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Deal A, Hayward SE, Crawshaw AF, Goldsmith LP, Hui C, Dalal W, Wurie F, Bautista MA, Lebanan MA, Agan S, Hassan FA, Wickramage K, Campos-Matos I, Hargreaves S. Immunisation status of UK-bound refugees between January, 2018, and October, 2019: a retrospective, population-based cross-sectional study. Lancet Public Health 2022; 7:e606-e615. [PMID: 35636439 PMCID: PMC9581781 DOI: 10.1016/s2468-2667(22)00089-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND WHO's new Immunization Agenda 2030 places a focus on ensuring migrants and other marginalised groups are offered catch-up vaccinations across the life-course. Yet, it is not known to what extent specific groups, such as refugees, are immunised according to host country schedules, and the implications for policy and practice. We aimed to assess the immunisation coverage of UK-bound refugees undergoing International Organization for Migration (IOM) health assessments through UK resettlement schemes, and calculate risk factors for under-immunisation. METHODS We undertook a retrospective cross-sectional study of all refugees (children <10 years, adolescents aged 10-19 years, and adults >19 years) in the UK resettlement programme who had at least one migration health assessment conducted by IOM between Jan 1, 2018 and Oct 31, 2019, across 18 countries. Individuals' recorded vaccine coverage was calculated and compared with the UK immunisation schedule and the UK Refugee Technical Instructions. We carried out multivariate logistic regression analyses to assess factors associated with varying immunisation coverage. FINDINGS Our study included 12 526 refugees of 36 nationalities (median age 17 years [IQR 7-33]; 6147 [49·1%] female; 7955 [63·5%] Syrian nationals). 26 118 vaccine doses were administered by the IOM (most commonly measles, mumps, and rubella [8741 doses]). During the study, 6870 refugees departed for the UK, of whom 5556 (80·9%) had at least one recorded dose of measles-containing vaccine and 5798 (84·4%) had at least one dose of polio vaccine, as per the UK Refugee Technical Instructions, and 1315 (19·1%) had at least one recorded dose of diphtheria-containing vaccine or tetanus-containing vaccine. 764 (11·1%) of refugees were fully aligned with the UK schedule for polio, compared with 2338 (34·0%) for measles and 380 (5·5%) for diphtheria and tetanus. Adults were significantly less likely than children to be in line with the UK immunisation schedule for polio (odds ratio 0·0013, 95% CI 0·0001-0·0052) and measles (0·29, 0·25-0·32). INTERPRETATION On arrival to the UK, refugees' recorded vaccination coverage is suboptimal and varies by age, nationality, country of health assessment, and by disease, with particularly low coverage reported for diphtheria and tetanus, and among adult refugees. These findings have important implications for the delivery of refugee pre-entry health assessments and catch-up vaccination policy and delivery targeting child, adolescent, and adults migrants in the UK, and other refugee-receiving countries. This research highlights the need for improved data sharing and clearer definition of where responsibilities lie between host countries and health assessment providers. FUNDING UK National Institute for Health Research (NIHR300072) and Medical Research Council (MR/N013638/1).
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Affiliation(s)
- Anna Deal
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sally E Hayward
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK; Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Alison F Crawshaw
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Lucy P Goldsmith
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Charles Hui
- Department of Paediatrics, University of Ottawa, ON, Canada
| | - Warren Dalal
- International Organization for Migration, Nairobi, Kenya
| | - Fatima Wurie
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK
| | | | | | | | | | | | - Ines Campos-Matos
- Office for Health Improvement and Disparities, Department of Health and Social Care, London, UK
| | - Sally Hargreaves
- Migrant Health Research Group, Institute for Infection and Immunity, St George's, University of London, London, UK.
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Self-rated health and quality of life among Syrian refugees in Ireland - data from a cross-sectional study. BMC Public Health 2022; 22:1202. [PMID: 35705914 PMCID: PMC9202096 DOI: 10.1186/s12889-022-13610-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION As a response to the humanitarian crisis in Syria, the Irish government agreed to accept up to 4000 refugees for resettlement in Ireland in 2016. Prior to their arrival in Ireland, health screening was carried out by the International Organisation for Migration. However, no population-level measurement of the health status or needs takes place in Ireland to inform policy or health services requirements. METHODS Cross-sectional data from a self-completed questionnaire among 194 Syrian Refugees aged 16 years and older resident in reception centres in Ireland in 2017/2018 is reported upon. The questionnaire measured self-reported health including quality of life and all study material were available in English and Arabic. The data was examined applying descriptive statistics and regression analysis. RESULTS Syrian Refugees in Ireland consist of a relatively young cohort; in this study the majority of participants were younger than 35 years (69.5%). Two-thirds of the respondents reported their overall health status to be good or very good. The most common health condition was found to be headache and the most common medications used were painkillers. Chronic pain was experienced by one quarter of respondents; 27.5% were considered as suffering from anxiety and 10.0% had symptoms compatible with post-traumatic stress disorder (PTSD). A significant relationship was observed between chronic pain and self-rated health, as well as between chronic pain and anxiety. Quality of life (QoL) scores were lowest for the QoL environment domain. CONCLUSIONS Chronic pain is relatively widespread among these young and otherwise healthy refugees. Psychological distress and trauma are important factors in respondents' quality of life scores. Chronic pain is associated with one's mental health. Our findings and the literature suggests that the diagnosis and treatment of pain and providing care in a culturally sensitive manner should be a priority and included in the preparation and training of the relevant care providers. Additionally, the impact of living conditions on quality of life should not be underestimated.
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Rosenthal T, Touyz RM, Oparil S. Migrating Populations and Health: Risk Factors for Cardiovascular Disease and Metabolic Syndrome. Curr Hypertens Rep 2022; 24:325-340. [PMID: 35704140 PMCID: PMC9198623 DOI: 10.1007/s11906-022-01194-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2022] [Indexed: 11/09/2022]
Abstract
PURPOSE OF REVIEW To summarize results of recent studies of migrants in Europe and North America and ongoing efforts to adapt strategies to provide them with inclusive sensitive health care. RECENT FINDINGS Major predisposing factors for developing hypertension, obesity, diabetes, and the metabolic syndrome in migrating populations and refugees were identified. Susceptibility to the metabolic syndrome is predominantly due to environmental factors and psychological stress. Acculturation also contributes to the emergence of cardiovascular (CV) risk factors in first-generation adult immigrants. Increased risk for later development of hypertension and dyslipidemia has also been detected in adolescent immigrants. Targets for public health efforts were based on data that show important differences in CV risk factors and prevalence of the metabolic syndrome among ethnic immigrant groups. Studies in young adults focused on lifestyle and dietary behaviors and perceptions about weight and body image, while the focus for older adults was end-of-life issues. Two important themes have emerged: barriers to health care, with a focus on cultural and language barriers, and violence and its impact on immigrants' mental health.
