National health examination protocol for asylum seekers in Finland
Submitted by: Awa Ahmed Haji Omar, Project coordinator, Finnish Institute for Health and Welfare
Email: [email protected]
Introduction to the project
January 2017-December 2019
The national health examination protocol eases the pressure on the host country by providing a feasible, evidence-based and structured way of conducting initial health examination for recently arrived asylum seekers. All health care professionals that perform these health examinations are able to carry them out efficiently and in a coherent manner. The protocol also provides a monitoring tool for the health status of asylum seekers.
The health examination protocol also fosters the asylum seekers’ self-reliance because they are provided with comprehensive information about their health status, both physical and mental health. Asylum seekers are referred to further services if necessary and are provided with health promotion information, such as psychoeducation which enhances people’s self-reliance.
The national development project for the health examination protocol for asylum seekers in Finland (TERTTU) aimed to develop a national health examination protocol for assessing the health, well-being, and need for health care services of asylum seekers.
In Finland, asylum seekers are entitled to a voluntary health examination carried out by a nurse within two weeks from their arrival. The objectives of the health examination are not only to screen for illnesses, but also to recognize vulnerable groups in need of special care (e.g. pregnant women, victims of torture and human trafficking, victims of sexual violence).
As a part of the project, the Asylum Seekers Health and Wellbeing Survey (TERTTU), the largest population-based health examination survey among asylum seekers to date, was carried out. The survey aimed to provide information on the health and well-being, risk factors, and service needs of adults and children who applied for asylum in Finland during the year 2018. This survey-based information was used in the development process of the health examination protocol. Additionally, in the development process, qualitative interviews and workshops were carried out with key stakeholders, such as authorities, receptions center nurses and recently-arrived asylum seekers.
The health examination protocol and its recommendations will be further specified in a guidebook for the reception centre nurses. The guidebook will provide a comprehensive description regarding the good practices in conducting health examinations among asylum seekers.
The European Union, the Asylum, Migration and Integration Fund (AMIF) (Donor)
Finnish government: The implementation of this project was facilitated by the good collaboration between the Finnish Institute for Health and Welfare and the Finnish Immigrations Service. Finnish Immigration Service is an agency working under the Finnish Ministry of Interior. The agency coordinates and organizes health services provided to all asylum seekers. The project was funded by The European Union, the Asylum, Migration and Integration Fund (AMIF).
How challenges were overcome
Challenges encountered in the delivery of the project were related to the electronic patient health record development. In fact, another main goal of the project is to build a systematic and structured system of documentation to store the data collected during the health examinations. The challenge was overcome when a multi-professional approach was developed to gather and store the electronic health records of the patients.
Results of the Good Practice
The national health examination protocol will be implemented in reception centres from 1st Jan 2020 onwards. It is expected that the national health examination protocol will improve the lives of asylum seekers arriving in Finland due to the implementation of unified and evidence-based practices. The protocol will consist of an assessment of the overall health and well-being of the individual and include screening for infectious diseases and vaccinations, improved assessment of service needs, and the identification of vulnerable populations (victims of torture, severe trauma, human trafficking, sexual minorities, disabled and elderly).
Although the project finishes in December 2019, the Finnish Immigration Service will implement and launch the national health examination protocol in the reception centres through training sessions and by providing recommendations. Equally important, the good collaboration between the stakeholders will continue beyond the end of the program.
In the future, it will be important to monitor the initial health examinations and vaccinations coverage, the need and usage of health services outside of the reception centre, as well as the health and wellbeing of asylum seekers more comprehensively and based on data from the electronic patient health records. Regularly executed population-based surveys on the health and wellbeing of asylum seekers will be needed as asylum seeking processes and profiles of asylum seekers change over time
Recording of the Final Seminar for the Asylum Seekers Health and Well-Being Survey (only in Finnish):