Intercultural mediators to ensure equitable health care services

A newly published WHO Health Evidence Network (HEN) synthesis report has found that intercultural mediators are highly effective in bridging linguistic and cultural gaps and are therefore indispensable to high-quality, comprehensive health care provision for refugees and migrants. However, the report also shows that the impact of intercultural mediators is hindered by a lack of professionalization, insufficient training and the non-systematic and inconsistent implementation of intercultural mediation programmes.

Evidence-based advocacy for intercultural mediation programmes

Currently, 1 in 10 of the WHO European Region’s 920 million people is a refugee or migrant, accounting for some 90.7 million people. This demographic change has created specific demands on regional health systems, since cultural and linguistic barriers often prevent refugees and migrants from accessing high-quality health care, leading to avoidable health inequalities.

Intercultural mediators have been increasingly introduced throughout the WHO European Region to improve the quality of health care for refugees and migrants. However, there is a scarcity of literature which reviews how cultural mediators are trained and what roles they have taken on in the various countries where they are deployed.

Developed in collaboration between WHO/Europe’s project on Cultural Contexts of Health and Well-being, and the Migration and Health Programme, the HEN synthesis report explores the question: What are the roles of intercultural mediators in health care and what is the evidence on their contributions and effectiveness in improving accessibility and quality of care for refugees and migrants in the WHO European Region?

“The HEN report is a valuable addition to our knowledge about the importance of intercultural mediators to modern health care systems in the WHO European Region,” says Dr Santino Severoni, Special Adviser on Migration and Health and acting Director, Division of Health Systems and Public Health. “It demonstrates the complex range of roles that intercultural mediators fill, shows the value that they add within the health care systems and services towards the achievement of universal health coverage and Sustainable Development Goal 3 [Ensure healthy lives and promote well-being for all at all ages], and draws a number of conclusions for policy-makers to consider that will substantially improve the quality of health care for refugees and migrants.”

Hans Verrept, Head of the Intercultural Mediation and Policy Support Unit at the Belgian Federal Public Service for Health, Food Chain Safety and Environment, adds: “The positive results of the empirical studies on the effectiveness of intercultural mediators in health care should encourage policy-makers to further develop and implement intercultural mediation programmes in the diverse WHO European Region. The fact that such effects are observed – often in less than ideal circumstances – suggests that the potential of intercultural mediation programmes to contribute to the provision of equitable health care services is very substantial.”

The report was made possible through the generous financial contribution of the Wellcome Trust.