01 Patient experiences help improve health care for migrant women


The study identified social, economic and cultural factors that shape migra-tion-related inequalities in health care for women with chronic diseases in Switzerland. Based on patients' expe-riences and including them in all phas-es of the project, specific recommen-dations were developed to improve access to health care.

Portrait / project description (completed research project)

The study focused on chronically ill migrant women of Portuguese, Turk-ish and German origin as well as Swiss women. 48 interviews and two focus groups with patients and 12 interviews with health care provid-ers and social service providers were conducted. Based on the re-sults, stakeholder dialogues with representatives of relevant Swiss institutions and female patients were conducted. Recommendations for improving health care and re-ducing social inequalities were de-veloped.


Switzerland has one of the best healthcare systems. Yet access to healthcare is limited for certain population groups. Migrant women, for example, use healthcare services less often compared to population average usage although they are more likely to suffer from chronic illness. As yet, the practical experience gained by patients with migrant background has rarely been incorporated into scientific approaches to the problem. Similarly, these women have rarely been engaged in the development of solutions.


The aim of the study was to investi-gate the causes of inequalities in access to and use of health care services. The goal was to show how chronically ill migrant women expe-rience the health care system, what deficits they perceive and what resources they themselves use and contribute to the health care sys-tem. On this basis, new approaches for improved access to health care should be developed with the in-volvement of affected patients and experts from science and practice.


With regard to better care for fe-male patients with chronic diseases and migration experience, the fol-lowing need for action was identi-fied:

  • Reducing access barriers by promoting low-threshold, multi-lingual support services at the community and neighbourhood level (information on social ser-vices, care services and self-help groups, insurance models and benefits, or patients' rights).
  • Actively involving patients as experts of their own disease and promoting a trusting rela-tionship between patients and health care professionals.
  • Creating targeted training op-portunities for health and social professions on (inter-)professional handling of social and administrative challenges as well as transcultural and trans-categorical approaches in work-ing with chronically ill patients.

Significance of the results for research and practice

This is the first Swiss study to com-prehensively explore the relation-ship between the self-reported health status of immigrant women, their perceived health care needs, experiences with local health care systems, resources and utilization behaviors. It also puts patients’ re-ports in the center of the research. The participatory character of the study locates the project within the new ‘social practice of public health science’ and increases the potential of the findings to be taken up in health care practice.

Original title

Migrant Women’s Health Care Needs for Chronic Illness Services in Switzerland (MIWOCA)

Project leaders


  • Prof. Dr. Dr. Thomas Abel, Institut für Sozial- und Präventivmedizin, Universität Bern

Project partners:

  • Dr. Annika Frahsa, Institut für Sportwissenschaft, Universität Tübingen
  • Prof. Sibel Sakarya, School of Medicine, Koç University, Istanbul
  • Prof. Sandro Cattacin, Département de Sociologie, Faculté des Sciences de la Société, Université de Genève



Further information on this content


Prof. Dr. Dr. Thomas Abel Universität Bern
Institut für Sozial- und Präventivmedizin
Finkenhubelweg 11 3012 Bern +41 31 631 35 12

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