Mobiliser les populations migrantes ou précaires pour des approches collectives de promotion de la santé.

Abstract

Introduction: Access to healthcare for migrant and socially vulnerable populations remains marked by significant inequalities. Collective health approaches, defined as interventions bringing together several individuals around shared health issues (information workshops, group discussions, prevention or health promotion activities), are recognized as an important lever for health promotion. However, their implementation among these populations remains challenging. The aim of this study was to explore health perceptions among migrant patients attending a Médecins du Monde center and to identify barriers and facilitators to their participation in collective health activities.

Methods: An exploratory qualitative study was conducted at the Médecins du Monde Health and Orientation Centre (CASO) in Nice. Twenty-one exploratory interviews and eight semi-structured interviews were conducted with French-speaking migrant patients until data saturation was reached. Interviews were recorded, transcribed, and analyzed using a thematic approach. Partial double coding was performed using NVivo software.

Results: Participants displayed contrasting perceptions of health, ranging from a central life priority to a secondary concern behind housing, employment, or administrative regularization. Physicians were perceived positively as central figures of care and protection. Interest in collective activities appeared heterogeneous: Some participants viewed them as an opportunity for sharing, while others expressed reluctance. Several barriers were identified, including language barriers, constraints related to informal work, fatigue, community tensions, and the absence of cultural mediators.

Discussion: Engaging migrant patients in collective health approaches requires specific conditions, including long-term implementation, co-construction with participants, involvement of peers, and consideration of their life priorities. This exploratory study identifies key feasibility conditions and provides a basis for the design of pilot interventions, whose evaluation and impact indicators will need to be defined at a later stage.

Conclusion: Collective approaches to health can be a relevant lever for reducing inequalities in access to care, provided they are adapted to the social constraints and life priorities of migrant and socially vulnerable populations.