Passer du soin à la prévention auprès d'un public en grande précarité : les enjeux sociologiques et organisationnels du changement d'orientation de la mission Roms de Médecins du Monde à Nantes

Abstract : The recent change in the guidelines of the project targeting the Roma migrants at Doctors of the World in Nantes aims at a shift away from cure to more prevention-focused actions, through the implementation of health promotion actions, especially education for health. This new project was born from a series of assessments concerning the health condition of the Roma people met by the team in Nantes but also generally in France and Europe, that showed significant prevention-related needs. At first, the quite favourable context at the local level regarding the staying conditions for Romanian Roma and their access to the heath care system appeared as an asset for the project. However, this context is constantly evolving and partly depends on the national political context, that is always less favourable to economically precarious foreigners and to Roma people in particular. The increasing instability that results from political wills or the lack of the latter strengthens their pressurisation and affects the state of health and the effective access to the health care system, this access being already difficult like for any precarious population. While fighting for an improvement of the situation, the organization's team must take these elements into consideration for the implementation of the new project. Locally, the organization of the health care system and the practical details for the access to the health services are assets for this project. The start-up of a pilot-project in health mediation run by MdM Nantes through a full-time employed mediator, makes possible the creation of a proximity that helps the running of education for health activities, but the team faces other challenges and among others, its intervention patterns must evolve to bring the targeted population closer to the preventive side of health.
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Master Thesis
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Bénédicte Cabrol. Passer du soin à la prévention auprès d'un public en grande précarité : les enjeux sociologiques et organisationnels du changement d'orientation de la mission Roms de Médecins du Monde à Nantes. Science politique. 2011. ⟨dumas-00827979⟩

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