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Parchemins: Etude prospective de l’impact du programme de régularisation Papyrus sur la santé et les conditions de vie des migrants sans-papiers à Genève

English title Parchemins: a prospective study about the impact of regularization on undocumented migrants’ health and well-being
Applicant Jackson Yves-Laurent
Number 182208
Funding scheme Project funding
Research institution Service de médecine de premiers recours Département de Médecine Communautaire Hôpitaux Universitaires Genève
Institution of higher education University of Geneva - GE
Main discipline Sociology
Start/End 01.03.2019 - 31.05.2023
Approved amount 465'279.00
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All Disciplines (3)

Discipline
Sociology
Group Medicine
Economics

Keywords (6)

Living conditions; health outcomes; wellbeing; migration; employment; legal status

Lay Summary (French)

Lead
Un nombre croissant de personnes quittent leur lieu de vie d’origine dans le contexte de contraintes sociales, économiques, environnementales et politiques. Parmi ces migrants, certains résident dans le pays de destination sans permis de séjour valable (migration irrégulière, sans-papiers). Les migrants sans-papiers font généralement face à des conditions de vie précaires et rencontrent des difficultés à satisfaire leurs besoins fondamentaux tels que les soins médicaux, le logement et l’emploi.
Lay summary
En 2017, le Canton de Genève à mis en œuvre une politique pilote de régularisation de migrants sans-papiers répondant à des critères précis qui est unique en Suisse (Opération Papyrus). Cette politique publique offre une opportunité unique de mesurer l’impact du changement de statut légal sur le bien-être et la santé, les conditions de vie et l’emploi de ces migrants. 
L’étude pluridisciplinaire Parchemins va utiliser différentes méthodes de recherche en sciences sociales, économie et médecine pour mesurer l’évolution de ces différents domaines chez des migrants qui vont bénéficier d’un permis de séjour (groupe régularisés) et des migrants qui ne satisfont pas aux critères de régularisation et resteront sans-papiers (groupe contrôle). Elle s’intègre dans un riche réseau de partenaires tant politiques que dans la communauté. L’hypothèse est que l’obtention d’un statut légal influencera positivement les conditions de vie et d’emplois avec un impact favorable sur la santé et le bien-être mais créera en parallèle de nouvelles formes de vulnérabilité. 
Contexte scientifique et social du projet de recherche
Cette étude, la première de son genre en Europe, va permettre de mieux comprendre les conditions de vie et leurs relations avec la santé et le bien-être d’une population  peu étudiée à ce jour, notamment en raison de sa difficulté d’accès par les chercheurs. Par ailleurs, elle permettra de mesurer l’impact d’une politique publique innovante en Suisse. Enfin, elle permettra à des personnes traditionnellement soucieuses de ne pas se faire remarquer de faire entendre leur voix dans un cadre scientifique et public. 
 
Direct link to Lay Summary Last update: 03.10.2018

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Abstract

Driven by economic, political and environmental factors, human mobility has sharply increased in recent years. It is estimated that the stock of international migrants rose from 155 to 244 million between 2000 and 2015, of whom one third lives in Europe. Some migrants enter or remain in the country of destination without valid residency permits and are thus considered “undocumented” or “irregular”. Europe and Switzerland host up to 1.9-3.8 million and 58’000- 105’000 undocumented migrants, respectively. Adding to exposure to hazards and hardship in the country of origin, they frequently face precarious living and working conditions in the country of destination. Entitlement for undocumented migrants to access to the healthcare system differs among countries in Europe. Policies in Switzerland allow undocumented migrant to contract a health insurance, the gateway to healthcare, but only a minority is effectively insured due to administrative and economic barriers. These legal factors are thought to contribute to the consequent health disparities between undocumented migrants and the resident population in Europe but very scarce information exists about other factors involved. In 2017, Canton Geneva launched a pilot policy (Operation Papyrus) aiming to grant residency permit to selected undocumented migrants. Regularization may theoretically modify some key determinants of health such as employment, income, and social benefits. A few regularization programs have previously taken place in Europe but hardly any evidence exists on their impact on migrants’ health, well-being and living conditions. Difficulties for researchers to access this hard to reach group have limited the scope and quality of public health and social sciences research on undocumented migrants so far. Considering how irregular migration has become a global issue, the World Health Organization has called to bridge the knowledge gap in order to better guide migration-related health policies and tailor health services to the specific needs of migrants. Building on ten-year research activities with undocumented migrants in Geneva, a interdisciplinary team led by Yves Jackson (medical doctor, Geneva University Hospitals) and Claudine Burton-Jeangros (sociologist, Faculty of social sciences, University of Geneva) has implemented a prospective, interdisciplinary, mixed-methods study to respond to the unique opportunity provided by Operation Papyrus to describe living conditions, health status and healthcare access of undocumented migrants in Geneva, and to evaluate the impact of regularization on health (somatic, mental, access to care and behavioral components) and well-being. In addition, it aims to better understand the health, economic and social factors involved in the transition towards legality at individual and family levels. The study is made of two work packages, one quantitative and one qualitative, mixing different theoretical approaches and extending over four years. The recruitment started in late 2017 with 190 participants enrolled as to March 2018. This project, the first of its kind in Europe, will generate original science about a highly vulnerable group of population, create research and teaching activities in different academic domains, contribute to adapt health programs for migrants and inform policy-makers about the broader impact of integration policies in a Swiss and European perspective.
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