Challenges in access to health care among involuntary migrants in Germany. A case study of migrants' experiences in Oldenburg, Lower Saxony

In asking asylum seekers and refugees about their experiences in the healthcare system in Oldenburg in 2015, and a healthcare worker about her experiences with involuntary migrant groups, this article seeks to provide insight into the effects of policies and practices on refugees' and asylum seekers' experiences in the healthcare system in Oldenburg, an important destination for newly arrived refugees and asylum seekers in Lower Saxony, Germany. Asylum seekers face a wide range of challenges in their country of destination. One of these challenges is to attent to their health needs, due to their partial or full exclusion, "from the system of health care promotion, protection and provision that appl[ies] to citizens and authorized residents" (Willen, Mulligan & Castañeda, 2011: 331). Health as a multidimensional and multilevel phenomenon can be determined by several factors, ranging from socioeconomic status to cultural differences, all of which produce health inequalities. Health care for involuntary migrants has become a central topic, particularly, albeit not exclusively, in terms of access to health services. Different patterns of access to health services for asylum seekers could have lasting consequences for the health and quality of life of this particular group. Furthermore, cultural differences may be perceived as de-facto barriers to receiving health care for both asylum seekers and refugees. Even within tailor-made clinics dealing with migrants in general or involuntary migrants in particular, cultural and socioeconomic differences ought to be accounted for in order to provide an optimal level of health care.