Author
Primary health care
Applicants are entitled to health care. In 2023, the LITP was amended to extend applicants’ access to medical care beyond emergency situations, upon a doctor’s recommendation.[1] The LITP prescribes that the health care of applicants includes emergency medical assistance and the essential treatment of illnesses and of serious mental disorders in accordance with medical indication. An applicant who needs special reception and/or procedural guarantees, particularly victims of torture, rape or other serious forms of psychological, physical or sexual violence, shall be provided with appropriate health care related to their specific condition, i.e., the consequences caused by said acts.[2] The costs of the health care shall be borne by the ministry responsible for health care.[3]
In 2020, an Ordinance on health care standards for applicants for international protection and foreigners under temporary protection entered into force regulating, amongst other, initial and supplementary medical examinations and the scope of health care for applicants for international protection.[4] Additionally, the Ordinance lists the different vulnerable groups entitled to health care as follows: persons deprived of legal capacity, children, unaccompanied children, elderly and infirm persons, seriously ill persons, persons with disabilities, pregnant women, single parents with a minor children, people with mental disabilities and victims of human trafficking, victims of torture, rape or other psychological, physical and sexual violence, such as victims of female genital mutilation. These categories of persons have a right to psychosocial support and assistance in appropriate institutions. A pregnant woman or a parturient woman who requires monitoring of pregnancy and childbirth is entitled to health care to the same extent as an insured person benefiting from a compulsory health insurance. Children up to the age of 18 are guaranteed the entire right to health care in accordance with the legislation governing the right to health care from compulsory health insurance.[5]
Medical assistance is available in the Reception Centres for Applicants for International Protection in Zagreb and Kutina. Health care is also provided by the health care institutions in Zagreb and Kutina designated by the Ministry of Health. In the Health Centre, a competent ambulance (family medicine) has been designated to provide health care from the primary health care level for chronic and life-threatening illnesses. A specialist ambulance for vulnerable groups has been appointed by the Ministry of Health and Local Health Centres. This includes: paediatric ambulance, gynaecological ambulance, school medicine ambulance, neuropsychiatric ambulance at the Hospital of Kutina, ambulance for addiction treatment; dental ambulances and Psychiatric Hospital in Zagreb.
In addition, applicants are referred to local hospitals, i.e., in Sisak for those accommodated in Kutina, and the Hospital of Zagreb. Vaccination is performed by doctors in health centres or by specialists of school medicine.
In April 2024, the Ministry of the Interior adopted a decision on the allocation of financial resources for the implementation of the project “6P – Support in Providing Healthcare to Applicants for International Protection” under AMIF. The purpose of the project is to promote and protect the health of applicants for international protection and to prevent disease by ensuring access to medical consultations at the level of primary healthcare.[6]
In 2025, through the project “Support in Providing Healthcare to Applicants for International Protection”, funded by the AMIF and the Government of the Republic of Croatia (Ministry of Health), MdM continued to provide multidisciplinary and linguistically adapted care to applicants for international protection, especially in identifying and supporting the most vulnerable among them (women, children, minors, LGBTIQ+, survivors of gender-based violence, human trafficking or torture, persons with disabilities, children with developmental difficulties and their families, etc.) in the Reception centers for applicants for international protection in Croatia (Zagreb and Kutina). Direct services to applicants for international protection were provided every working day in the Reception Center in Zagreb, with team member also present on weekends and holidays.
The medical and mental health teams also provided services at the Reception center in Kutina once a week on average.[7]
MdM reported that one of the ongoing challenges throughout 2025 in facilitating access to healthcare for applicants for international protection was the difficulty in registering employed applicants for international protection with family doctors/general practitioners and other primary healthcare specialists. As the number of employed applicants for international protection entitled to mandatory health insurance through the Croatian Health Insurance Fund continued to rise, it became increasingly important to provide information and support for these patients in registering with general practitioners, dentists and gynaecologists within the public healthcare system. Despite MdM’s efforts to assist patients in registering with doctors (including referrals to the City of Zagreb Welcome Centre (One Stop Shop), a significant number of employed applicants for international protection remained unregistered and lacked a designated general practitioner. Many doctors further refused to register applicants for international protection, citing language barriers, time constraints, or the lack of sufficient spots for new patients as reasons, even in cases where official listings indicated that they were accepting new patients.[8]
In 2022, MDM-BELGIQUE’s team developed info-prevention posters/leaflets on three different topics: “How I feel matters”, “Everyone has the right to birth control” and “There is no room for violence in the family”; as well as a brochure on mental health.[9] In 2023, MdM issued the publication “Physical and mental health of applicants for international protection in the Republic of Croatia – new trends, observations, challenges and recommendations”.[10]
Complementary services by NGOs
MDM-BELGIQUE[11] continued to provide multidisciplinary and linguistically adapted medical and mental health care to applicants for international protection during 2025.
