Strategies for change among institutional and civil society actors
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Migrants and health: political and institutional responses to cultural diversity in health systems
This chapter will first provide background on the political and regulatory frameworks of Germany, Canada and Italy, as this is the legislation that qualifies access to health services. This allows us to highlight how the essential regulatory frameworks are both a considerable constraint and opportunity for civil society and migrant organizations. They also allow us to show the dynamic nature of the relation between state and civil society-more specifically, between state and organized civil society. In each of the countries we consider, civil society develops in ways that are in part isomorphic and in part complementary to the structure of the state. Each of the states we examine support civil society in different ways and for different purposes, and in doing so shape the way pro-migrant associations operate. The first section of this chapter will illustrate these processes. We will then move to examine how civil society actors have become engaged in the field of health care and what strategies they have adopted in our national contexts. Finally, we will examine what policy lessons can be learned from our case studies, both in terms of access and in terms of policy effectiveness in the service delivery and advocacy functions.