The project aims at improving the level of health protection for the people of Europe by addressing migrants’ and immigrants’ access, quality and appropriateness of health and social services as important wider determinants for health, focusing on healthcare services for undocumented migrants (UDMs) as an especially vulnerable group, an increasing public health risk and a group providing difficulties for healthcare providers and health policy.
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The paramount objective of the "Chain of Trust" project is to advance the empowerment of patients, health professionals and national health authorities across the EU in their understanding and effective use of telehealth services in an effort to actively contribute to the vision of high quality, patient-centred, equitable healthcare for all EU patients.
Through a series of focused and well defined actions the project will strengthen significantly the levels of awareness and trust for all key stakeholders.

To this end two specific objectives have been identified:

1. Knowledge gathering. To improve available knowledge of the specific views – needs, perceptions on the added value and concerns - among patients and health professionals with regard to telehealth services;

2. Rasing awareness and understanding. To increase awareness and understanding of users` perspective on telehealth amongst patients` and health professionals` organisations and health authorities at European and Member State level.
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The overall purpose of the project is to generate operational knowledge to better understand the role and impact of Community Based Voluntary Counselling and Testing services (CBVCTs) across Europe, as well as to study the use of innovative strategies based on new technologies and social networks, to increase early HIV/STI diagnosis and treatment among the most vulnerable groups.
Six specific Objectives have been defined: 1)To monitor and evaluate CBVCT services in Europe; 2) To identify determinants for HIV test seeking behaviour and sexual risk behaviour among MSM in Europe; 3) To describe and improve approaches of linkage to health services for HIV/STI among MSM in Europe; 4) To improve the implementation of CBVCT services specifically addressed to MSM in Europe; 5) To describe HIV testing patterns and identify barriers to testing and care among migrant populations in Europe; 6) To assess acceptability and feasibility of innovative strategies and interventions aimed at increasing HIV counselling and testing.
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The proposal creates a new, open ‘European network to reduce vulnerabilities in health’, bringing together NGOs and academic partners from 17 EU Member States and 2 EFTA/EEA countries. Our goal is to contribute to decreased EU-wide health inequalities and to more responsive health systems that are better equipped to deal with vulnerability factors that increase health inequalities.The economic crisis has demonstrated that everyone could be ‘vulnerable’ at a given moment in their life. Many members of ‘vulnerable groups’ such as (undocumented) migrants or asylum seekers, sex workers, drug users, Roma, the homeless etc. are actually quite resilient. Consequently, the concept of 'vulnerability' is more useful, inclusive and more precise than the term ‘vulnerable groups’. In order for health systems in Europe to be sustainable and resilient, they need to be able to cover the whole population without any gaps and effectively deal with multiple vulnerabilities.The founding members of the Network seek to gain greater capacity and skills through mutual learning about how to improve health service delivery, patient empowerment, common data collection and advocacy. As a result, people facing multiple vulnerabilities will get access to higher quality care in the health programmes run by Network members and the skills and knowledge they need to get easier access to good quality care in mainstream healthcare systems. The Network will undertake a common data collection process to generate robust data, analysed and validated by a leading epidemiologist. This data will be valuable for academics to review and acquire greater understanding about how vulnerabilities contribute to health inequalities. It will also be a new resource for local, regional, national and EU health authorities, enlarging the evidence base on reducing vulnerabilities in health and identifying ways that health systems could become more responsive and adapted.
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The ‘European Network to reduce vulnerabilities in health’ was founded in 2015 with NGOs and academic partners from 19 European countries. Our goal is to contribute to decreased EU-wide health inequalities and to more responsive health systems that are better equipped to deal with vulnerability factors. By collecting robust, comparative routine data (quantitative and qualitative) we aim to improve the quality of service delivery and build a solid evidence base for advocacy for people facing vulnerabilities. If this application is successful, we expect to integrate five new member organisations into the Network. The creation of the Network has been welcomed by its members, who confirmed the relevance to their everyday work and the added value of exchanges in the four strategic objectives: mutual learning, empowerment, data collection and advocacy. In addition to the data collection, analysis of legal frameworks in different countries, workshops and training activities, in 2016, we will begin peer reviews to allow members to directly experience different modes of providing health and care services. The Network will continue the process of rigorous data collection and analysis with specific support being provided by the Network secretariat to the five members that expect to start collecting data for the first time in 2016. The Network invites academics to independently review the data and understand how vulnerabilities contribute to health inequalities. The Network also engages with European institutions and stakeholders. Given the unprecedented economic crisis and the unpredictable, fast-changing refugee situation, and the fact that our members are in the front line in responding to their humanitarian needs, the Network may need to re-prioritize its mutual learning goals in the coming months.
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