Abstract
Background Undocumented migrants (UMs) in the Netherlands face significant barriers to accessing healthcare
despite legal entitlements to ‘necessary medical care.’ Non-governmental organisations (NGOs) play a critical role in
facilitating healthcare access for UMs, yet empirical research on their contributions remains limited. This study aims
to explore how NGOs perceive their role in facilitating healthcare access for UMs in the Netherlands and how these
perceptions align with their actual practices.
Methods The research employs a qualitative exploratory design, conducting twelve semi-structured interviews with
professionals from various NGOs supporting UMs in the Netherlands. Thematic analysis was used to identify key roles
and strategies employed by these organisations.
Results The data revealed four main roles: (1) mediating, (2) educating, (3) advocating, and (4) delivering services.
The findings suggest that while Dutch NGOs appear to share a common goal of facilitating healthcare access for
UMs within the existing Dutch healthcare system, some of their strategies exist outside the regular system, thereby
creating a parallel system. This parallel system subsequently results in a discrepancy between how NGOs perceive
themselves (i.e., the role they think they should take) and the role they play in practice. Findings further suggest
that the Dutch NGOs in this study face a humanitarian-equity dilemma, where limited resources and high pressure
from UMs’ immediate needs lead them to prioritize direct assistance over addressing systemic issues. Consequently,
many NGO strategies offer temporary solutions that help individual cases but fail to integrate UMs into the regular
healthcare system sustainably.
Conclusions Dutch NGOs play a critical role in facilitating healthcare access for UMs in the Netherlands. Despite
their invaluable efforts in addressing immediate needs, NGOs risk legitimizing a parallel system that allows the
state to retreat from its welfare duties. To facilitate lasting change, NGOs should focus more on educational and