Health is Wealth and Documents are the Currency Exploring the Role of NGOs in Facilitating Healthcare Access for Undocumented Migrants in the Netherlands

Abstract

Undocumented migrants (UMs) in the Netherlands face significant barriers to accessing healthcare despite legal entitlements to 'necessary medical care.' Non-governmental organisations (NGOs) play a critical role in facilitating healthcare access for UMs, yet empirical research on their specific contributions remains limited. This study aims to explore how NGOs perceive their role in facilitating healthcare access for UMs in the Netherlands and how these perceptions align with their actual practices. The research employs a qualitative exploratory design, conducting twelve semi-structured interviews with professionals from various NGOs supporting UMs. Thematic analysis was used to identify key roles and strategies employed by these organisations. The data revealed four main roles: 1) mediating, 2) educating, 3) advocating, and 4) delivering services. The findings suggest that while Dutch NGOs appear to share a common goal of facilitating healthcare access for UMs within the existing Dutch healthcare system, some of their strategies happen outside of the regular system, thereby creating a parallel system. Consequently, there seems to be a discrepancy between how NGOs perceive themselves (i.e., the role they think they should take) and the role they play in practice. The Dutch NGOs in this study face a humanitarian-equity dilemma, where limited resources and high pressure from UMs’ immediate needs, lead them to prioritize direct assistance over addressing systemic issues. Consequently, many NGO strategies offer temporary solutions that help individual cases but fail to sustainably integrate UMs into the regular healthcare system. To increase lasting change, NGOs should focus more on educational and advocacy roles and collaborate to reduce costs and enhance effectiveness. This strategic shift is essential for creating sustainable solutions that ensure UMs are included in the regular healthcare system and uphold the principles of equity and justice.