1. PROGETTO SPECIALE IMMIGRATI Dott.ssa Giovanna V. Dallari

2. THE MULTICULTURAL HOSPITAL = A HOSPITAL FOR EVERYONE BENCHMARKING, INTERCULTURAL MEDIATION AND WEB SITE: THREE USEFUL INSTRUMENTS TO IMPROVE COMMUNICATION, HEALTH SERVICES REENGINEERING AND HEALTH PROMOTION IN A MULTI-ETHNIC SOCIETY.

3. 900,000 emigrated in 1913 60 million people of Italian descent worldwide 1973 was the first year of balance between emigration/immigration ITALY: A COUNTRY OF MIGRANT PEOPLE

4. 2004 Migrant population in Italy 2,470,000 4.2 % of the Italian population 190 nationalities in Bologna 22,663 M11,013 F11,650 more than 130 ethnic groups Most used services: obstetrics & gynaecology

5. First 10 nationalities in Bologna

7. It’s impossible to satisfy the needs of each ethnic group Bologna’s LHU has implemented a set of services, focused on individual needs and on the reengineering of health services which are more accessible, appropriate and sensitive to every patient and service user whether Italian or not

8. Progetto Speciale Immigrati MISSION Improve access for immigrants to all the health services in Bologna by working in partnership with all relevant agencies in all sectors. The unit is supported by a network involving volunteers associations, public and private sector The unit is supported by a network involving volunteers associations, public and private sector Institutions

9. Actions and Instruments (1) Analysis of the law, medical literature and experiences at local, national and international level involvement of all stakeholders in the community a comprehensive health programme and monitoring process specific training for socio-health and administrative staff patient education programmes intercultural mediators (liaison officers) training course analysis of quality perception in different health services

10. multicultural menu a web site showing all the information tools, documents, projects, laws, activities, news, links, etc. related to immigrants’ social and health care informative brochures in different languages intercultural liaison officers to help bridge the cultural and linguistic divides between patient and healthcare professional – eight languages free telephone line and information centre –offers counselling and information on health services in eight languages to support foreign citizens and socio-health professionals –a consultative instrument which enables users to contribute effectively to service development Actions and Instruments (2)

11. Particular relevance… 1.Benchmarking 2.Liaison officer (intercultural mediators) and free line 3.Web site

12. 1) Benchmarking Continuous improvement To be as good as the best Work with exemplars in Italy and Europe

13. 2) Liaison Officers (intercultural mediators) In 1998 the Regional Government organized for the first time an EU funded a 700 hour training course for liaison officers (350 + 350 hours) Later on…Liaison officers created AMISS (Associazione Mediatrici Interculturali Socio - Sanitarie), the Socio-Health Liaison officers organization

14. Health For Everyone Health Promoting Hospitals Intercultural Hospital Project Multi Lingual Free Line Information Service

15. the aim of the multi lingual information service to solve Immigrants’ Problems in Health and Social Services access

16. Objectives To ensure equal access to Health and Social Services in the Province of Bologna To help in the reengineering of the hospital organization, structure and activities To implement communicational and educational activities, to protect migrants from social and cultural differences To achieve better access and better health

17. Main Activities Information about health assistance rights Information about the correct use of services offered by the health service and social services offered by local government Contribution to the reengineering of the hospital and ward services Connection with volunteer services Set up innovative activities Teaching in the Multicultural Course for health and social services professionals

18. 3) The web site Health’s colours

20. Objectives To create a reference point for institutions charged with improving access to Health Services To facilitate dissemination of best practice To create a network of public and private institutions to monitor and improve access opportunities for migrant citizens Scientific Committee & Local, Regional, National and international contributors

21. Future plans Cross-culture communication enhanced by use of translated information cards and pictorial aids, also useful for illiterate people. Diverse spiritual care.

23. TOTAL NUMBER OF ITALIAN CITIZENS RESIDENT IN BOLOGNA 01/01/2003355,785 MALE ITALIAN CITIZENS165,249 FEMALE ITALIAN CITIZENS190,478 TOTAL NUMBER OF FOREIGN RESIDENTS17,807 MALE FOREIGN RESIDENTS8,876 FEMALE FOREIGN RESIDENTS8,931 % FOREIGNERS4.77 % MALE FOREIGNERS5.1 % FEMALE FOREIGNERS4.48

24. Az. Di ricoveroEstero Altre RegioniBo sudBo nordBo cittàTotale Bo sud 601.89811.6114582.073 16100 Bo nord 4058799919.4621.399 22487 Bo città 48711.88816.5465.76434.882 69567 Az OSP Bo 1.65610.87412.8065.95534.333 65.624 IOR 1619.6291.2697592.351 14.169 Totali Bologna240434.87643.2313239875.038187.947 Provenienza

25. Health promotion is a global socio – political process based on: empowerment of people, to enable them to take care of their own wellbeing and health determinants also based on actions aimed to make changes in social, economical and ecological environment, to reduce their impact on health.

26. Among the reasons for migration is to look for better job opportunities, therefore a form of natural selection takes place in their own countries healthy migrant effect therefore migrant workers were mainly healthy young men.