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The paper reviews the available evidence on access to health care and two health outcomes, perinatal mortality and accident/disability, for migrant and ethnic minorities in selected receiving industrialized countries. The health of these communities is analyzed using the entitlement approach, which considers health as the product of both the individual's private endowments and the social environment he or she faces. Migrants, especially first and second generations, and ethnic minorities often have reduced entitlements in receiving societies. Not only are they exposed to poor working and living conditions, which are per se determinants of poor health, but they also have reduced access to health care for a number of political, administrative and cultural reasons which are not necessarily present for the native population. The paper argues that the higher rates of perinatal mortality and accidents/disability observed in many migrant groups compared to the native population are linked to their lower entitlements in the receiving societies. Policies aimed at reducing such health gaps need to be accompanied by a more general effort to reduce inequalities and to promote full participation of these groups in the mainstream of society. Key words - equity, migrant health, ethnic health, entitlements

Limiting Medicaid drug-reimbursement benefits for schizophrenics appears to increase patients' use of acute mental health services and the overall cost of caring for these patients. The effects of limiting Medicaid drug reimbursement to three prescriptions a month were measured by recording the use of drugs and visits to community and emergency mental health centers in two states, New Hampshire and New Jersey. When the three-prescription limit was imposed in New Hampshire, the use of antipsychotic drugs, lithium, antidepressants, and anxiolytic and hypnotic drugs was reduced immediately. However, an increase of between one and two visits per patient per month to community and emergency mental health centers was also found. The cost reduction to Medicaid of limiting prescriptions was more than off-set by the increased costs resulting from the extra use of mental health facilities.

During the 1980s, Italy expanded its development assistance, soon becoming the fifth largest donor. Italian development cooperation directed much effort to alleviate hunger, malnutrition and their health consequences. This paper provides an evaluation of Italy's fight against world hunger considering the political environment in which the policy was conceived and implemented, the organizational structure behind the policy, and the available quantitative indicators of outcome. The analysis shows how powerful humanitarian drives, supported by inchoate thinking about development problems and priorities, and by institutional and technical confusion, gave rise to development programs below accepted standards. Poor financial planning and the absence of proper mechanisms for project appraisal facilitated the capture of some programs by domestic political and commercial interests. In 1992, Italian magistrates began investigations into the extent of corruption in development assistance; preliminary reports documented widespread waste and ineffectiveness in major aid projects. Substantial changes in organization and priorities are needed in order to control past practices of corruption, improve the effectiveness of projects, and redirect Italian aid towards development goals.

Migration is a special category of human mobility; while many people move during their lifetime from one place to another, a migrant is a person who in moving crosses boundaries, [...]

Contemporary medical knowledge is sufficient to control the suffering of most of the millions of terminally patients in the world if applied appropriately. However, palliative care is still unavailable to most patients in developing countries. Effective models of palliative care delivery that have been tested in developed countries seldom apply to the developing world where poverty, extended families, and insufficient health infrastructure require the adaptation of such care to local cultures and circumstances. Research from developing countries is therefore needed to develop, implement, and monitor the delivery of palliative care in ways that are feasible in resource-poor settings and acceptable to local populations. Palliative care research shares most of the obstacles common to health research in the developing world. Additional obstacles include a lack of consideration of palliative care as part of cancer control strategies and the low political acceptability of such care because it involves the use of opioid analgesics. Coordinated research efforts through active networking and common protocols would increase the visibility of the discipline, provide answers relevant to the local contexts, and assist in expanding palliative care services across the developing world. [ABSTRACT FROM AUTHOR]

Presents a systematic survey on the impact of trauma and torture on an asylum-seeker's health. Methodology; Results and discussion; Implications of the results for reception and treatment of asylum-seekers.

Compares the health system structure and immigration policy on receiving countries such as France, United Kingdom, Switzerland, Italy, Sweden, United States and Canada. Methods used in the comparative study; Research on immigrant communities' access to political representation and health policies; Issues on ideology, structure and financing of the health system on seven countries; Results of the study.

In September 1992, the International Organization for Migration (IOM), an intergovernmental humanitarian organization based in Geneva, Switzerland, implemented the special medical programme (SMP) for the medical evacuation of war victims in former Yugoslavia. For inclusion into the SMP, patients must be victims of war, suffer from a serious medical condition with a favourable prognosis, not treatable locally, be stable enough to survive air travel and withstand delay between medical documentation and actual evacuation. As of August 1994,1,484 patients In need of secondary treatment not locally available were evacuated to hospitals in 31 countries. Most patients suffered from fractures, amputations and nerve injuries. Seventy-two per cent originated from Bosnia-Herzegovina. This paper discusses various problems encountered, such as bureaucratic obstacles, ongoing armed conflict hampering humanitarian activities, lack of funding and the effects of the sustained media attention. [ABSTRACT FROM AUTHOR]

The strategy of high-dose intramuscular haloperidol as routinely applied in a general hospital psychiatric ward to 74 successive patients, 33 of whom stayed only up to seven days, and a further 34 up to 15 days, led to a complete recovery in only six, and complete lack of change in 23. Adverse reactions were recorded in 42, severe enough to stop treatment in eight; there were three deaths. In view of this risk-benefit analysis, systematic application of this high dose strategy to get a more rapid turnover of patients is unjustified. [ABSTRACT FROM AUTHOR]