The Reform of the Common European Asylum System - Implications for the Public Health Workforce

Abstract Background Identifying and addressing special needs of refugees is essential for adequate accommodation, healthcare and the asylum process. In 2024, the EU regulations on identifying and dealing with persons with special protection needs have been revised in the scope of the reform of the Common European Asylum System (CEAS). In this study, we examined what processes were used to identify and address refugees’ protection needs in Germany, a major host country, prior to the CEAS reform, and analysed the reform's requirements with a focus on implications for public health services. Methods We conducted a mixed methods study with three multi-stakeholder workshops involving 60 participants from public health services, reception authorities, medical and social care, among others, across six German federal states. We employed network analysis, qualitative synthesis, and document analysis of new EU directives under the CEAS reform and triangulated the results. Results Identifying and addressing protection needs requires the cooperation of a wide range of diverse actors. Structured procedures are common during initial medical assessment of refugees on infectious diseases, but are still lacking in other domains. Challenges in sharing relevant information are often described, both for data protection and data processing reasons. The new EU directives adopted as part of the CEAS reform specify the implementation of vulnerability screenings and attempt to achieve greater harmonisation, but await its transposition into national law and further operationalisation. Conclusions In many places, public health services are already involved in the initial assessment of refugees. So far, this has often focused on infection control aspects. As part of the implementation of the CEAS reform, the mandate of public health services in EU Member States should be broadened to play a greater role in identifying special needs, coordinating care services and supporting vulnerable groups. Key messages • Identification of special needs of refugees are essential for adequate accommodation, healthcare and the asylum process, a common understanding about a structured process is still missing. • Following the CEAS reform, EU Member States should expand the role of public health in refugee care, with a focus on vulnerability assessment and coordination to better address special needs.