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Affiliation(s)
- Talma Rosenthal
- Department of Physiology and Pharmacology, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Rhian M Touyz
- Research Institute of McGill University Health Centre, Montreal, QC, Canada
| | - Suzanne Oparil
- Vascular Biology & Hypertension Program, Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, 1720 2nd Avenue South, Birmingham, AL, 35294-0007, USA.
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Baumann KJ, Adera T. Sociodemographic Characteristics and Inadequate Usual Sources of Healthcare in a National Sample of US Refugees. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127234. [PMID: 35742484 PMCID: PMC9223584 DOI: 10.3390/ijerph19127234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/22/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Refugees resettled into the United States (US) face challenges in accessing adequate healthcare. Knowledge of demographic and social characteristics related to healthcare access among refugees is scarce. This study examines potential sociodemographic predictors of inadequate usual sources of care (USCs)-one key component of healthcare access-within the US refugee population. METHODS The 2016 Annual Survey of Refugees (ASR) involving 4037 refugees resettled into the US served as the data source for this study. Inadequate USC was defined as a USC that was neither a private healthcare provider nor a health clinic. We used multiple binary logistic regression methods to identify sociodemographic predictors of inadequate USCs. In addition, we used multinomial logistic regression to further assess predictors of inadequate USCs with a particular focus on severely deficit USCs (i.e., emergency department dependence and USC absence). RESULTS Refugees with interrupted healthcare coverage were more likely to have an inadequate USC. Refugees who were young (age 10-19), resettled into the western region of the US, and highly educated were less likely to have an inadequate USC. Refugees with an education level higher than secondary had a significantly lower likelihood of having a severely deficient USC, while refugees with interrupted healthcare were more than twice as likely to have a severely deficient USC. CONCLUSIONS Considering these results alongside our previous healthcare coverage findings provides a more comprehensive understanding of sociodemographic predictors of poor healthcare access among refugees resettled into the US. This improved understanding has the potential to assist early refugee contacts toward more effective healthcare resource allocation and aid policymakers attempting to improve programs linked to refugee healthcare access.
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Affiliation(s)
- Kyle J. Baumann
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA;
- Department of Medicine, University of Minnesota Medical School, Minneapolis, MN 55455, USA
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN 55455, USA
- Correspondence:
| | - Tilahun Adera
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University School of Medicine, Richmond, VA 23298, USA;
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Meaza A, Tola HH, Eshetu K, Mindaye T, Medhin G, Gumi B. Tuberculosis among refugees and migrant populations: Systematic review. PLoS One 2022; 17:e0268696. [PMID: 35679258 PMCID: PMC9182295 DOI: 10.1371/journal.pone.0268696] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 05/04/2022] [Indexed: 11/18/2022] Open
Abstract
Tuberculosis (TB) is an important cause of morbidity and mortality among refugees and migrant populations. These groups are among the most vulnerable populations at increased risk of developing TB. However, there is no systematic review that attempts to summarize TB among refugees and migrant populations. This study aimed to summarize evidence on the magnitude of TB among refugees and migrant populations. The findings of this review will provide evidence to improve TB prevention and control policies in refugees and migrants in refugee camps and in migrant-hosting countries. A systematic search was done to retrieve the articles published from 2014 to 2021 in English language from electronic databases. Key searching terms were used in both free text and Medical Subject Heading (MeSH). Articles which had reported the magnitude of TB among refugees and migrant populations were included in the review. We assessed the risk of bias, and quality of the included studies with a modified version of the Newcastle–Ottawa Scale (NOS). Included studies which had reported incidence or prevalence data were eligible for data synthesis. The results were shown as summary tables. In the present review, more than 3 million refugees and migrants were screened for TB with the data collection period between 1991 and 2017 among the included studies. The incidence and prevalence of TB ranged from 19 to 754 cases per 100,000 population and 18.7 to 535 cases per 100,000 population respectively among the included studies. The current findings show that the most reported countries of origin in TB cases among refugees and migrants were from Asia and Africa; and the incidence and prevalence of TB among refugees and migrant populations is higher than in the host countries. This implies the need to implement and improve TB prevention and control in refugees and migrant populations globally. Trial registration: The protocol of this review was registered on PROSPERO (International prospective register of systematic reviews) with ID number, CRD42020157619.