The organisation achieved the following results in 2025:
- MdM continued to conduct initial health examinations for newly arrived applicants for international protection. The organisation facilitated access to medical consultations, mental health care, crisis interventions and the distribution of prescribed medication through teamwork of general practitioners, nurses, psychologists, psychiatric specialists and interpreters (for Arabic, Farsi, Urdu, Pashto, Russian, Spanish and French). Additionally, MdM continued working in partnership with the health centre (Dom zdravlja Zagreb – Centre) to ensure comprehensive care. Direct provision of services was provided every working day in the Reception Center in Zagreb, with a team member also present on weekends and holidays. The medical and mental health teams also provided services at the Kutina Reception center once a week on average.
- To ensure accessible and comprehensive care and support, MdM’s social worker and interpreters provided timely information and practical assistance to applicants for international protection in accessing their rights. This included scheduling appointments for specialist examinations and diagnostic procedures at public health institutions, arranging transportation and accompaniment as needed (with additional support from the CRC when available) and providing interpreter assistance during appointments. By coordinating transportation and accompanying applicants to public health institutions, MdM facilitated further medical examinations and treatments, helping to bridge language and cultural barriers between patients and healthcare providers.
- In cases where infectious diseases were identified in the Reception center for Applicants for International Protection, the MdM medical team responded promptly. In cooperation with the epidemiologist from the Teaching Institute of Public Health “Dr. Andrija Štampar” the team supported the identification and isolation of infected individuals to prevent further transmission.
- Vaccinations for children of applicants for international protection and medical examinations required for preschool and school enrolment continued in partnership with the health centre Dom zdravlja Zagreb – Centar and the Teaching Institute for Public Health “Dr. Andrija Štampar”. MdM also ensured healthcare access for pregnant women in the Reception centre, arranging transport/accompanying with interpreters to the Women’s Diseases and Obstetrics Clinic at hospital. Postpartum care was provided through visits from home care nurses in collaboration with the health center Dom zdravlja Zagreb – Centar in Dugave.
- Additionally, in cooperation with the health centre Dom zdravlja Zagreb – Centar, MdM organized necessary gynaecological and dental care for patients, with successful collaboration continuing in 2025
- In cooperation with the CRC, MdM also organised visits to opticians, supported the provision of prescription glasses and facilitated the procurement of essential medical equipment and orthopaedic aids for applicants for international protection as needed.
- MdM provided a total of 7,715 services to 2,435 applicants for international protection accommodated in reception centres for applicants for international protection in Zagreb and Kutina. Among those, 543 individuals (22%) were women, while 394 (16%) were children, including 150 girls and 244 boys. One person identified as non-binary.
- MdM medical team conducted 5,578 medical consultations for 2,361 applicants for international protection, including 1,961 initial medical examinations for newly arrived individuals. Of these consultations, 25% were with women, and 11% with children. The patients came from a diverse range of countries, highlighting the exceptional cultural and linguistic diversity among the population. The five most common countries of origin among patients were Türkiye (16%), Russian Federation (13%), Syria (11%), Afghanistan (10%) and Egypt (7%).
- In addition, MdM organized a total of 1,015 transportation and accompaniment services for 308 applicants to public health institutions for specialist and diagnostic exams. This included transportation for paediatric care, vaccinations, and school medicine specialist exams for child applicants.
The most common health issues identified among applicants for international protection were skin diseases (19%), respiratory illnesses (18%), musculoskeletal problems (13%) and digestive issues (9%).
Despite this decrease in the number of applicants for international protection in 2025 compared to 2024, the overall workload did not decline, and it did not result in a reduced number of people supported by the MdM team compared to the previous year as service needs remained high and many cases required intensive and coordinated support. Alongside particularly complex cases (including post-operative care, frostbites and multiple traumas, severe mental health disorders, chronic diseases, adults and children with disabilities, cancer and acute conditions), the increase in newly arrived applicants for international protection over the past four years, coupled with a high transit dimension and a rise in incoming transfers under the Dublin III Regulation has led to a significant increase in the number of medical consultations. This has also resulted in additional administrative tasks related to arranging medical tests, specialist exams and transportation. A significant number of applicants also had shorter stays in Reception centres, preventing them from completing the initial health examination. For other applicants for international protection, initial health examinations were organized daily.
