New report on addressing communication barriers for refugees and migrants in the WHO European Region

WHO/Malin Bring

Health workers in a Swedish centre for migrants assist a man seeking asylum to register his health information.

The provision of effective health care to linguistically and culturally diverse migrant populations is a critical public health challenge. Communication barriers can severely hamper refugee and migrants’ access to, and use of, health-care services.

To help inform the development of national policies, a new Health Evidence Network (HEN) synthesis report has been published summarizing the best available evidence on strategies to address communication barriers for refugees and migrants in health-care settings across the WHO European Region. This is the 9th report of the HEN themed issues on migration and health.

The report was launched at the ministerial lunch at the 68th session of WHO Regional Committee for Europe in September 2018, where minsters of health from the Region outlined migration and health developments, as well as areas of future focus at the global level. The HEN synthesis report was also presented to researchers and policy-makers at the WHO Summer School on Refugee and Migrant Health.

The report was commissioned and developed jointly by WHO/Europe’s Division of Policy and Governance for Health and Well-being and Division of Information, Evidence, Research and Innovation.

Implications for policy development

The report identifies policies and formalized responses for addressing communication barriers in 14 countries, which can be categorized under cultural mediation, interpretation, translation of health information, and guidance and training for health-care providers. Since these strategies are usually implemented via multiple organizations or agencies, the report also emphasizes the importance of promoting intersectoral collaboration. Identified strategies have been used to support access to health care, management of specific diseases and promotion of health across many health-care settings.

Based on the findings of the review, the report puts forth the following considerations for policy and practice:

  • encourage collaboration between statutory health-care organizations, non-statutory organizations such as nongovernmental organizations with an interest in refugee and migrant health, and academic institutions to develop and implement strategies to address communication barriers for refugees and migrants in health-care settings;
  • establish intersectoral dialogues on cultural mediation and interpretation to clarify the terminology used to describe the role(s) of mediating and interpreting;
  • develop and implement consistent systems across countries for training, accreditation and professionalization;
  • provide training for health-care staff in working effectively with cultural mediators and interpreters in cross-cultural consultations with refugees and migrants;
  • ensure the use of professionals who have been trained and accredited for mediating and interpreting roles in health-care settings;
  • establish incident reporting systems in health-care settings where strategies to address communication barriers are being implemented;
  • involve refugees and migrants in developing and implementing strategies to address communication barriers;
  • encourage development of a combination of strategies, such as specific clinics and support services within a centre to support both health-care professionals and refugees and migrants in provision of effective health care;
  • develop a national policy that emphasizes the importance of formal strategies to effectively address communication barriers experienced by refugees and migrants in health-care settings.

Relevance to evidence-informed policy-making

Evidence-informed policy-making is a core function of WHO/Europe. WHO/Europe works to ensure that the best available evidence is used to formulate national and regional policies and practices. The Migration and Health programme, the first fully fledged programme on migration and health at WHO/Europe, supports Member States to strengthen the health sector's capacity and utilizes HEN synthesis reports to provide evidence-informed responses to the public health challenges of refugee and migrant health.

The HEN Secretariat is located in the Division of Information, Evidence, Research and Innovation of WHO/Europe. For information about HEN, please contact euhen@who.int