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Affiliation(s)
- Abyot Meaza
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- * E-mail:
| | | | - Kirubel Eshetu
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
| | - Tedla Mindaye
- Sibley Memorial Hospital, Johns Hopkins Medicine, Washington, DC, United States of America
| | - Girmay Medhin
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Balako Gumi
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
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Manfredi L, Sciannameo V, Destefanis C, Prisecaru M, Cossu G, Gnavi R, Macciotta A, Catalano A, Pepe RR, Sacerdote C, Ricceri F. Health status assessment of a population of asylum seekers in Northern Italy. Global Health 2022; 18:57. [PMID: 35659014 PMCID: PMC9164173 DOI: 10.1186/s12992-022-00846-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 05/02/2022] [Indexed: 11/11/2022] Open
Abstract
Background Since 2011 Italy has faced an extraordinary increase in migrants arrivals, mainly from the Mediterranean route, one of the world’s most dangerous journeys. The purpose of the present article is to provide a comprehensive picture of the migrants' health status in the "T. Fenoglio" centre, Settimo Torinese (Turin, Italy). Methods A retrospective cross-sectional study was conducted using data collected from June 2016 to May 2018 on adult migrants (over 18 years old) from Africa, Middle East and South East Asia (Bangladesh, Cambodia, India, Nepal). Data was collected through the migrants' medical records. Descriptive statistics were performed on socio-demographic variables. The diagnosed diseases were anonymously registered and classified according to the International Classification of Primary Care (ICPC-2). Conditional Inference Trees were used to perform a descriptive analysis of the sample and to detect the covariates with the strongest association with the variables Disease on arrival, Disease after arrival, ICPC on arrival and ICPC after arrival. Results Analyzed observations were 9 857. 81.8% were men, median age was 23 (Interquartile range: 20.0–27.4). 70.3% of the sample came from Sub-Saharan Africa. 2 365 individuals (24%) arrived at the centre with at least one disease. On arrival, skin (27.71%), respiratory (14.46%), digestive (14.73%) and generic diseases (20.88%) were the most frequent. During the stay respiratory diseases were the most common (25.70%). The highest probability of arriving with a disease occurred in 2018 and during the period September–November 2016, in particular for people from the Horn of Africa. During this period and also in the first half of 2017, skin diseases were the most reported. In seasons with lower prevalence of diseases on arrival the most common disease code was generic for both men and women (usually fever or trauma). Conclusions This study provides information on the diverse diseases that affect the asylum seekers population. In our sample, the Horn of Africa was the most troubled area of arrival, with severe conditions frequently reported regarding skin diseases, in particular scabies. 2018 was the most critical year, especially for migrants from the Horn of Africa and Sub-Saharan Africa. During the stay at the camp, the prevalence of respiratory diseases increased. However, skin diseases remained the main issue for people from the Horn of Africa. Overall, the most reported diseases in the sample were dermatological, respiratory, digestive and generic diseases, both on arrival and during the stay. A better understanding of the health status of asylum seekers is an important factor to determine a more efficient reception and integration process and a better allocation of economic resources in the context of migrants' health care. Supplementary Information The online version contains supplementary material available at 10.1186/s12992-022-00846-0.
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Affiliation(s)
- Luca Manfredi
- Unit of Epidemiology, Regional Health Service ASLTO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy.
| | - Veronica Sciannameo
- Department of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
| | | | - Marta Prisecaru
- Degree in Strategy and Policy, University of Turin, Turin, Italy
| | - Giorgia Cossu
- Degree in Strategy and Policy, University of Turin, Turin, Italy
| | - Roberto Gnavi
- Unit of Epidemiology, Regional Health Service ASLTO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy
| | - Alessandra Macciotta
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | - Alberto Catalano
- Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
| | | | - Carlotta Sacerdote
- Unit of Cancer Epidemiology, Città Della Salute E Della Scienza University-Hospital, Turin, Italy
| | - Fulvio Ricceri
- Unit of Epidemiology, Regional Health Service ASLTO3, Via Sabaudia 164, 10095, Grugliasco, TO, Italy.,Department of Clinical and Biological Sciences, University of Turin, Turin, Italy
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Donnelly O, Leavey G. Screening Tools for Mental Disorders Among Female Refugees: a Systematic Review. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:209-219. [PMID: 35600514 PMCID: PMC9120328 DOI: 10.1007/s40653-021-00375-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/11/2021] [Indexed: 06/15/2023]
Abstract
Female refugees are particularly vulnerable to mental disorders but assessment may be complex and challenging. Various screening tools have been developed for this population, but little is known about their usefulness. The main aim is to examine the literature on the effectiveness of screening tools for mental health problems among female refugees. Systematic review of PubMed, PsycINFO and Embase to locate all published work. Comprehensive search terms were used and inclusion and exclusion criteria were formulated. The initial search yielded 877 articles, of which 757 were removed after titles and abstracts were reviewed. Then, 121 full-text versions of articles were examined and 96 excluded according to the criteria. A total of 25 articles were included in this systematic review in accordance with the PRIMSA guidelines. Twenty screening tools were evaluated. There is a lack of tools used to screen refugee women, and in particular those in emergency settings. Cultural factors may not be accounted for in the development of screening instruments. Further research in this field can help inform public health policies to address social, educational and occupational inclusion for refugee women in different contexts.
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Affiliation(s)
| | - Gerard Leavey
- Bamford Centre of Mental Health & Wellbeing, Ulster University, Coleraine, Northern Ireland
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Nöstlinger C, Cosaert T, Landeghem EV, Vanhamel J, Jones G, Zenner D, Jacobi J, Noori T, Pharris A, Smith A, Hayes R, Val E, Waagensen E, Vovc E, Sehgal S, Laga M, Van Renterghem H. HIV among migrants in precarious circumstances in the EU and European Economic Area. Lancet HIV 2022; 9:e428-e437. [PMID: 35460600 DOI: 10.1016/s2352-3018(22)00032-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 01/22/2022] [Accepted: 01/28/2022] [Indexed: 06/14/2023]
Abstract
HIV epidemics in the EU and European Economic Area are increasingly diverse in transmission modes and groups affected. Substantial gaps in data exist on HIV burden and access to the HIV continuum of care among migrants living in this region, particularly individuals in precarious circumstances such as migrants with irregular status. Migrants have a higher HIV burden compared with the general population, and high rates of post-migration HIV acquisition. Migrants also face challenges in access to health and HIV services, with irregular migrants, foreign-born key populations such as men who have sex with men, sex workers, and people who inject drugs, and migrants from sub-Saharan Africa being most affected. Intersecting factors negatively affect their access to services along the full continuum of care, including prevention and psychosocial services. Ensuring equitable access to general health and HIV services, regardless of immigration status, and implementing interventions to reduce stigma and discrimination are crucial to ending AIDS by 2030.