One of the ongoing challenges throughout 2025 in facilitating access to healthcare for applicants for international protection in Croatia was the difficulty in registering employed individuals with family doctors/general practitioners and other primary healthcare specialists. As the number of employed applicants entitled to mandatory health insurance through the Croatian Health Insurance Fund (HZZO) continued to rise, it became increasingly important to provide information and support for these patients in registering with general practitioners, dentists and gynaecologists within the public healthcare system. Despite efforts of the MdM team to assist patients in registering with doctors (including referrals to the City of Zagreb Welcome Centre (One Stop Shop) for applicants for international protection, persons granted international or temporary protection, and foreign workers holding a residence and work permit that also assisted patients in registering), a significant number of employed applicants still remained unregistered and lacked a designated general practitioner. Many doctors further refused to register applicants for international protection, citing language barriers, time constraints, or the lack of sufficient spots for new patients as reasons, even in cases where official listings indicated that they were accepting new patients.
Through daily direct work with applicants for international protection, MdM once again observed that many applicants for international protection returned under Dublin III Regulation suffer from various physical and/or mental health issues. This contrasts with the generally healthier population of applicants entering Croatia through non-EU countries. In 2025, transfers included oncology patients, individuals with chronic illnesses, people with disabilities, new-borns, children with serious congenital diseases and individuals who had started treatment in their previous country of residence. It was also noted that transfers often did not include the transfer of medical records, which in some cases delayed the continuation of treatment and disrupted the continuity of care for those arriving in Croatia under Dublin III.
Among the documented cases, particular attention was drawn to the involuntary transfer of a child with a severe genetic haemoglobin disorder and recurrent crises that could not be adequately treated in Croatia. Following nearly six months of stay and medical treatment in Croatia, the child was formally arranged for a return transfer to Switzerland for the continuation of treatment. The transfer was facilitated through cooperation between the MoI, MdM and a specialist from the Institute for Paediatric Oncology, as well as through the work and advocacy efforts of child’s family members and humanitarian organisations in Switzerland.
In 2025, through the project “Strengthening initial health screening of asylum seekers in Croatia: Improved tools and procedures for early identification of vulnerable children and caregivers“ (funded by the UNICEF Office in Croatia, with financial support from the State Secretariat for Migration of the Government of the Swiss Confederation), MdM contributed to strengthening the initial medical examination process for applicants for international protection by improving the tools and procedures used at first contact. The main purpose was to enable earlier and more consistent identification of vulnerabilities and specific needs, including physical health concerns, mental health and psychosocial risks and developmental concerns related to children. In practice, this means that professionals conducting the initial medical examination have clearer guidance and a better screening form to document relevant findings, recognize risk indicators and assure timely referrals and follow-up care.
A recommendations report was drafted in Croatian and English with detailed guidance for improving the Ordinance on Healthcare Standards for Applicants for International Protection and Foreigners with Temporary Protection, including a revision of its Annex 1 (i.e., the medical examination form). The report proposes a more structured and practical approach to screening, supported by clearer protocols, so that the initial examination can function not only as a basic health check but also as an entry point for identifying vulnerabilities and connecting people with the right services as early as possible. To ensure the recommendations were grounded in practice and multidisciplinary needs, external experts were included in the development on screeners related to mental health, legal frameworks, and early childhood development.
A pilot phase of the new version of the first medical examination was initiated in the Reception centres in Zagreb and Kutina. The expressed interest of both the Ministry of Health and the MoI in the report provides a basis for continuing formal consultations on integrating the proposed tools and procedures into national practice.
Capacity building was also delivered through four trainings, reaching in total 53 participants in November 2025. Participants included MdM staff, professionals working in the MoI Reception centres in Zagreb and Kutina and representatives of civil society organisations. Trainings covered trauma-informed approach in MHPSS, early childhood development and identification of developmental delays (basic and advanced modules), and the legal framework related to migration with focus on the right to health.
Through the project “Access to health rights by women, girls, and gender minorities living in precarious environments in Europe” (funded by the Chanel Foundation) and the support of MdM France, MdM continued to work on the topic of gender equality, inclusion of gender minorities, rights to abortion and Sexual and Reproductive Health Rights (SRHR).
