Sensitivity to diversity in public and patient involvement policy: A comparison of 40 countries

Abstract

Background: Developing diversity-responsive healthcare systems calls for inclusive public and patient involvement policy and practice. Although several studies show that migrants and ethnic minorities are amongst the groups least involved in health participatory spaces, few efforts have been made to assess whether policy on public and patient involvement in healthcare governance is sensitive to diversity. This paper addresses this question. Methods: Migrant health experts from 40 countries (including the EU28 and EFTA) completed a questionnaire jointly developed by members of COST Action IS1103, the International Organization for Migration and the Migrant Integration Policy Index, in 2014-2015. The 24-item questionnaire included two questions about policy on the involvement of migrants in health policy-making and care provision, respectively. Results: Preliminary results show that 60% of the countries surveyed have not formulated policy enabling migrants’ involvement in health policy-making. In the countries where such policy exists, migrants participate through one-off consultation exercises, i.e. none of the countries surveyed promote migrants’ structured cooperation in policy-making (e.g. through advisory boards or regular reviews of legislation, services or outcomes). Concerning policy on involvement in healthcare provision, 28% of the countries promote migrants’ participation in information development and dissemination, 28% in service delivery, 13% in service planning, management and evaluation, 18% in research and 10% in mediation between services and the community. Conclusions: Investment in diversity-sensitive policy on public and patient involvement in health care governance is limited. There is a gap between policy and practice, raising concerns about the potentially negative consequences of low migrant involvement in the design and implementation of healthcare policies and programmes seeking to address their needs. Message: Developing diversity-responsive healthcare systems requires inclusive public and patient involvement policy Few countries have invested in making their public involvement policy sensitive to diversity.