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Affiliation(s)
| | - Theo Cosaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Ella Van Landeghem
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jef Vanhamel
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Gary Jones
- Fast Track Implementation Department, UNAIDS, Geneva, Switzerland
| | - Dominik Zenner
- Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | | | - Teymur Noori
- Air-Borne, Blood-Borne and Sexually Transmitted Infections, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Anastasia Pharris
- Air-Borne, Blood-Borne and Sexually Transmitted Infections, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Alyna Smith
- Platform for International Cooperation on Undocumented Migrants (PICUM), Brussels, Belgium
| | - Rosalie Hayes
- Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Elena Val
- Migration Health Division, International Organisation of Migration (IOM), Brussels, Belgium
| | - Elisabeth Waagensen
- Migration and Health Programme, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Elena Vovc
- HIV/viral Hepatitis, STIs Unit of the Joint Infectious Diseases Program, WHO Regional Office for Europe, Copenhagen, Denmark
| | - Sarita Sehgal
- Graduate School of Business, University of Cape Town, Cape Town, South Africa
| | - Marie Laga
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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Mellou K, Gkolfinopoulou K, Andreopoulou A, Tsekou A, Papadima K, Stamoulis K, Kossyvakis A, Mentis A, Maltezou HC. A COVID-19 outbreak among migrants in a hosting facility in Greece, April 2020. J Infect Prev 2022; 23:235-238. [PMID: 36003137 PMCID: PMC9389273 DOI: 10.1177/17571774221092568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 03/22/2022] [Indexed: 12/04/2022] Open
Abstract
In April 2020, a coronavirus disease 2019 outbreak was identified among migrants/refugees
in Greece. Overall, 155 of 450 hosted migrants and two of 46 employees were infected
(attack rates: 34.4% and 4.3%, respectively). The mean age of infected migrants was
24.9 years (3 days-68 years). In addition, 177 community contacts were tested negative.
Cases were cohorted in separate rooms from people tested negative. Surfaces were cleaned
and disinfected daily. The implementation of measures for the containment of the outbreak
was challenging due to language barriers and lack of space for cohorting. At that time,
there was no official recommendation to the general population regarding the use of masks
or other personal protective equipment. Extensive testing of vulnerable populations and
building trust in order to report symptoms and comply with the recommendations are
essential.
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Affiliation(s)
- Kassiani Mellou
- Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Kassiani Gkolfinopoulou
- Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Anastasia Andreopoulou
- Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
| | - Aikaterini Tsekou
- Directorate of Preparedness and Response, National Public Health Organization, Athens, Greece
| | - Kalliopi Papadima
- Directorate of Epidemiological Surveillance and Interventions for Infectious Diseases, National Public Health Organization, Athens, Greece
| | | | - Athanasios Kossyvakis
- National Reference Laboratory for Influenza and Other Respiratory Viruses, Hellenic Pasteur Institute, Athens, Greece
| | - Andreas Mentis
- National Reference Laboratory for Influenza and Other Respiratory Viruses, Hellenic Pasteur Institute, Athens, Greece
| | - Helena C Maltezou
- Directorate of Research, Studies and Documentation, National Public Health Organization, Athens, Greece
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Agbata EN, Buitrago-Garcia D, Nunez-Gonzalez S, Hashmi SS, Pottie K, Alonso-Coello P, Arevalo-Rodriguez I. Quality assessment of systematic reviews on international migrant healthcare interventions: a systematic review. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-020-01390-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kuo SF, Yeh YC, Chang CC, Lin YF, Wang SY. Psychometrics and measurement invariance: Health Literacy Scale for Vietnamese and Indonesian married immigrants. J Adv Nurs 2022; 78:1836-1847. [PMID: 35384029 DOI: 10.1111/jan.15241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/13/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
AIMS To examine the psychometrics and measurement invariance of the Short-Form Health Literacy 12-item questionnaire (HL-SF12) among Vietnamese and Indonesian married immigrants. DESIGN A cross-sectional survey design. METHODS In total, 1171 Vietnamese and Indonesian married immigrants were enrolled between September 2019 and December 2019. An exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to verify the structural validity of the suggested factor structure. The multiple-group CFA (MGCFA) used a series of hierarchical nested-in models as a measurement invariance test which confirmed the adequacy of the model fit at each stage. RESULTS/FINDINGS The Kaiser-Meyer-Olkin coefficient was 0.898, and the Bartlett test of sphericity was statistically significant (χ2 [66] = 1965.97, p < 0.01). According to a scree plot and Kaiser's criterion for eigenvalues of >1, the EFA explained 61.6% of the total variance and confirmed three theoretically supported factors of health care, disease prevention and health promotion. The 12 items showed factor loadings of >0.4 and four items were in each subscale. The CFA showed adequate structural validity, including a relative chi-squared/degrees of freedom (X2 /df) of 2.01, a comparative fit index (CFI) of 0.98 and a root mean square error of approximation (RMSEA) of 0.04 (95% confidence interval [0.03, 0.05]) in married immigrants. For the measurement invariance, a change in the goodness-of-fit measures did not exceed 0.02 for the RMSEA or 0.01 for the CFI. The results indicated Cronbach's α values of 0.87 for the HL-SF12 scale in Vietnamese and Indonesian combined samples (n = 1171). A t-test showed that the HL-SF12 and its three subscales were unable to significantly differentiate between Vietnamese and Indonesian groups (all p > 0.05). CONCLUSIONS The HL-SF12 scale showed acceptable theoretically supported structural validity, equivalent measurement invariance and reliable internal consistency among Vietnamese and Indonesian married immigrants. Measurements of immigrants' HL using the HL-SF12 could be integrated into future immigrant health policies. IMPACT As the first study of the measurement invariance of the HL-SF12 instrument among immigrants. Related factors of immigrants' HL can be further explored to increase immigrants' health and empowerment.
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Affiliation(s)
- Shu-Fen Kuo
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Yueh-Chen Yeh
- Department of Nursing, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Chia-Chi Chang
- School of Gerontology Health Management, College of Nursing, and Dean of College of Interdisciplinary Studies, Taipei Medical University, Taipei, Taiwan
| | - Yu-Fang Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Shu-Yi Wang
- Loretto Heights School of Nursing, Rueckert-Hartman College for Health Professions, Regis University, Denver, Colorado, USA
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Lewtak K, Kanecki K, Tyszko P, Goryński P, Bogdan M, Nitsch-Osuch A. Ukraine War Refugees - Threats and New Challenges for Healthcare in Poland. J Hosp Infect 2022; 125:37-43. [DOI: 10.1016/j.jhin.2022.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 04/04/2022] [Indexed: 11/25/2022]
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Eslam Parast N, Taştekin Ouyaba A. The impact of the demographic and migration process factors of refugee women on quality of life and the mediating role of mental health. Perspect Psychiatr Care 2022; 58:785-794. [PMID: 34003486 DOI: 10.1111/ppc.12849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 04/15/2021] [Accepted: 05/02/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This study aims to examine the effect of sociodemographic, before, during, and postmigration factors of women refugees on quality of life (QOL) and to assess the mediation effect of mental health as a mediator in the relationships. DESIGN AND METHODS This cross-sectional study was conducted on 190 refugee women between June and August 2019. The data were analyzed using the structural equation model. FINDINGS Before migration factors affect during migration. The during migration factors affect postmigration. The before, during, and postmigration factors affect the QOL directly or indirectly. Mental health mediates this effect. PRACTICE IMPLICATIONS The study can guide interventional studies to increase the welfare of refugee women.
