1. HEALTH PROMOTION FOR MIGRANTS IN THE CZECH REPUBLIC Hana Janata MD PhD hana.janata@szu.cz http://http://www.szu.cz/tema/p odpora-zdravi/healthy-inclusion National Institute of Public Health Centre for Health Promotion

2. BACKGROUND  Project Healthy Inclusion : Development of Recommendations for Integrating Socio-Cultural Standards in Health Promoting Offers and Services ( 2.PHP 2008-2010)  Objective: to contribute to increasing the participation of migrants in health promotion interventions.  Gain knowledge about barriers for migrants in accessing health promotion interventions  Gain knowledge about positive factors for participation of migrants in health promoting activities  Raise awareness on the importance of migrants’ needs concerning the design of health promotion interventions  Contribute to networking of relevant actors in the field of migration and health.

3. BACKGROUND - CHARACTERISTICS OF MIGRANTS  Population of migrants – 451 923 documented persons (4, 2% of population if the CZ) comes mainly from the third countries: Ukraine, Vietnam, Russia and Asian countries of the former Soviet Union. Asylum seekers and documented migrants with permanent residency ( 53 %)have the same right and access to health care based on public health insurance as Czech citizens.

4. MIGRANTS´ S HEALTH „ Healthy migrant effect“ : they feel more healthy than the main population especially at the beginning of emigration and they probably are ( even the undocumented migrants They consume less health care and treatment. They don´t participate on prevention programmes and screenings. Another explanatory hypothesis is that migrant´s feeling what is illness, pain or when to look for treatment is different. Longer they stay in the CR the better access to health care they have, the more they use it and their health status is the same or worse than health of majority population ( work more days a week and longer, their behaviour is becoming more non - healthy : smoking, alcohol, unhealthy diet habits.

5. THE MAIN HEALTH PROBLEMS MIGRANTS  Work related injuries  Mental disorders (alcohol abuse consequences and post-traumatic stress disorders  Dental health

6. HEALTH PROMOTION  Health promotion is free, anonymous and nobody is excluded... Migrants can use it most probably during special actions called Healthy Days in companies with high proportion of migrants (Ukraine’s) or among migrant’s communities (Vietnamese’s).

7. INTERVENTION  “Health Days” – prevention of chronic disease  This method is based on a free offer of services in the community or in special settings, including schools, senior homes and workplaces. They are often organised as a part of other events for the public (such as exhibitions and cultural and sporting events). The HP professionals offer a free of charge services. They varies according to personal, technical and financial resources and generally consists of:  measurement and examination of health indicators, including blood cholesterol, body fat, glucose, body mass index and blood pressure;  determination based on the objective measurement of the individual’s health status and risks in life style;  consultation on smoking cessation;  consultation on HIV/AIDS prevention  injury prevention programs for children  free overall consultation and advice on how to improve lifestyle

8. GOOD PRACTICE FOR MIGRANTS  Medical students –both Vietnamese and Czech provide Health Days for migrants in the largest Vietnamese community in Prague:  increase interest on prevention, healthy life style  decrease socio – cultural barriers on both side: Czech medical students and migrants: mutual trust support  HP for migrants: needs to go to them and not expect they would go to you, professionals

9. BARRIERS FOR MIGRANTS TO PARTICIPATE ON HEALTH PROMOTION INTERVENTION  Lack of information, Lack of time, No need („ I am healthy“)  Possible barriers: religion, are not much important in CZ: orthodox Christians ( Ukraine), Buddhists ( Vietnam)  Language : in two years migrants feel comfortable using Czech – they are motivated to learn for better integration  Migrants encountered health promotion either by chance or by taking advantage of an opportunity offered by their employers. Almost all found it useful, interesting and even good fun. The positive motivation to participate in a campaign was the possibility of winning prizes. The motivation to participate in ‘Health Days’ at work was: no fees and participation during working hours.

10. CONCLUSION  Migrants themselves do not demand special services but they wish to be involved in projects and services designed for the domestic population.  However ( universal/specific approach)  Access to health promotion is equal in the Czech Republic and it does not depend on health insurance, it is free of fees and anonymous. „Health days“ in migrants settings ( communities, enterprises) seems to be the effective way to increase interest and information about other health promotion intervencies and preventive measures in health care facilities ( screening, vaccination)