TF MFH HPH TASK FORCE ON MIGRANT FRIENDLY HOSPITALS AND HEALTH SERVICES REGIONAL HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA UNITÀ SANITARIA LOCALE DI REGGIO EMILIA 1 HPH TF MFH Task Force on Migrant-Friendly Hospitals and Health Services Annual report and action plan Antonio Chiarenza Leader of HPH-TF MFH AUSL di Reggio Emilia, Italy General Assembly of HPH coordinators and TF leaders 22th International Conference HPH 23 April Barcelona, Spain

TF MFH TF Activities May 2013 – April 2014 VISIBILITY 4-5 September 2013 Norway. Første Nasjonale Konferanse om Migrasjon og Helse, Oslo November 2013 Antalya. 5th International Conference on Patient and Health Worker Rights, Turkey 6 December 2013, Brussels. Diversité à l’Hôpital, quel Rôle pour le Médiateur Interculturel? Belgium March 2014, Greece. Expert meeting. Screening for Infectious Diseases among Migrants in EU/EEA, Athens April 2014, Spain. 5th EUPHA Conference on Migrant and Ethnic Minority Health, Granada HPH TASK FORCE ON MIGRANT FRIENDLY AND CULTURALLY COMPETENT HEALTHCARE HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA USL DI REGGIO EMILIA – DIREZIONE GENERALE 2

TF MFH COST/Action ADAPT ( ) project funded by COST coordinated by Prof David Ingleby (TF leads the Working Group on Health Systems) EQUI-HEALTH ( ) EC-funded project coordinated by IOM “Promoting appropriate health care provision to migrants at the Southern borders of the EU” (Pilot Test Equity Standards) EURO MoMiH ( ) ECDC funded project aimed to develop “Framework for Monitoring Migrant Health and Infectious Diseases”. Coordinated by ISS, Rome (TF MFH is part of the project consortium) MEM-TP ( ). EC-funded project aimed to develop “Migrant and Ethnic Minorties Training Packages” (2012-) coordinated by EASP, Granada (TF is WP leader) HPH TASK FORCE ON MIGRANT FRIENDLY AND CULTURALLY COMPETENT HEALTHCARE HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA USL DI REGGIO EMILIA – DIREZIONE GENERALE 3 TF Activities May 2013 – April 2014 COLLABORATIONS

TF MFH HPH TASK FORCE ON MIGRANT FRIENDLY AND CULTURALLY COMPETENT HEALTHCARE HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA USL DI REGGIO EMILIA – DIREZIONE GENERALE 4 TF Activities May 2013 – April 2014 PUBLICATION “Equity Standards for Health Care Organisations: a Theoretical Framework.” Diversity and Equality in Health Care 10(4): , 2013

TF MFH HPH TASK FORCE ON MIGRANT FRIENDLY AND CULTURALLY COMPETENT HEALTHCARE HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA USL DI REGGIO EMILIA – DIREZIONE GENERALE 5 Project aim: The project aims to develop a comprehensive framework for measuring and monitoring the capacity of healthcare organisations to improve accessibility to appropriate and effective health services; health promotion and preventive care for migrants and other vulnerable groups. Standards for equity in health care: Standard 1: EQUITY IN POLICY Standard 2: EQUITABLE ACCESS AND UTILISATION Standard 3: EQUITABLE QUALITY OF CARE Standard 4: EQUITY IN PARTICIPATION Standard 5: PROMOTING EQUITY Project to develop Standards For Equity in Health Care (started 2011)

TF MFH A set of preliminary standards pilot tested in 45 organisations from 12 countries (April-September 2012) HPH TASK FORCE ON MIGRANT FRIENDLY AND CULTURALLY COMPETENT HEALTHCARE HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA USL DI REGGIO EMILIA – DIREZIONE GENERALE Aims: To assess the clarity, relevance and applicability of the standards To assess the compliance with the standards in pilot- organisations To collect comments and suggestions and effective practices from pilot- organisations COUNTRYN. Organisations AUSTRALIA5 CANADA10 FINLAND2 IRELAND3 ITALY9 NORWAY4 SCOTLAND1 SLOVENIA1 SPAIN5 SWEDEN1 SWITZERLAND1 THE NETHERLAND3 TOTAL45

TF MFH HPH TASK FORCE ON MIGRANT FRIENDLY AND CULTURALLY COMPETENT HEALTHCARE HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA USL DI REGGIO EMILIA – DIREZIONE GENERALE 5 Main standards 19Sub standards 50 Measurable elements Final Equity standards