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Affiliation(s)
- Nastaran Eslam Parast
- Department of Obstetrics and Gynecology Nursing, Afyonkarahisar Health Sciences University Graduate Education Institute, Afyonkarahisar, Turkey
| | - Ayşe Taştekin Ouyaba
- Department of Obstetrics and Gynecology Nursing, Afyonkarahisar Health Sciences University Faculty of Health Sciences, Afyonkarahisar, Turkey
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Van Hemelrijck WMJ, Vandenheede H, Argeseanu Cunningham S. Diabetes management in the face of adversity: Experiences of asylum-seekers in Belgian reception centres. Diabet Med 2022; 39:e14742. [PMID: 34773673 DOI: 10.1111/dme.14742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 11/03/2021] [Accepted: 11/10/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Diabetes poses a heavy burden on patients due to its progressive and chronic nature; it requires continuous management to promote a high-quality and long life. Disease management is especially challenging in emergency settings. We examined how displaced people with diabetes experienced managing their illness before and throughout the process of fleeing their home communities and seeking resettlement in Europe. DESIGN We designed an interview instrument with closed- and open-ended questions about diabetes diagnosis and management before fleeing the home country, during migration, stays in transit countries and reception in the European Union. We interviewed 20 asylum-seekers living in Belgian reception centres with diagnosed diabetes mellitus. RESULTS Primary topics emerging from interviews were availability, accessibility, and quality. Belgium was described as a setting with high availability, accessibility and quality of diabetes management components (medication, tools, care) compared with other settings before and during migration. Even in Belgium, maintaining a healthy diet as an asylum-seeker was difficult. Other concerns such as safety, other health issues and the asylum request itself often outweighed diabetes management. CONCLUSIONS Displaced people in non-Western countries need attention for nutrition and diabetes medicine, so aid agencies should consider providing for those needs. For people seeking asylum in the West and living in temporary facilities, care should be paid to the dietary options available for those with diabetes. For irregular migrants, diabetes can be deadly, and resources should be made available for their basic diabetes needs, even if they are not eligible for regular health services.
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Affiliation(s)
- Wanda Monika Johanna Van Hemelrijck
- Interface Demography - Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
- The Netherlands Interdisciplinary Demographic Institute (NIDI)-KNAW/University of Groningen, The Hague, the Netherlands
| | - Hadewijch Vandenheede
- Interface Demography - Department of Sociology, Vrije Universiteit Brussel, Brussels, Belgium
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Montiel I, Park J, Husted BW, Velez-Calle A. Tracing the connections between international business and communicable diseases. JOURNAL OF INTERNATIONAL BUSINESS STUDIES 2022; 53:1785-1804. [PMID: 35345569 PMCID: PMC8942389 DOI: 10.1057/s41267-022-00512-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 02/02/2022] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
We posit that international business and the emergence and spread of communicable diseases are intrinsically connected. To support our arguments, we first start with a historical timeline that traces the connections between international business and communicable diseases back to the sixth century. Second, following the epidemiology of communicable diseases, we identify two crucial transitions related to international business: the emergence of epidemics within a host country and the shift from epidemics to global pandemics. Third, we highlight international business contextual factors (host country regulatory quality, urbanization, trade barriers, global migration) and multinationals' activities (foreign direct investment, corporate political activity, global supply chain management, international travel) that could accelerate each transition. Finally, building on public health insights, we suggest research implications for business scholars on how to integrate human health challenges into their studies and practical implications for global managers on how to help prevent the emergence and spread of communicable diseases.
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Affiliation(s)
- Ivan Montiel
- Baruch College, Zicklin School of Business, The City University of New York, 55 Lexington Ave at 24th Street, New York, NY 10010 USA
| | - Junghoon Park
- Baruch College, Zicklin School of Business, The City University of New York, 55 Lexington Ave at 24th Street, New York, NY 10010 USA
| | - Bryan W. Husted
- Tecnológico de Monterrey, EGADE Business School, Eugenio Garza Lagüera & Rufino Tamayo, Valle Oriente, 66269 San Pedro Garza García, Nuevo León Mexico
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Pichemin C, Boyer E, Jarno P, Bertaud V, Meuric V, Couatarmanach A. Oral Care Needs Amongst Disadvantaged Migrants in France. Int Dent J 2022; 72:559-564. [PMID: 35279328 PMCID: PMC9381369 DOI: 10.1016/j.identj.2021.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 11/28/2021] [Accepted: 12/04/2021] [Indexed: 11/23/2022] Open
Abstract
Background Disadvantaged migrant populations face risk factors that can affect their oral health amongst other health issues. The purpose of this study was to explore the oral care needs of these populations and to identify the obstacles they might encounter in accessing dental care. Methods A cross-sectional study using secondary data was carried out in the Centre Médical Louis Guilloux in Rennes, France, a health centre offering dental consults to migrants. The data were obtained by clinical oral examination and analysed according to various criteria: reason for consultation, diagnosis, treatment plan, drug prescriptions, and referrals to other practitioners. Results A high prevalence of decay was observed amongst the patients (72.3%). Fifty-nine patients were identified as needing major oral health care amongst the 130 files that were analysed. The lack of proficiency in the host country's language was associated with a major need for oral care (P < .02). Conclusions This study highlights that disadvantaged migrants face important oral care needs in France. It suggests alternative actions that should be carried out to improve their access to dental care, including access to interpreting.
