Health care professionals’ experiences and views of sexual and reproductive health service provision to undocumented Roma women in Finland

Sammanfattning: Aim: This qualitative study explores the sexual and reproductive health service provision offered to undocumented Roma women migrating to Finland and traces the major challenges in this regard through the experiences, the perceptions, and the views of Finnish health professionals. Background: Sexual and reproductive health (SRH) of undocumented Roma women is of a particular concern since the lack of health insurance, their mobility, and disadvantaged educational, social, and economic level make them more vulnerable to health risks. In Finland, the provision of sexual and reproductive health services is limited and not equally distributed across the country, creating obstacles for these patients to address their health problems. Helsinki and few other cities have decided to extend the service provision to this population. Methods: The applied analytical method is a qualitative manifest content analysis. 7 Finnish health professionals, providing care for undocumented migrants in Helsinki, Finland, were recruited for this study using a criterion sampling. Main findings: Despite the overall improvement of SRH service provision; there is necessity to train health professionals in working with undocumented patients. There is a severe need of clear guidelines on service provision to this population, more precise definitions of ‘undocumented’, and current health policy’s further improvement in order to avoid inequity in accessing and receiving SRH services. Competent health professionals, smooth communication, successful delivery of patient education and building positive relationship to patients are key important for overcoming the existing barriers and hence, for the ensuring of continuance of care. SRH service provision at lower threshold with availability of Walk-in service proved crucial for improving approachability, accessibility, and provision of SRH health services to undocumented Roma women. Conclusions: Health professionals, competent in working with undocumented migrants, are crucially important in the public sector’s primary healthcare for meeting this population’s sexual and reproductive health needs. Clear guidelines and straightforward definition of ‘undocumented’ status are required to help health professionals in SRH provision to undocumented patients. Sexual and reproductive health service provision at lower threshold is the instrument toward avoiding more costly medical care. Health policy revision toward unifying the SRH service provision at national level is necessary in order to secure the continuance of care for undocumented Roma women and undocumented migrants as a whole.