Data quality toolkit to improve monitoring of access to healthcare services for marginalised groups

Data quality toolkit to improve monitoring of access to healthcare services for marginalised groups.

International migration is increasing as a result of people moving to work, study, and join families as well as those being forced to move due to persecution, conflict, natural disasters and other humanitarian conflicts. Despite international commitments to provide universal health coverage (UHC) and ensure ‘no-one is left behind’, many migrants struggle to access timely and affordable healthcare they need.

A team from UCL Institute for Health Informatics (IHI), in collaboration with the non-governmental organisation, Doctors of the World (Medicins du Monde, MdM), is finding ways to improve how data on migrants’ access to healthcare is collected so it can better monitor developments that will ensure countries do more to provide UHC.

MdM runs medical clinics in countries across Europe, including the UK, supporting more than 40,000 people each year, many of whom are undocumented migrants. To monitor and improve their services, each country’s MdM branch collects data on who attends clinics and why.  This large dataset of health-related information for a group of people that do not appear in national statistics, helps the organisation identify gaps in services and provide for the unmet needs of service users.

The UK clinic of MdM is based in Stratford, London, where clinicians see approximately 2,000 patients each year and support hundreds more through telephone-based advocacy. The team works with GP surgeries to register patients and runs a training programme called ‘Safe Surgeries’ to ensure surgery staff are aware of the rights of undocumented migrants.

“Some underserved migrant groups struggle to access healthcare services in the UK, either because they don’t know what they are entitled to, or because they are incorrectly refused GP registration.”

“Some underserved migrant groups struggle to access healthcare services in the UK, either because they don’t know what they are entitled to, or because they are incorrectly refused GP registration,” explains Rachel Burns (UCL IHI).

Rachel is a member of the MdM Observatory Project,  a project that brings together UCL epidemiologists with representatives from ten MdM clinics worldwide, to find better ways to standardise their data collection and analysis and improve the data quality of the MdM clinics.

“This data is vital for the development of national policies that are inclusive for migrants,” Rachel emphasises. “By collecting robust and appropriate information, we can break down the data into detailed sub-categories to identify the barriers that some groups face when accessing UHC and start to address the inequalities.”

Through a series of workshops, issues such as variations in sample size, missing data and inconsistent wording have been identified. A quality improvement toolkit is now being designed that will be implemented across all MdM clinics across the world. The team is also running culturally relevant workshops with advocates and service users, that will help identify ways to evidence the unmet UHC needs of migrants.

“Huge inequalities exist in who can access supposedly universal healthcare,” says Rachel. “We want to break down barriers and ensure people with lived experience of exclusion from health services can help to shape research and influence provision that will help these underserved groups to access healthcare.”

The report received funding from the 2022/23 UCL Pathways to Achievement (SDGs) funding call.