Enabling access to healthcare to the most vulnerable in France

Mobile care-access units for homeless women in Ile-de-France

Location of Project Ile-de-France (Greater Paris)
Name of Association
ADSF: Acting for the Development of Women's Health

Issue / local context

The IDF (Greater Paris area) has a high population density in municipalities and counties with high poverty rates. In 2016, 5,739 people were living in slums in the IDF and two in five homeless people were women. The latest estimate by the INSEE (2012) referred to over 7,000 women living on the streets in Paris alone. In 2005, the ADSF conducted a study in partnership with the Samu Social de Paris which revealed that more than 1,500 homeless women had received no medical care during pregnancy prior to arriving at the maternity ward. Moreover, according to a 2009 report by the INVS, it is much harder for poverty-struck women than for men to access healthcare, as homeless women had nine times less access to care than the general population, compared to five times less access for men.

In 2013, faced with an extremely tense situation, the French government adopted a multi-year plan to fight poverty and social exclusion with measures that included reducing perceived inequalities in access to healthcare for the poorest populations even though many institutions provided free services in France.

Program description

The medico-social mobile units of the Santé des Femmes (Women's Health) plan established by ADSF aim to improve the physical, social, and mental as well as the sexual and reproductive health of women living in an unfavorable social and/or economic situation (beneficiaries of medical aid and healthcare coverage, or residing in disadvantaged areas, or migrants or of immigrant origin, or living illegally in France, and Roma women) and therefore outside the standard care circuits or at least finding it difficult to access such services as all these women are in a high-risk situation.

To improve the care pathway for these women and those who are victims of violence, the proposed solution incorporates teams of medical and non-medical volunteers to provide women in need with:

  • Close, caring attention to their background and life story
  • An awareness of issues specific to women's health, particularly with respect to their sexuality and reproductive function, together with preventive consultations and screening
  • Guidance and support for the poorest cohorts from health structures and aid workers.
  • Detecting situations of violence or psychological distress

The project's objectives

  • Going out to engage with women where they live to create a social and medical bond
  • Guiding and supporting women in gaining access to care and throughout their care pathway to improve their health (physical, mental, social, sexual and reproductive)
  • Improving best practices for mobile units to provide an appropriate response to women, depending on their location and life context

Partner since June 2017