title: Access to health care for undocumented migrant children and pregnant women: the paradox between values and attitudes of health care professionals.
abstract: Access to health care for undocumented migrant children and pregnant women confronts human rights and professional values with political and institutional regulations that limit services. In order to understand how health care professionals deal with these diverging mandates, we assessed their attitudes toward providing care to this population. Clinicians, administrators, and support staff (n = 1,048) in hospitals and primary care centers of a large multiethnic city responded to an online survey about attitudes toward access to health care services. Analysis examined the role of personal and institutional correlates of these attitudes. Foreign-born respondents and those in primary care centers were more likely to assess the present access to care as a serious problem, and to endorse broad or full access to services, primarily based on human rights reasons. Clinicians were more likely than support staff to endorse full or broad access to health care services. Respondents who approved of restricted or no access also endorsed health as a basic human right (61.1%) and child development as a priority (68.6%). A wide gap separates attitudes toward entitlement to health care and the endorsement of principles stemming from human rights and the best interest of the child. Case-based discussions with professionals facing value dilemmas and training on children's rights are needed to promote equitable practices and advocacy against regulations limiting services.
authors.affiliation: Department of Psychiatry, McGill University, Montreal, Canada. monica.ruizcasares@mcgill.ca
authors.forename: Mónica
authors.initials: M
authors.lastname: Ruiz-Casares
authors.forename: Cécile
authors.initials: C
authors.lastname: Rousseau
authors.forename: Audrey
authors.initials: A
authors.lastname: Laurin-Lamothe
authors.forename: Joanna Anneke
authors.initials: JA
authors.lastname: Rummens
authors.forename: Phyllis
authors.initials: P
authors.lastname: Zelkowitz
authors.forename: François
authors.initials: F
authors.lastname: Crépeau
authors.forename: Nicolas
authors.initials: N
authors.lastname: Steinmetz
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D002170:Canada; D002648:Child; D005260:Female; D019538:Health Care Surveys; D006291:Health Policy; D006296:Health Services / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D054625:Healthcare Disparities; D006806:Human Rights; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D037841:Pregnant People; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014171:Transients and Migrants / Q000706:statistics & numerical data*; D055815:Young Adult