4.7 Article

Deservingness: migration and health in social context

Journal

BMJ GLOBAL HEALTH
Volume 6, Issue -, Pages -

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/bmjgh-2021-005107

Keywords

public health; health policies and all other topics; health systems; treatment; qualitative study

Funding

  1. Deutscher Akademischer Austauschdienst (DAAD)
  2. Global Futures Initiative (Georgetown University)
  3. Berkeley Center for Social Medicine (UC Berkeley)
  4. Peder Sather Center for Advanced Study
  5. Paoli Calmettes Institute Chair IMeRA Mediterranean Institute for Advanced Study

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This article discusses the impact of the concept of deservingness on clinical cases of transnational migrant patients, highlighting the significant implications of deservingness assumptions on inequalities in healthcare access and quality for migrant patients. It suggests that healthcare professionals should adopt a critical lens to help improve global health equity.
This article brings the social science concept of 'deservingness' to bear on clinical cases of transnational migrant patients. Based on the authors' medical social science research, health delivery practice and clinical work from multiple locations in Africa. Europe and the Americas, the article describes three clinical cases in which assumptions of deservingness have significant implications for the morbidity and mortality of migrant patients. The concept of deservingness allows us to maintain a critical awareness of the often unspoken presumptions of which categories of patients are more or less deserving of access to and quality of care, regardless of their formal legal eligibility. Many transnational migrants with ambiguous legal status who rely on public healthcare experience exclusion from care or poor treatment based on notions of deservingness held by health clinic staff, clinicians and health system planners. The article proposes several implications for clinicians, health professional education, policymaking and advocacy. A critical lens on deservingness can help global health professionals, systems and policymakers confront and change entrenched patterns of unequal access to and differential quality of care for migrant patients. In this way, health professionals can work more effectively for global health equity.

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