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COVID-19 vaccination intention and behavior in a large, diverse, U.S. refugee population. Vaccine 2022; 40:1231-1237. [PMID: 35125223 PMCID: PMC8806127 DOI: 10.1016/j.vaccine.2022.01.057] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 01/08/2022] [Accepted: 01/26/2022] [Indexed: 11/23/2022]
Abstract
Introduction Refugees often face increased risk of exposure to COVID-19 due to their disproportionate representation in the essential workforce and crowded household conditions. There is a paucity of data about risk factors for under-immunization for COVID-19 among refugees. Methods Refugees were surveyed in two phases that corresponded to before and after wide availability of COVID-19 vaccines. Participants were asked about their attitudes, and perceptions about COVID-19, previous acceptance of vaccines, sources utilized to obtain trusted health information, and intent to get vaccinated. The overall participant vulnerability was assessed using the social vulnerability index. In-depth semi-structured interviews were completed with key stakeholders through snowball sampling. Results Of 247 refugees, 244 agreed to participate in the initial survey. Among those, 140 (57.4%) intended to get vaccinated, 43 (17.6%) were unsure, and 61 (25%) did not intend to get vaccinated. In the follow up survey, all 215 who were reached, agreed to provide information about their vaccination status. Among those respondents, 141 (65.6%) were either vaccinated or expressed intent to do so, and 74 (34.4%) remained hesitant. We did not observe any significant correlation between socio-demographic variables, country of origin, and vaccination status/intent. Among those who initially intended to get vaccinated, nearly 1 in 5 changed their mind and decided to forego vaccination, and among those who initially did not plan getting vaccinated, 1 in 3 changed their mind and got vaccinated. Fears related to the vaccine, concerns that the vaccine is religiously prohibited, “wait and see” how others did with the vaccine, communication and transportation barriers were commonly cited as reason not to get vaccinated. Conclusions Over a third of refugees in our study were hesitant to get vaccinated. Refugees desired additional education about the benefits and safety of vaccines along with easier access to vaccination clinics in their communities.
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Khanom A, Alanazy W, Couzens L, Evans BA, Fagan L, Fogarty R, John A, Khan T, Kingston MR, Moyo S, Porter A, Rhydderch M, Richardson G, Rungua G, Russell I, Snooks H. Asylum seekers' and refugees' experiences of accessing health care: a qualitative study. BJGP Open 2021; 5:BJGPO.2021.0059. [PMID: 34376383 PMCID: PMC9447303 DOI: 10.3399/bjgpo.2021.0059] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/05/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Asylum seekers and refugees (ASRs) often experience poor health in host countries. The United Nations High Commissioner for Refugees (UNHCR) requires hosts to ensure these sanctuary seekers have access to basic health care. AIM To identify barriers and facilitators that affect access to health care by ASRs in Wales. DESIGN & SETTING Participatory research approach using qualitative focus groups across Wales, which hosts 10 000 refugees. METHOD Eight focus groups were undertaken with ASRs, support workers, and volunteers (n = 57). RESULTS Specialist NHS-funded services and grant-aided non-governmental organisations (NGOs) facilitated access to health care, including primary care. Most ASRs understood the role of general practice in providing and coordinating care, but were unaware of out-of-hours services. Reported barriers included: language difficulties, health literacy, unrecognised needs, and the cost of travel to appointments. Participants recognised the importance of mental health, but were disappointed by the state of mental health care. Some feared seeking support for mental health from their GP, and few were aware they had the right to move practice if they were unhappy. Written information about health care was not as accessible to refugees as to asylum seekers (ASs). While some participants read such material before consulting, others struggled to access information when in need. Few participants were aware of health prevention services. Even when they knew about services, such as smoking cessation, these services' difficulty in accommodating ASRs was a barrier. CONCLUSION The main barriers identified were: availability of interpreters; knowledge about entitlements; and access to specialist services.
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Affiliation(s)
| | - Wdad Alanazy
- Lecturer, Midwifery, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Lauren Couzens
- Senior Project Manager, Public Health Wales, Policy and International Health WHO Collaborating Centre on Investment for Health and Well-being, Cardiff, UK
| | | | - Lucy Fagan
- Speciality Registrar in Public Health, Imperial College Healthcare NHS Trust, London, UK
| | - Rebecca Fogarty
- Senior Project Manager, Public Health Wales , Policy and International Health WHO Collaborating Centre on Investment for Health and Well-being, Cardiff, UK
| | - Ann John
- Professor in Public Health,, Medical School, Swansea University, Swansea, UK
| | - Talha Khan
- Medical Student, School of Medicine, University College Cork, Cork, Ireland
| | | | - Samuel Moyo
- Public Member and Asylum Seeker, Patient and Public Involvement Members, Swansea University, Swansea, UK
| | - Alison Porter
- Associate Professor, Swansea University, Swansea, UK
| | - Melody Rhydderch
- Senior Project Manager and Lead Specialist Advisor, Behavioural Insights, Natural Resources Wales, Cardiff, UK
| | - Gillian Richardson
- Senior Professional Advisor to Chief Medical Officer for Wales, Welsh Government, Population Healthcare Directorate, Cardiff, UK
| | - Grace Rungua
- Public Member and Asylum Seeker, Patient and Public Involvement Members, Swansea University, Swansea, UK
| | - Ian Russell
- Professor Emeritus (Medicine), Medical School, Swansea University, Swansea, UK
| | - Helen Snooks
- Professor in Health Services Research, Swansea University, Swansea, UK
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Chen J, Mittendorfer-Rutz E, Berg L, Norredam M, Sijbrandij M, Klimek P. Associations between Multimorbidity Patterns and Subsequent Labor Market Marginalization among Refugees and Swedish-Born Young Adults-A Nationwide Registered-Based Cohort Study. J Pers Med 2021; 11:jpm11121305. [PMID: 34945776 PMCID: PMC8705997 DOI: 10.3390/jpm11121305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/19/2021] [Accepted: 11/23/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Young refugees are at increased risk of labor market marginalization (LMM). We sought to examine whether the association of multimorbidity patterns and LMM differs in refugee youth compared to Swedish-born youth and identify the diagnostic groups driving this association. Methodology: We analyzed 249,245 individuals between 20–25 years, on 31 December 2011, from a combined Swedish registry. Refugees were matched 1:5 to Swedish-born youth. A multimorbidity score was computed from a network of disease co-occurrences in 2009–2011. LMM was defined as disability pension (DP) or >180 days of unemployment during 2012–2016. Relative risks (RR) of LMM were calculated for 114 diagnostic groups (2009–2011). The odds of LMM as a function of multimorbidity score were estimated using logistic regression. Results: 2841 (1.1%) individuals received DP and 16,323 (6.5%) experienced >180 annual days of unemployment during follow-up. Refugee youth had a marginally higher risk of DP (OR (95% CI): 1.59 (1.52, 1.67)) depending on their multimorbidity score compared to Swedish-born youth (OR (95% CI): 1.51 (1.48, 1.54)); no differences were found for unemployment (OR (95% CI): 1.15 (1.12, 1.17), 1.12 (1.10, 1.14), respectively). Diabetes mellitus and influenza/pneumonia elevated RR of DP in refugees (RRs (95% CI) 2.4 (1.02, 5.6) and 1.75 (0.88, 3.45), respectively); most diagnostic groups were associated with a higher risk for unemployment in refugees. Conclusion: Multimorbidity related similarly to LMM in refugees and Swedish-born youth, but different diagnoses drove these associations. Targeted prevention, screening, and early intervention strategies towards specific diagnoses may effectively reduce LMM in young adult refugees.
