Health Profile of Precarious Migrants Attending the Médecins Du Monde's Health and Social Care Centres in France: a Cross-Sectional Study.

Objective: The present study aimed to compare the precarious migrants' health problems managed in Médecins du Monde's health and social care centres (CASO) with those of patients attending general practice in France. Methods: We compared the most frequent health problems managed in the 19 CASO in metropolitan France with those of a national sample of usual general practice consultations, after standardisation for age and sex. Results: Precarious migrants had fewer health problems managed per consultation than other patients (mean: 1.31 vs. 2.16), and these corresponded less frequently to chronic conditions (21.3% vs. 46.8%). The overrepresented health problems among CASO consultations were mainly headache (1.11% vs. 0.45%), viral hepatitis (1.05% vs. 0.20%), type 1 diabetes (1.01% vs. 0.50%) and teeth/gum disease (1.01% vs. 0.23%). Their underrepresented health problems were mainly lipid disorder (0.39% vs. 8.20%), depressive disorder (1.36% vs. 5.28%) and hypothyroidism (0.50% vs. 3.08%). Prevention issues were nominal in precarious migrants (0.16%). Conclusion: Both chronic somatic and mental conditions of precarious migrants are presumably underdiagnosed. Their screening should be improved in primary care.

Médecins du monde et le principe d'universalisme proportionné appliqué à la prévention du cancer du col de l'utérus.

For over 30 years, Médecins du Monde (MDM) has been working with people living in vulnerable conditions in order to promote and facilitate their access to fundamental human rights and healthcare. Women encountered within MDM programs have many risk factors for developing precancerous and cancerous lesions of the cervix. They may not seek or have little access to health services and preventive health measures.These findings prompted MDM to adopt a 'proportionate universalism' approach in order to improve access to prevention for people living in vulnerable conditions, by reaching out to the population and offering preventative health consultations. In order to address health inequalities, this approach combines health mediation, use of visuals (binder, patient leaflet), professional interpretation services, as well as preventative health consultations run by a team aware of counselling approaches and techniques. MDM diversifies screening options by inviting women to perform a self-collected vaginal swab for high risk HPV testing.This multi-level intervention aims to create favorable conditions for public participation and empowerment by promoting specifically tailored tools and a "proportionate universalism" approach.

[MDM and proportionate universalism applied to cervical cancer prevention] / Médecins du monde et le principe d'universalisme proportionné appliqué à la prévention du cancer du col de l'utérus.

For over 30 years, Médecins du Monde (MDM) has been working with people living in vulnerable conditions in order to promote and facilitate their access to fundamental human rights and healthcare. Women encountered within MDM programs have many risk factors for developing precancerous and cancerous lesions of the cervix. They may not seek or have little access to health services and preventive health measures.These findings prompted MDM to adopt a 'proportionate universalism' approach in order to improve access to prevention for people living in vulnerable conditions, by reaching out to the population and offering preventative health consultations. In order to address health inequalities, this approach combines health mediation, use of visuals (binder, patient leaflet), professional interpretation services, as well as preventative health consultations run by a team aware of counselling approaches and techniques. MDM diversifies screening options by inviting women to perform a self-collected vaginal swab for high risk HPV testing.This multi-level intervention aims to create favorable conditions for public participation and empowerment by promoting specifically tailored tools and a "proportionate universalism" approach.

[Cervical and breast cancer prevention among underprivileged women in France: an epidemiological study]. / Prévention des cancers du col de l'utérus et du sein chez les femmes en situation de grande précarité: étude épidémiologique.

If cervical cancer and breast cancer screening are frequent practices in general population, studies indicate that these practices are less common among underprivileged women. Doctors of the World conducted a study to measure cancer prevention and screening among women attending medical consultation in their health care centers (Caso) in France. The survey was conducted in 5 Caso. A questionnaire was proposed to all women (aged 14 years and older) attending medical consultation. 203 women participated in the survey. Only 33.1% of women aged 25-65 declared that they have ever realized a cervical smear in their lives. More than a third of the concerned women did not know cervical smear and 72% of the women under 35 years old do not know the HPV vaccine. 70.8% of women aged 50-74 said they had never realized a mammogram. The survey highlights less use of cancer screening among underprivileged women compared to the general population, underlines the need for appropriate actions for these populations and the need to facilitate health coverage access for women facing multiple vulnerability factors.

[Measles vaccination campaign for vulnerable populations: lessons learned]. / Campagne de vaccination rougeole des populations précaires : retour d'expérience.

CONTEXT: Between 2008 and 2011, a measles epidemic raged in France. Immunization coverage in France, already insufficient in the general population, is even more worrying for deprived populations in whom exposure to the disease and the risk of complications are much higher. In this context, Medecins du Monde (MdM), the General Council of the Seine-Saint-Denis (CG93) and the Territorial Directorate of the Regional Health Agency (DTARS) implemented a measles vaccination campaign among the Rom population of the department. OBJECTIVES: The objective was to improve coverage of this population by providing ambulatory services in collaboration between various field partners in a single public health project. MATERIALS AND METHODS: Twenty-two of the known Rom settlements were selected to receive vaccination. MdM was in charge of logistics, mediation and vaccinations at 13 sites and the DTARS and CG93 were in charge of vaccination at another 9 sites with support from MdM for mediation and logistics. RESULTS: Between January and June 2012, 250 persons were vaccinated, 34.7% of the target population. CONCLUSION: Coverage of the population after the vaccination campaign was still very low. The partnership between MdM, DTARS and CG93 helped to create a positive mobile action experience and extended prevention actions towards the most vulnerable populations excluded from conventional health care structures.