Improving access to healthcare for the most vulnerable populations

Supporting healthcare actions for young women and their children

When I am sick, I always come to the Red Cross because the doctors in hospitals send me bills I can’t pay
I was discouraged at that time and didn’t want to take care of myself

Words from beneficiaries at a Social Health Center

Location of Project Mainland France
Name of Association
French Red Cross
  www.croix-rouge.fr (in French)
Project Partners
(financial and operational)
  • Local authorities and the Communal Centers for Social Action
  • Département councils
  • Regional Health Agencies
  • Primary Health Insurance payers
  • Hospitals, especially Access to Health Care hotlines (PASS)
  • Other associations working with the poorest communities
  • Departmental Directorates for Social Cohesion
  • The Sanofi Espoir Foundation

Issues/local context

Living conditions and life events play a key role in access to care. Health no longer becomes a leading priority and can often take second place when vital needs are not being met.

Living in poverty and precariousness may cause a feeling of worthlessness, poor self-image, shame and malaise that demotivates the sufferer from taking care of their health, whether by taking administrative steps, performing necessary healthcare actions or trying to prevent illness.

The conditions related to such insecurity, such as instability in terms of jobs or housing, housing quality, mobility or transportation problems, or the need to find solutions for taking care of children, also have a large impact on the opportunities to access healthcare, or to access such rights with, for example, problems related to the receipt and preservation of supporting documents required for entitlement.

In rural areas, there are further difficulties due to remoteness and geographical isolation.

Problems of understanding, difficult or misunderstood previous experiences, and difficulties in understanding prevention and care products can lead to deep apprehension about the medical and administrative world.

Due to the accumulation of difficulties, the experience of distress and incapacity to cope, people enter into a situation of denying or minimizing their health problems and then giving up or rejecting any attempt to receive care or claim their rights.

Program Description

Project goals

The goals are to:

  • Offer low-threshold care and social counseling for vulnerable groups particularly in desertified parts of France
  • Help women in precarious situations to take or regain control of their health
  • Restore self-esteem and dignity
  • Help people regain their confidence and learn self-respect before undertaking anything in their healthcare agenda.
  • Carry out preventive actions (contraception, anti-addiction, nutrition, etc.)

The program, which runs from access to care to access to health, consists of two complementary actions.

  • Action 1
    Propose care provision for vulnerable groups in areas where it is lacking.
  • This involves continuing our access to care actions via Social Health Centers(1) with the ambition of strengthening the existing facilities and developing new approaches in areas weakened by the decline of local public services. From 2012 to 2015, with the support of the Sanofi Foundation, we increased from 9 to 14 facilities. The number of consultations is estimated to have doubled over the period from about 4,500 to 9,000. Knowledge about the areas and especially under-medicalized zones is helping to find ways to reach out to potential beneficiaries through mobility support actions. We feel that our experience acquired from the mobile teams now being developed at the scale of the entire Ain département should be leveraged as part of our strategic goal of "support life paths in the countryside." Being present in regions where public services have dried up is one of our goals. This action line covers rural and some suburban areas. One of our major work focuses in the coming years will involve modeling facilities that are best adapted to medical “deserts.”

  • Action 2
    Address the social determinants of health to improve care solutions
  • This aims to support the health of young mothers in social precariousness situations by means of health and well-being workshops led by a midwife and a socio-beautician. In group workshops, we will address the concerns of women and mothers (preparing for childbirth, motherhood, breastfeeding, and sexuality). We already have the appropriate infrastructure for these groups. Pregnant women who have to reduce their movements will be able to participate in these actions. They will be carried out in three types of FRC facility for women, spread over the whole area:

    • 5 maternal centers (337 places) which take in young and future mothers (usually between 14 and 25 years) for the first three years of the child’s life. They provide accommodation and medical and social support for the mother and child. The women all have undergone negative life experiences in their recent past.
    • 3 shelters for social reintegration (85 places, 200 women) that take in women, mostly young and sometimes minors who have broken with their family or suffer from a marital breakdown; sometimes they have been abused or forced into prostitution.
    • 13 parenthood support facilities (1,100 families supported) that take in small-income families (entitled to an earned income supplement), foreign asylum seekers whose cases are under investigation, people in precarious situations due to changes in their family situation (divorce, moving), and single-parent families.

More than 11,000 people will benefit from the overall project (both actions) including 2,000 women in the health support action.


1 Social Health Centers (formerly APASM) are run by volunteers who provide medical prevention and health education support, as well as social support for those admitted.