The Global Health Centre (GHC) facilitates the development of synergies among different groups of professionals working in the Tuscany Region in the fields of international health cooperation and migrants’ health. It participates in the development of information and training activities (pre-service and in-service) on its thematic areas. Through collaboration with national and international networks of experts in different disciplines, the GHC aims to stimulate debate, reflection, and analysis in the global health field, clinical and epidemiological research, the management of healthcare services, and health policies. The GHC also provides technical assistance in project management, promotes the creation of international agreements in the health sector, and prepares reports and recommendations to promote greater awareness of global health issues. More information about the GHC can be found at: www.centrosaluteglobale.eu
By Maria José Caldés Pinilla and Michele De Luca
The Global Health Centre is a multidisciplinary facility of the Tuscany Region (TR).Established in 2012 its objective is to highlight the connections between globalisation and health in terms of equality, human rights, sustainability, diplomacy, and international collaborations. The fundamental objective is to enhance, disseminate, and apply knowledge to the two thematic priorities on which the Centre is founded: international health cooperation and migrants’ health.
Since 2005, Tuscany has been active with over 317 International Health Cooperation projects and over 500 health professionals involved
The Tuscany Region’s strategy for International Health Cooperation (IHC) is tailored to global health challenges which have changed considerably over the past decade. The mobilisation for HIV/AIDS, tuberculosis and malaria has made a significant improvement to a number of health indicators. At the same time, the increase in life expectancy and improvement in living standards have made chronic diseases a real issue for public health. They come in addition to infectious diseases, including in least developed countries. The globalisation of trade also fosters the emergence of new epidemics. Epidemiological surveillance is therefore becoming a global challenge and the impacts of environmental factors on health require greater attention. The Tuscany Region has progressively adapted its development policy to help achieve the Millennium and Sustainable Development Goals.
The IHC strategy prioritises the achievement of the health targets of SDG 3 (Ensure healthy lives and promote wellbeing for all at all ages) and those related to maternal and child health. It also aims to strengthen the fight against emerging and re-emerging infectious diseasesand takes into account the growing pressure on health system from non-communicable diseases (NCDs) It emphasises the need for multisectoral prevention policies to address common risk factors and social and environmental determinants. The IHC strategy supports the enhancement ofs fragile health systems , particularly in the Mediterranean Area, through support for sustainable health financing based on solidarity, training of competent and motivated personnel, and the development of reliable health information systems. The strategy also underlines the importance of human capital accumulation, and giving a central place to individual welfare and health rights. Meeting the SDGs goals will make it possible to act on migration, which all too often penalises the countries of origin and proves harrowing for the people concerned, sometimes making their integration more difficult.
In accordance with the national framework strategy for development cooperation, the health sector strategy prioritizes low income countries in Sub-Saharian Africa. The Mediterranean area also is central to the Tuscan regional strategy ; Tuscany and its neighbouring territories on the southern and eastern shores of the Mediterranean have woven close ties as a result of geographic proximity. Due to historical migratory flows there are large communities from these countries in Tuscany which are involved in the implementation of the IHC initiatives..
Through its IHC projects, the GHC provides the Tuscan Health System’s staff with the opportunity to participate in international health cooperation projects and encourages scientific and academic cooperation and partnerships across all developing countries. Such international relationships contribute to the creation of quality healthcare in neighbouring countries, and supports the use of the Tuscany model based notably on mutual financing of health coverage, excellence in health professionals, equitable access to healthcare, and the right to health.
Through the Global Health Center the Tuscany Region wants to promote equity and appropriateness in the offer of healthcare to the migrant population.
In Italy the foreign population makes up an average of 7.4% of the total population but in Tuscany it is much higher at 10.5%. This population includes new arrivals and 25.6% of new births in the past year.
The large share of migrants of migrants in the Tuscan population, of which 54% are women, is taken into account when considering how to address issues such as the provision of services and health resources, (and the partial or incorrect knowledge of these), and the right to health.
Since the Italian Health System is decentralised, the regions play an important role in the application of the national laws and policies. In order to guarantee the proper application of national indications on migrants’ health in the regional territory and ensure their right to access to health services, the Region of Tuscany has assigned the main role of coordination of the different Tuscan Health Units work on migrant health to the GHC. The GHC coordinates a regional of Local Health Units and Areas, and provides continuous training and update on migrants’ health and related legal framework. The representatives in the network are responsible for connecting their institutions with the Regional level on issues concerning migrants’ health. This ensures the coordination and harmonisation of procedures, approaches, and policies.
The Health Centre also organises health screening for migrants at arrival. At present, every Local Health Unit is autonomous in deciding which department is responsible, what kind of screening carry out, which medical examinat ions to conduct and when. This leads to significant differences within the Region. Therefore, the GHC has started a work of consultation among the Local Health Units in order to define the main criteria that should guide the screening and to harmonise the procedures in the Region following the most recent national guidelines.
The GHC continually organises training in the field of migrants’ health, both for socio-health staff and for third sector organisations. In particular, in 2018 the GHC will organise a comprehensive regional training programme on migrants’ health (with a particular focus on mental health) for family doctors, paediatricians, social health staff and local organisation involved in migrants’ support and reception activities.
 In Italy, a child born to one Italian and one non-Italian parent only acquires (dual) Italian nationality if that parent recognises the relationship.
About the Authors
Maria José Caldés Pinilla is the international health cooperation manager at the Florence Meyer Hospital. She has many years of experience in research and training in the field of public health, health education and promotion. Maria has aDegree in Medicine and Surgery (University of Barcelona), a post-graduate degree in Health Education (University of Perugia), specialisation in Hygiene and Preventive Medicine (University of Perugia), PhD in Community Medicine (University of Padua).
Michele De Luca has a degree in Political Science – International Relation (University of Florence), post-graduate degree in International Relation (University of Florence), and a PhD in Political System and Institutional Change (IMT Lucca Institute of Advanced Studies). He spent a period of fifteen years in developing countries working with many international organisations such as UE, UNDP, and the Italian Development Cooperation managing international cooperation projects and conducting inter-disciplinary policy analysis and impact assessments. Before starting his PhD, she has been a Research Officer in the University of Florence. Since 2011, he has been working on full-time basis at the Florence Meyer Hospital/Global Health Center as international health cooperation officer.