[How do asylum seekers experience access to medical care?] / Wie erleben Asylsuchende den Zugang zu medizinischer Versorgung?

BACKGROUND: In Germany basic medical care for asylum seekers is organized outside the statutory health insurance system. Currently there are few empirically based statements on how asylum seekers experience their access to healthcare. The aim is therefore to evaluate their experiences with healthcare focussing on subjective health, utilisation and access to medical care, and experiences with medical care. METHODS: Between August and November 2015, we performed 16 qualitative problem-oriented guided interviews with asylum seekers, who received or sought medical care in Saxony-Anhalt. The interpreter-assisted interviews were evaluated with content analysis. RESULTS: Access begins with a voucher for medical treatment issued by the social security office. Asylum seekers experience that procedure as onerous and incapacitating. These experiences influence subjective health and utilisation of medical help. If their efforts for treatment certificates are rejected, people increasingly resign. If medical treatment is achieved, they experience medical staff mostly as competent and friendly, in spite of language difficulties and time pressure. CONCLUSIONS: Reducing the "voucher bureaucracy" by uniform rules and practices may bring about a relief to access and utilisation of healthcare. Introducing an electronic health insurance card for asylum seekers would retransfer decision making about treatment needs from the welfare system into the medical system.

Artisanal and small-scale mining in Tanzania and health implications: A policy perspective.

The mineral sector, especially its small-scale subsector, has become significant in the emerging economies of the Global South. Tanzania is the focus of this policy exposition paper because, aside from Ghana and South Africa, Tanzania is ranked 4th in Africa in terms of its mineral deposits and small-scale mining activities. The focus is also on artisanal and small-scale mining (ASM) because ASM operations have significantly increased in recent times across this mineral-rich country of East Africa. This is done against a negative backdrop-labelling of ASM as unsustainable, environmentally unfriendly, inefficient, and illegal. Tanzania has made some progress to respond to some of the challenges in the mining sector to improve the micro and macroeconomics of the country. Some areas remain challenging including the lack of proper environmental health education for the ASM miners; the lack of clear national-level policies to guide health-related matters in the ASM subsector, and the small capital investment of the ASM subsector to support healthy mining practices. The details related to the persistence of these challenges are not well known, particularly those that pertain to policymaking. This article attempts to evaluate the policy environment of the ASM subsector in Tanzania and propose appropriate actions for the future of mineral resource policymaking in Tanzania.