Background: European Member States are facing a challenge to provide accessible and effective health care
services for immigrants. It remains unclear how best to achieve this and what characterises good practice in
increasingly multicultural societies across Europe. This study assessed the views and values of professionals working
in different health care contexts and in different European countries as to what constitutes good practice in health
care for immigrants.
Methods: A total of 134 experts in 16 EU Member States participated in a three-round Delphi process. The experts
represented four different fields: academia, Non-Governmental Organisations, policy-making and health care
practice. For each country, the process aimed to produce a national consensus list of the most important factors
characterising good practice in health care for migrants.
Results: The scoring procedures resulted in 10 to 16 factors being identified as the most important for each
participating country. All 186 factors were aggregated into 9 themes: (1) easy and equal access to health care, (2)
empowerment of migrants, (3) culturally sensitive health care services, (4) quality of care, (5) patient/health care
provider communication, (6) respect towards migrants, (7) networking in and outside health services, (8) targeted
outreach activities, and (9) availability of data about specificities in migrant health care and prevention. Although
local political debate, level of immigration and the nature of local health care systems influenced the selection and
rating of factors within each country, there was a broad European consensus on most factors. Yet, discordance
remained both within countries, e.g. on the need for prioritising cultural differences, and between countries, e.g.
on the need for more consistent governance of health care services for immigrants.
Conclusions: Experts across Europe asserted the right to culturally sensitive health care for all immigrants. There is
a broad consensus among experts about the major principles of good practice that need to be implemented
across Europe. However, there also is some disagreement both within and between countries on specific issues
that require further research and debate.