Healthcare practitioners as brokers of social innovation for the inclusion of migrant patients: a case study in South Tyrol

This work presents an ongoing process of social innovation at San Maurizio hospital in Bolzano, giving an overview of the enacted measures for the accessibility of services to migrant patients. It particularly focuses in two areas. Firstly, in the STP clinic for migrants in irregular situations and asylum seekers, implemented in the last few years, which has created low-threshold entry points to comprehensive screenings, general medicine and dental care, preventive initiatives, in the respect of anonymity and free of charge for the indigent. Secondly, in maternity services, where the use of linguistic and cultural mediation services has been combined with training programs for healthcare practitioners and mediators together, and later expanded to the entire hospital. The methodology could be framed as experience research (Kirby, Greaves and Reid 2007) and it has used participative and ethnographic methods. The empirical base of this work is centered in the perspective of practitioners, and triangulated with other sources, like mediators, administrators, social workers or NGO employees. The data consists of 62 semi-structured individual interviews, group discussions, participant observation, documentary sources, fieldnotes, and iterative dialogue with three main research partners who occupy key positions in the field. The first part of this work describes the research process, positioning the research problem in the transdisciplinary area of study of migration and health, and presents the current policy framework about the topic in Europe and in Italy. The second part describes the case study, exploring the issue of barriers in access to healthcare from the perspective of practitioners, the accessibility measures implemented in both mentioned wards, the various aspects of the implementation process as well as the networked action of practitioners and its impact on service delivery, relational patterns and organizational culture. The main contributions of this work regard the conditions for the successful implementation of mediation services, and the transformative potential of networked interventions for specialized knowledge circulation and cooperation between the social and the healthcare services in the shaping of accessible services targeting migrants in irregular situations.