practises are presented and some suggestions for further implementations of health services for asylum seekers and refugees are proposed.