Capacity building was a key focus of the project, with the conduction of two capacity building sessions in April 2025 for MdM staff, the MoI and the CRC (44 participants in total). The sessions were facilitated by an SRHR and GBV focal point and were delivered as a one-day training followed by a workshop. The program included training on sexual and reproductive health and rights, gender-based violence and a gender-sensitive approach. It presented our overall vision and practical approach to SRHR and GBV. The training was followed by a workshop on values clarification for action and change, based on the VCAT methodology on abortion. The workshop offered a structured space for participants to reflect on personal assumptions and moral reasoning related to SRHR and access to services, with the aim of strengthening awareness of how values can influence our decision-making and behaviour. Overall, the sessions supported more consistent, rights-based and sensitive practice in daily work with applicants for international protection.
The CRC reported that in 2025 access to healthcare services was provided to 487 applicants for international protection through specialist paediatric examinations, gynaecological check-ups, dental examinations, consultations at the clinic for child and adolescent psychiatry, as well as a range of other aids prescribed by the competent physician.[12]
Mental health
Psychological counselling and support was provided by MdM during 2025.[13]
MdM psychologists were available for initial psychological assessments and individual counselling every working day and psychiatrists were available for psychiatric examinations 3 times per month on average at the Reception centre for applicants for international protection in Zagreb throughout 2025.
In 2025, the increasing trend in the number of applicants with mental health disorders persisted. Notably, more than 60% of patients with mental health conditions staying at the Reception centre for applicants for international protection in Zagreb were transferred under Dublin III Regulation. These patients had previously been treated for various disorders, including paranoid schizophrenia, unspecified non-organic psychosis, suicidality, post-traumatic stress disorder, major depressive episodes, addiction syndrome, anxiety disorders, panic disorders, personality disorders and adjustment disorders. In many cases, symptoms were exacerbated or new mental health issues developed after the transfer. This situation led to frequent crisis interventions and hospitalizations organized by the MdM team following transfers. Among the documented cases, particular attention was drawn to a woman who was a survivor of gender-based violence and who attempted suicide immediately after her organized transfer to Croatia. Thanks to the prompt response of the medical and psychological support teams, emergency services were called and the patient was first admitted to an acute ward and subsequently hospitalized in a psychiatric facility.
Compared to previous years, 2025 saw a decrease in cases of sexual and gender-based violence (SGBV) in the Reception centres, with 37 recorded cases compared to 106 in 2023 and 63 in 2024. MDM-BELGIQUE provided appropriate psychological support, psychiatric treatment, and further referrals for all survivors of violence, in collaboration with relevant service providers.
MdM also continued to provide support to applicants for international protection whose health needs required urgent and coordinated multidisciplinary care. This included individuals diagnosed with serious conditions during their stay in the Reception centers, as well as people who arrived after accidents and people who needed immediate medical attention. In a number of cases, applicants had been exposed to life-threatening situations, severe injuries, or impacts of harsh weather conditions (such as frostbites) and some had witnessed death or experienced the loss of close family members. The team responded by ensuring timely and coordinated medical assessment and referrals while also addressing the psychological consequences of these events, including the organisation of crisis interventions when needed.
Throughout 2025, 643 individual psychological counselling sessions were held, and referrals were made to a psychiatric specialist from the MDM-BELGIQUE team (196 psychiatric exams). When needed, referrals were also made to the Psychiatric Clinic “Sveti Ivan”, the Psychiatric Hospital for Children and Youth, the Addiction Department at Clinical Hospital Sestre Milosrdnice, and for hospital treatment where indicated.
During 2025, a total of seven psychoeducational workshops on mental health were delivered for applicants for international protection. The workshops were designed to support emotional empowerment, strengthen psychological resilience and promote healthy coping strategies in response to stress and uncertainty. The sessions covered key topics including emotional awareness and emotional literacy, stress management and coping techniques and approaches to tolerating and navigating uncertainty. A further workshop series used a creative and reflective format to help participants identify personal strengths and values and to strengthen self-confidence, a sense of identity and group connectedness. All workshops were facilitated by psychologists, and their role was to provide structured psychoeducation grounded in evidence-informed practice, to ensure a safe and supportive environment and to guide participants through practical exercises and reflective discussion. This format helped normalize stress reactions, strengthen participants understanding of emotional processes and increase access to concrete tools that can be applied in daily life. The group setting also promoted cohesion and mutual support, contributing to emotional stabilization and a stronger sense of community.