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Affiliation(s)
- Jiaying Chen
- Section for Science of Complex Systems, CeMSIIS Medical University of Vienna, 1090 Vienna, Austria;
- Complexity Science Hub Vienna, 1090 Vienna, Austria
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Ellenor Mittendorfer-Rutz
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, 17177 Stockholm, Sweden;
| | - Lisa Berg
- Department of Public Health Sciences, Stockholm University, 10691 Stockholm, Sweden;
- Centre for Health Equity Studies, Stockholm University/Karolinska Institutet, 10691 Stockholm, Sweden
| | - Marie Norredam
- Danish Research Centre for Migration, Ethnicity, and Health (MESU), Section for Health Services Research, Department of Public Health, University of Copenhagen, 1014 Copenhagen, Denmark;
- Section of Immigrant Medicine, Department of Infectious Diseases, University Hospital Hvidovre, 2650 Hvidovre, Denmark
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology and WHO Collaborating Centre for Research and Dissemination of Psychological Interventions, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands;
| | - Peter Klimek
- Section for Science of Complex Systems, CeMSIIS Medical University of Vienna, 1090 Vienna, Austria;
- Complexity Science Hub Vienna, 1090 Vienna, Austria
- Correspondence:
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Tan ST, Low PTA, Howard N, Yi H. Social capital in the prevention and management of non-communicable diseases among migrants and refugees: a systematic review and meta-ethnography. BMJ Glob Health 2021; 6:e006828. [PMID: 34952855 PMCID: PMC8710856 DOI: 10.1136/bmjgh-2021-006828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 12/05/2021] [Indexed: 12/31/2022] Open
Abstract
Globally, the burden of non-communicable diseases (NCDs) falls disproportionately on underserved populations. Migrants and refugees are particularly vulnerable due to economic instability and systemic poverty. Despite the myriad of health risks faced by migrants and refugees, access to appropriate healthcare is hindered by structural, cultural and socioeconomic barriers. We conducted a systematic review and meta-ethnography to obtain critical insight into how the interplay of social capital and structural factors (eg, state policies and socioeconomic disadvantage) influences the prevention and treatment of NCDs in migrant and refugee populations. We included 26 studies of 14 794 identified articles, which reported qualitative findings on the structure and functions of social capital in NCD prevention and management among migrants and refugees. We synthesised findings, using the process outlined by Noblit and Hare, which indicated that migrants and refugees experienced weakened social networks in postmigration settings. They faced multiple barriers in healthcare access and difficulty navigating healthcare systems perceived as complex. Family as the core of social capital appeared of mixed value in their NCD prevention and management, interacting with cultural dissonance and economic stress. Community organisations were integral in brokering healthcare access, especially for information diffusion and logistics. Healthcare providers, especially general practitioners, were important bridges providing service-user education and ensuring a full continuum of quality care. While social capital reduced immediate barriers in healthcare access for NCD prevention and management, it was insufficient to address structural barriers. System-level interventions appear necessary to achieve equitable healthcare access in host countries. PROSPERO registration number: CCRD42020167846.
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Affiliation(s)
- Sok Teng Tan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Pei Ting Amanda Low
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Natasha Howard
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Huso Yi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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Matlin SA, Karadag O, Brando CR, Góis P, Karabey S, Khan MMH, Saleh S, Takian A, Saso L. COVID-19: Marking the Gaps in Migrant and Refugee Health in Some Massive Migration Areas. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12639. [PMID: 34886367 PMCID: PMC8657173 DOI: 10.3390/ijerph182312639] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 11/15/2021] [Accepted: 11/27/2021] [Indexed: 11/16/2022]
Abstract
The health of migrants and refugees, which has long been a cause for concern, has come under greatly increased pressure in the last decade. Against a background where the world has witnessed the largest numbers of migrants in history, the advent of the COVID-19 pandemic has stretched the capacities of countries and of aid, health and relief organizations, from global to local levels, to meet the human rights and pressing needs of migrants and refugees for access to health care and to public health measures needed to protect them from the pandemic. The overview in this article of the situation in examples of middle-income countries that have hosted mass migration in recent years has drawn on information from summaries presented in an M8 Alliance Expert Meeting, from peer-reviewed literature and from reports from international agencies concerned with the status and health of migrants and refugees. The multi-factor approach developed here draws on perspectives from structural factors (including rights, governance, policies and practices), health determinants (including economic, environmental, social and political, as well as migration itself as a determinant) and the human security framework (defined as "freedom from want and fear and freedom to live in dignity" and incorporating the interactive dimensions of health, food, environmental, economic, personal, community and political security). These integrate as a multi-component 'ecological perspective' to examine the legal status, health rights and access to health care and other services of migrants and refugees, to mark gap areas and to consider the implications for improving health security both for them and for the communities in countries in which they reside or through which they transit.
