Meeting the long-term health needs of Ukrainian refugees.

OBJECTIVES: Since Russia's full-scale invasion of Ukraine on 24 February 2022, millions of people have fled the country. Most people have gone to the neighbouring countries of Poland, Slovakia, Hungary, Romania, and Moldova. This vulnerable population has significant healthcare needs. Among the most challenging to address will be chronic non-communicable diseases (NCDs), including mental disorders, as these require long-term, continuous care and access to medicines. Host country health systems are faced with the challenge of ensuring accessible and affordable care for NCDs and mental disorders to this population. Our objectives were to review host country health system experiences and identify priorities for research to inform sustainable health system responses to the health care needs of refugees from Ukraine. STUDY DESIGN: In-person conference workshop. METHODS: A workshop on this subject was held in November 2022 at the European Public Health Conference in Berlin. RESULTS: The workshop included participants from academia and non-governmental organisations, health practitioners, and World Health Organisation regional and country offices. This short communication reports the main conclusions from the workshop. CONCLUSION: Addressing the challenges and research priorities identified will require international solidarity and co-operation.

[When Chance Decides About Access to Health Care: The Case of Refugees in Germany]. / Wenn Zufall über den Zugang zur Gesundheitsversorgung bestimmt: Geflüchtete in Deutschland.

Health and access to health care are considered a human right. "Regular" immigrants such as work migrants in Germany have the same entitlement to health care coverage through the statutory health insurance as the majority population. This, however, is not the case for refugees and asylum seekers. According to paragraphs 4 and 6 of the Asylum Seekers' Benefit Act, their entitlement is restricted to care for acute pain, pregnancy and childbirth, as well as immunizations in the first 15 months. Additional care can be financed on a case-by-case basis. Care provision is regulated in different ways by the communities; it is further complicated by different regulations at the federal state levels and by differences in knowledge of the physicians on how entitlement restrictions can be circumvented on a case-by-case basis. Thus, entitlement and access to care of asylum seekers and refugees is driven by chance in 3 respects: when they are assigned to a federal state, when they are assigned to a community, and when they are treated by a doctor with more or less knowledge of the legal regulations. Restrictions on entitlement to health care are associated with higher health care expenditure. They may also lead to delayed treatment of life-threatening conditions. Furthermore, they may negatively affect social integration of asylum seekers. Therefore, the restrictions of entitlement in paragraphs 4 and 6 of the Asylum Seekers' Benefit Act need to be lifted immediately. Asylum seekers should be granted the same entitlements to health care as the majority population in the whole of Germany.