Additionally, in 2025, MdM’s organized 13 workshops for women applicants for international protection at the Reception Center in Zagreb. These workshops aimed to inform women about MdM’s services, foster group cohesion, and encourage the development of support networks among participants. Activities included jewellery making, henna drawing, music and dance workshops, and other creative and relaxing activities.
Regarding informative and preventive activities, in 2023 MDM-BELGIQUE developed a platform for basic psychological support “Mental Health Zone” (www.mental-health-zone.com) available in eight languages – Croatian, English, French, Spanish, Arabic, Farsi, Turkish and Bajaj. The platform was designed as an interactive online tool which goal is to provide support to beneficiaries of the MDM-BELGIQUE team’s services, as well as to all interested parties, in dealing with short-term and long-term reactions to crisis events and traumatic experiences and their psychological consequences. The platform contains psycho-educational content with practical advice and exercises that can help people integrate the crisis experience more healthily and strengthen natural mechanisms for dealing with stress while encouraging psychological resilience.
The platform was developed by the MDM-BELGIQUE expert team in Croatia as part of the so called OPOPS project, financed by the European Social Fund (ESF) and the Office for Cooperation with NGOs of the Government of the Republic of Croatia.
Special health needs
Applicants who need special reception and/or procedural guarantees, especially victims of torture, rape or other serious forms of psychological, physical or sexual violence, shall be provided with the appropriate health care related to their specific condition or the consequences resulting from the mentioned acts.[14] According to the Law on Mandatory Health Insurance and Health Care for Foreigners in the Republic of Croatia, an ordinance which defines the scope of the right to health care for applicants who have been subject to torture, rape or other serious forms of violence and as well as for those with special health care needs, must be adopted. The Ordinance on health care standards for applicants for international protection and foreigners under temporary protection was adopted in 2020 and entered into force in March 2020 (see Primary health care for more information).[15]
According to national legislation, the procedure of recognising the personal circumstances of applicants shall be conducted continuously by specially trained police officers, employees of the MoI and other competent bodies, from the moment of the expression of the intention to apply for international protection until the delivery of the decision on the application. However, according to the knowledge of the the CLC there is still no further detailed guidance available in the law, nor an early identification mechanism in the form of internal guidance.
The Standard Operational Procedure in Cases of Sexual and Gender-Based Violence in the Reception Centres for Applicants of International Protection” was developed in cooperation with the Ministry of Interior, UNHCR, IOM, MdM, the CRC and the CLC. It entered into force in April 2021.
[1] EUAA: National Asylum Developments 2024, June 2024, page 7, available at: https://euaa.europa.eu/sites/default/files/publications/2024-06/2024_National_Asylum_Developments_EN.pdf.
[2] Article 57(1) -(2) LITP.
[3] Article 57 (4) LITP.
[4] Official Gazette 28/2020, available in Croatian at: https://bit.ly/3asTWel.
[5] Article 9 (1) (4) Ordinance on health care standards for applicants for international protection and foreigners under temporary protection
[6] Ministry of the Interior: Decision on the allocation of financial resources for the implementation of the project “6P – Support in Providing Healthcare to Applicants for International Protection”, 25 April 2024, available at: https://eufondovi.mup.hr/UserDocsImages/dokumenti/Odluke%20o%20dodjeli%20financijskih%20sredstava/Odluka%20-%206P.pdf?vel=847607.
[7] Information provided by MDM-BELGIQUE, 17 February 2026.
[8] Information provided by MDM, 17 February 2026.
[9] Information provided by MdM, 14 February 2023.
[10] MdM: Publication “Physical and mental health of applicants for international protection in the Republic of Croatia – new trends, observations, challenges and recommendations”, available in Croatian at: https://bit.ly/3IQ6ZI7; and in English at: https://bit.ly/ 3C4pO6r.
[11] Information provided by MDM-BELGIQUE, 17 February 2026.
[12] Croatian Red Cross: Annual report on the work of the Croatian Red Cross in 2025, available at: https://www.hck.hr/UserDocsImages/dokumenti/Pristup%20informacijama/Dokumenti,%20zakonski%20i%20podzakonski%20akti/Izvje%C5%A1%C4%87e%20o%20radu%20HCK%20u%202025.pdf?vel=3338517.
[13] Information provided by MdM, 17 February 2026.
[14] Article 57(2) LITP.
[15] Official Gazette 28/2020, available in Croatian at: https://bit.ly/2QKE3ZK.