title: Exploring barriers to primary care for migrants in Greece in times of austerity: Perspectives of service providers.
abstract: BACKGROUND
  Migration in Europe is increasing at an unprecedented rate. There is an urgent need to develop 'migrant-sensitive healthcare systems'. However, there are many barriers to healthcare for migrants. Despite Greece's recent, significant experiences of inward migration during a period of economic austerity, little is known about Greek primary care service providers' experiences of delivering care to migrants.
  
  
  OBJECTIVE
  To identify service providers' views on the barriers to migrant healthcare.
  
  
  METHODS
  Qualitative study involving six participatory learning and action (PLA) focus group sessions with nine service providers. Data generation was informed by normalization process theory (NPT). Thematic analysis was applied to identify barriers to efficient migrant healthcare.
  
  
  RESULTS
  Three main provider and system-related barriers emerged: (a) emphasis on major challenges in healthcare provision, (b) low perceived control and effectiveness to support migrant healthcare, and (c) attention to impoverished local population.
  
  
  CONCLUSIONS
  The study identified major provider and system-related barriers in the provision of primary healthcare to migrants. It is important for the healthcare system in Greece to provide appropriate supports for communication in cross-cultural consultations for its diversifying population.
authors.affiliation: a Faculty of Medicine , University of Crete , Heraklion , Greece.|b Department of Social Work , School of Health and Social Welfare, Technological Educational Institute of Crete , Heraklion , Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Papadakaki
authors.affiliation: a Faculty of Medicine , University of Crete , Heraklion , Greece.
authors.forename: Christos
authors.initials: C
authors.lastname: Lionis
authors.affiliation: a Faculty of Medicine , University of Crete , Heraklion , Greece.
authors.forename: Aristoula
authors.initials: A
authors.lastname: Saridaki
authors.affiliation: c Institute of Psychology, Health and Society , University of Liverpool , Liverpool , UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Dowrick
authors.affiliation: d Discipline of General Practice , School of Medicine, National University of Ireland , Galway , Ireland.
authors.forename: Tomas
authors.initials: T
authors.lastname: de Brún
authors.affiliation: d Discipline of General Practice , School of Medicine, National University of Ireland , Galway , Ireland.
authors.forename: Mary
authors.initials: M
authors.lastname: O'Reilly-de Brún
authors.affiliation: e General Practice and Primary Care , Institute of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow , Glasgow , UK.
authors.forename: Catherine A
authors.initials: CA
authors.lastname: O'Donnell
authors.affiliation: e General Practice and Primary Care , Institute of Health & Wellbeing, College of Medical, Veterinary and Life Sciences, University of Glasgow , Glasgow , UK.|f Lancaster Medical School, Faculty of Health and Medicine, Furness College, Lancaster University , Lancaster , UK.
authors.forename: Nicola
authors.initials: N
authors.lastname: Burns
authors.affiliation: g Department of Primary and Community Care Radboud University Medical Center , Nijmegen The Netherlands.
authors.forename: Evelyn
authors.initials: E
authors.lastname: van Weel-Baumgarten
authors.affiliation: g Department of Primary and Community Care Radboud University Medical Center , Nijmegen The Netherlands.|h Pharos Centre of Expertise on Health Disparities , Utrecht , The Netherlands.
authors.forename: Maria
authors.initials: M
authors.lastname: van den Muijsenbergh
authors.affiliation: i Centre for Public Health, Medical University of Vienna , Vienna , Austria.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Spiegel
authors.affiliation: j Graduate Entry Medical School, University of Limerick , Limerick , Ireland.
authors.forename: Anne
authors.initials: A
authors.lastname: MacFarlane
mesh_terms: D000293:Adolescent; D000328:Adult; D001291:Attitude of Health Personnel; D003144:Communication Barriers; D054521:Cultural Competency; D003695:Delivery of Health Care / Q000191:economics* / Q000331:legislation & jurisprudence; D054242:Emigrants and Immigrants / Q000331:legislation & jurisprudence; D005260:Female; D017144:Focus Groups; D058006:General Practice; D006115:Greece / Q000208:ethnology; D054625:Healthcare Disparities; D006801:Humans; D007802:Language; D008297:Male; D017057:Medically Uninsured / Q000208:ethnology; D008875:Middle Aged; D011203:Poverty / Q000208:ethnology; D011320:Primary Health Care / Q000191:economics; D036301:Qualitative Research; D012922:Social Change; D055815:Young Adult
keywords: Migrants; attitudes; capacity; financial crisis; primary healthcare