Abstract:
Research on migration and health shows that immigrants, especially those with precarious legal status, encounter barriers to accessing healthcare. In Poland, migrants' interactions with the healthcare system remain understudied. This study begins to fill the gap by focusing on healthcare use and access strategies among Ukrainian migrant women working in the domestic sector, whose access to services remains uncertain due to legal status, circular migration patterns, and the informal nature of their work. This explorative qualitative study, based on 10 semi-structured interviews with Ukrainian migrant workers in Warsaw, found that women had difficulties accessing healthcare in Poland and that they often cycled through various insurance statuses. Women were found to deliberately navigate their healthcare options and to strategically use care in both Poland and Ukraine in response to systemic barriers and personal needs. The main barriers to access were lack of formal employment in Poland, healthcare costs, wait times, discrimination, inadequate tourist insurance, language, and fear of legal consequences. Facilitators included access to the national healthcare system, social networks, and the behaviors of some employers. This paper concludes that Ukrainian domestic workers skillfully leverage available access options, but formal employment remains the primary barrier to healthcare. Circular migration patterns and Poland's lack of cohesive integration policies encourage informality and perpetuate dubious relationships with employers, often leavin migrants uninsured. Recommendations include creating frameworks for low-cost insurance schemes, creating better systems for formalized employment, and ensuring healthcare access is not neglected within the emergent immigration policies.
