:: Mediation Concept
The profession of mediator is under construction in France:
- Work has been underway for many years to structure the profession of social mediator: a unique definition, a reference framework, an ethical framework, diploma courses and a professional code. This profession is now politically recognizable, via the article 67 of the Equality Citizenship Act, which proposes to include social mediation in the code of social action and families. A profession standard in social mediation has just been published and aims to support its technical recognition.
- On the other hand, health mediation has been recognized institutionally within the framework of the Modernization of our Health System Act, which provides for the development of "benchmarks of competence, training and good practice" concerning health mediation and linguistic interpreting. Mandated by the Ministry of Social Affairs and Health, the High Authority of Health has started consultations with stakeholders since October 2016. These benchmarks should be finalized in the spring of 2017 following a public consultation.
Mediation in health within the framework of the National Program of Health Mediation (cf: referential of the National Program of Sanitary Mediation:
Within the national program of health mediation for vulnerable groups, the mediators are employed by local associations which have already worked with this public or in the medical field.
The role of the mediator is to create connections between the target population and the health actors in order to build the access to the public health system for vulnerable groups.
They are professionals with at least a two years postgraduate degree in social, medical fields or anthropology. They are not from the community, but they speak the language and have a good knowledge of the public. The mediators have to be independent of the two parties and able to dialogue with both of them.
The mediators receive an additional training within the framework of the program, before and during the action. Also, they often meet to exchange good practices between themselves and the coordinators.
They are included in a multidisciplinary team inside the association and work in partnership with others local organisations. In this way, they can meet demands which do not concern health.
All stakeholders on the ground have deplored the very poor health of Roma migrant population, due to poor living conditions and access to health care in their native country and in France.
In 2008-2009, based on this observation, the national collective Romeurope defined a program of health mediation, with the support of the Ministry of Heatlh and the National Institute of Health Prevention and education.
The project aims to develop mediation actions in order to improve access to health care and prevention to public health services for the Roma living in France as well as others vulnerable groups.
This national program is coordinated by ASAV, l’Association pour l’Accueil des Voyageurs “the association for the welcome of travellers”, a non-profit organisation which has worked with the Travellers and the Roma for 20 years. It promotes access of health and social rights of these populations.
The coordination is in charge of monitoring and to evaluate actions, training of mediators, and networking of local associations which develop health mediation actions.
With the support of the Ministry of Health, the scope of the health mediation program (geography and target population) was extended over the period 2013-2016 by developing actions in other territories and by targeting the entire Roma population (previous focus on maternal and child health). The challenge of this extension lies also in the adaptation of the program to other groups experiencing similar barriers to access healthcare, such as Travelers in precarious situations. Health mediation aimed at this public was included in the multiannual plan against poverty and social inclusion formally adopted by the French Government on 21 January 2013.
In 2016, the program includes fourteen mediators from twelve local associations, working in the cities of Caen, Grenoble, Lille, Lyons, Marseilles, Nantes, Rouen, Montpellier and in Ile-de-France.
Profile of the Mediator
· Minimum training: bac + 2 (social, health, ethnology)
· Proficiency in French and Romanian (or languages of the field of intervention: Bulgarian, Serbian ...)
· Knowledge of the healthcare system and social protection in France
· Experience working with associations and/or local institutional partners
· Experience in mediation, health education or health promotion
· Driver's license (if places of intervention are difficult to access by public transport)
· Ability to listen and empathize, diplomacy
· Editorial capacity
· Intercultural sensitivity
· Ability to adapt and work independently
· Team spirit