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Israel Journal of Health Policy Research
Published in: Israel Journal of Health Policy Research 1/2017

Open Access 01-12-2017 | Original research article

Applying a community-based participatory research approach to improve access to healthcare for Eritrean asylum-seekers in Israel: a pilot study

Authors: Nora Gottlieb, Tomer Weinstein, Jonah Mink, Habtom M. Ghebrezghiabher, Zebib Sultan, Rachel Reichlin

Published in: Israel Journal of Health Policy Research | Issue 1/2017

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Abstract

Background

Israel hosts approximately 50,000 asylum seekers, most of them from Eritrea. Exclusive policies restrict their access to healthcare. In 2013, local activists partnered with Eritrean asylum seekers to assess health needs as well as willingness to pay for health insurance among the Eritrean communities. This initiative was meant as a step towards jointly advocating access to Israel’s public healthcare system and towards strengthening collective efficacy among the asylum-seeking communities, as well as a first attempt to apply a community-based participatory research (CBPR) approach to migrant health research in Israel.

Methods

Applying a CBPR approach, a 22-item survey was developed by a team of activists, academics and community members. It was administered by community members in four different cities. Cell weighting was applied to align sample estimates with the population distribution. The results were analyzed by means of a Generalized Linear Model. Six follow-up interviews and two focus group discussions helped interpret the quantitative findings and provided additional information.

Results

The results from 445 questionnaires show that most (95%) asylum seekers are interested in purchasing health insurance. To this end, more than half of the respondents are willing to invest up to 300 NIS monthly, which represents a significant part (5–7.5%) of their median monthly income. Willingness to pay for health coverage was independent from employment and income; it was significantly associated with city of residence – which translates into current healthcare options - understanding of health insurance, and health seeking motives. The study further highlights the role of labor policies in shaping not only asylum seekers’ access to care but also psychosocial wellbeing.

Conclusions

The study provides initial evidence for asylum seekers’ willingness to pay monthly contributions into a public health insurance scheme, in spite of economic hardship, and it points to understanding of and trust in the healthcare system as a central factor influencing willingness to pay. The outcomes of this initiative further offer some support for the potential of CBPR to enhance research into the health of marginalized populations and, moreover, to counter their social exclusion through capacity building and strengthening of collective efficacy.
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Metadata
Title
Applying a community-based participatory research approach to improve access to healthcare for Eritrean asylum-seekers in Israel: a pilot study
Authors
Nora Gottlieb
Tomer Weinstein
Jonah Mink
Habtom M. Ghebrezghiabher
Zebib Sultan
Rachel Reichlin
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Israel Journal of Health Policy Research / Issue 1/2017
Electronic ISSN: 2045-4015
DOI
https://doi.org/10.1186/s13584-017-0185-9

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