TF MFH TF MFH Action Plan agreed at HPH General Assembly ( ) Strengthen the evidence base of the equity standards; Identify equity-based indicators that complement the five standards; Develop a self-assessment tool that health care organisations can use to benchmark structures, processes and results related to health equity; Undertake a second pilot-test to evaluate how institutions can utilize the standards and self-assessment process, as well as to explore challenges and opportunities for effective uptake in connection with existing policies and practices. HPH TASK FORCE ON MIGRANT FRIENDLY AND CULTURALLY COMPETENT HEALTHCARE HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA USL DI REGGIO EMILIA – DIREZIONE GENERALE 8

TF MFH 9 HPH TASK FORCE ON MIGRANT FRIENDLY AND CULTURALLY COMPETENT HEALTHCARE HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA USL DI REGGIO EMILIA – DIREZIONE GENERALE Standards For Equity In Health Care Self-Assessment Tool To allow healthcare organizations to assess structures, processes and results, to identify gaps, and develop improvement plans based on the findings from self-assessment

TF MFH 10 HPH TASK FORCE ON MIGRANT FRIENDLY AND CULTURALLY COMPETENT HEALTHCARE HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA USL DI REGGIO EMILIA – DIREZIONE GENERALE SELF-ASSESSMENT TOOL: Three main components 1.Standards-based assessment: to evaluate whether appropriate structures, systems and processes are in place and functioning. 2.Indicators-based assessment: to evaluate whether service performance leads to results. 3.Guidance for action plan development: to identify areas for equity improvement and to develop an improvement plan based on the information gathered through the assessment process. Measurable element Assign a score

TF MFH 11 HPH TASK FORCE ON MIGRANT FRIENDLY AND CULTURALLY COMPETENT HEALTHCARE HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA USL DI REGGIO EMILIA – DIREZIONE GENERALE 1.Standards-based assessment: to evaluate whether appropriate structures, systems and processes are in place and functioning. 2.Indicators-based assessment: to evaluate whether service performance leads to results. 3.Guidance for action plan development: to identify areas for equity improvement and to develop an improvement plan based on the information gathered through the assessment process. SELF-ASSESSMENT TOOL: Three main components Standard 2: Equitable access and utilisation 3 example indicators provided by TF IndicatorDescription/Rationale INTERPRETING SERVICES ARE PROVIDED TO USERS WHO REQUIRE ONE % INTERPRETER USE IN HEALTH CARE ORGANISATION HEALTH LITERACY% OF NEW HEALTH INFORMATION LITERATURE DEVELOPED THAT IS PLAIN LANGUAGE PROOF ACCESS AND UTILISATION OF SERVICES BY THE POPULATION GROUPS % BREAKDOWN OF THE DEMOGRAPHIC PROFILE OF SERVICE USERS ACCESSING SERVICES Additional Indicators: Indicators already used in your organisation; New indicators you may want to consider for the action plan.

TF MFH 12 HPH TASK FORCE ON MIGRANT FRIENDLY AND CULTURALLY COMPETENT HEALTHCARE HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA USL DI REGGIO EMILIA – DIREZIONE GENERALE 1.Standards-based assessment: to evaluate whether appropriate structures, systems and processes are in place and functioning. 2.Indicators-based assessment: to evaluate whether service performance leads to results. 3.Guidance for action plan development: to identify areas for equity improvement and to develop an improvement plan based on the information gathered through the assessment process. SELF-ASSESSMENT TOOL: Three main components

TF MFH 13 HPH TASK FORCE ON MIGRANT FRIENDLY AND CULTURALLY COMPETENT HEALTHCARE HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA USL DI REGGIO EMILIA – DIREZIONE GENERALE PILOT-TEST IMPLEMENTATION April October 2014 Participating countries 1.Australia 2.Belgium 3.Canada 4.Finland 5.Ireland 6.Italy 7.Malta 8.Norway 9.The Netherlands 10.Scotland 11.Slovenia 12.Spain 13.Sweden 14.UK Five phases: 1.Phase. Preparation (April 2014) 2.Phase. Assessment of standards and selection of indicators (April-June 2014) 3.Phase. Identification of improvement areas (July 2014) 4.Phase. Development of action plan (July –September 2014) 5.Phase. Reporting of results (End October 2014)

TF MFH 14 HPH TASK FORCE ON MIGRANT FRIENDLY HOSPITALS AND HEALTH SERVICES REGIONAL HEALTH PROMOTING HOSPITALS NETWORK OF EMILIA – ROMAGNA AZIENDA UNITÀ SANITARIA LOCALE DI REGGIO EMILIA 14 TF MFH