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Affiliation(s)
- Stephen A. Matlin
- Institute of Global Health Innovation, Imperial College London, South Kensington, London SW7 2AZ, UK;
- Global Health Centre, Graduate Institute of International and Development Studies, 1202 Geneva, Switzerland
| | - Ozge Karadag
- Center for Sustainable Development, Earth Institute, Columbia University, New York, NY 10115, USA
| | - Claudio R. Brando
- Education and International Relations Office, Hospital Universitario San Ignacio, Bogotá 11001, Colombia;
| | - Pedro Góis
- Faculty of Economics, University of Coimbra, 3004-512 Coimbra, Portugal;
| | - Selma Karabey
- Istanbul Faculty of Medicine, Istanbul University, Fatih, Istanbul 34093, Turkey;
| | - Md. Mobarak Hossain Khan
- Department of Social Relations, Faculty of Liberal Arts and Social Sciences, East West University, Dhaka 1212, Bangladesh;
| | - Shadi Saleh
- Global Health Institute, American University of Beirut, Beirut 1107 2020, Lebanon;
| | - Amirhossein Takian
- Health Equity Research Center (HERC) and Department of Global Health & Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran 1417613151, Iran;
| | - Luciano Saso
- Department of Physiology and Pharmacology Sapienza University of Rome, 00185 Rome, Italy;
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Lillekroken D, Halvorsrud L, Gulestø R, Bjørge H. Family caregivers' experiences of providing care for family members from minority ethnic groups living with dementia: A qualitative systematic review. J Clin Nurs 2021; 32:1625-1641. [PMID: 34786789 DOI: 10.1111/jocn.16127] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To review the literature on family caregivers' experiences of providing care for a family member from an ethnic minority group living with dementia within the European context. BACKGROUND Due to labour migration during the late 1960s and early 1970s, many European countries are now encountering an increasing number of older people from diverse ethnic minority groups who have been diagnosed with dementia. Although family care is predominantly used as a care pathway among families with immigrant backgrounds, little is known about family caregivers' experiences of providing care for a family member with dementia. DESIGN A systematic review of qualitative literature. METHODS Eight databases (CINAHL, EMBASE, MEDLINE, PsychINFO, SCOPUS, Social Care Online, SocIndex and Epistemonikos) were searched for original, peer-reviewed papers, published in English between 2010 and 2021. The literature review was conducted and reported in accordance with PRISMA 2020 checklist for reporting systematic reviews. RESULTS After identifying, screening and assessing articles for eligibility, 14 articles were critically appraised using the standardised assessment tool Mixed methods Appraisal Tool (MMAT, version 2018) and included in the review. The data synthesis process identified four themes across the qualitative studies: controversies and challenges; a lack of health literacy; barriers to seeking support from the healthcare or social services; and models of care. CONCLUSIONS Most of the family caregivers highlighted the value of being able to care for a family member living with dementia. However, the findings also reveal that they experience controversies and challenges due to their lack of dementia health literacy and perceived barriers to seeking healthcare support. RELEVANCE TO CLINICAL PRACTICE The findings from the current review can inform healthcare and social services in relation to implementing models of care that facilitate and complement family caregivers' role in caring for family members living with dementia from minority ethnic groups.
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Affiliation(s)
- Daniela Lillekroken
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Liv Halvorsrud
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Ragnhild Gulestø
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Heidi Bjørge
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Palliative Care Utilization Among Non-Western Migrants in Europe: A Systematic Review. J Immigr Minor Health 2021; 24:237-255. [PMID: 34709528 DOI: 10.1007/s10903-021-01302-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2021] [Indexed: 10/20/2022]
Abstract
The paper aims to identify and describe the European evidence on opportunities and barriers to access and utilization of palliative care among non- western migrants. A systematic review in accordance with PRISMA guidelines was conducted in June 2020, searching Medline, CINAHL, PsychINFO and EMBASE databases. PROSPERO# CRD42020193651. Studies included empirical research published between 2011 and 2020. Search words were, for example, ethnic groups and palliative care. Thematic analysis was used to analyze data. Twenty nine qualitative and six quantitative studies were included. Four main themes were identified: communication and language; knowledge and awareness; patient preferences, cultural and religious issues; and lack of resources at different levels of palliative care service provision. Migrants' access to palliative care is impeded at system, community and individual levels, yet, recommendations are mostly at the individual level. Closer attention is required to these different levels when designing future palliative interventions for migrants.
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Cortier M, de La Porte C, Papot E, Goudjo A, Guenneau L, Riou F, Cervantes-Gonzalez M, Prioux M, Yazdanpanah Y, Galy A. Health status and healthcare trajectory of vulnerable asylum seekers hosted in a French Reception Center. Travel Med Infect Dis 2021; 46:102180. [PMID: 34699955 DOI: 10.1016/j.tmaid.2021.102180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 08/19/2021] [Accepted: 10/18/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Europe lacks studies related to asylum-seekers' health. METHODS We described the health status, healthcare and follow-up of men seeking asylum, accommodated in a primary reception center in Paris (CPA). This observational study included volunteer patients presenting for care at the CPA primary care unit (PCU) from January to March 2018. They could be referred to on-site GPs and psychiatrists or to surrounding healthcare facilities. After their asylum application, patients were transferred to other French accommodation centers. PCU healthcare professionals could make referrals for close medical reassessments after transfer. RESULTS The 728 included men came mostly from Central Asia or Middle East (65%) and Africa (34%). Seventy percent reported violence during migration. Seventy-five percent (547/728) were referred to on-site GPs, 20% to psychiatrists. During patients' stay at CPA, 67% (144/214) of referrals to surrounding healthcare facilities led to performed consultations. Seven percent of all the included patients (49/728) were referred for frequent communicable infectious diseases screening. Final diagnoses (n = 1108) included 31% infectious diseases and 7% psychiatric disorders. When post-transfer accommodation centers could be reached, 69% (33/48) of the medical referrals had led to a scheduled appointment. CONCLUSIONS The healthcare trajectory at CPA could benefit from optimization of infectious and psychiatric screenings, and improved coordination of care and follow-up.
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Affiliation(s)
- Marie Cortier
- Assistance Publique - Hôpitaux de Paris, Nord - Université de Paris, Bichat - Claude-Bernard University Hospital, Department of Infectious and Tropical Diseases, 46 rue Henri Huchard, 75018, Paris, France
| | - Clémentine de La Porte
- Assistance Publique - Hôpitaux de Paris, Nord - Université de Paris, Bichat - Claude-Bernard University Hospital, Department of Infectious and Tropical Diseases, 46 rue Henri Huchard, 75018, Paris, France.
| | - Emmanuelle Papot
- Assistance Publique - Hôpitaux de Paris, Nord - Université de Paris, Bichat - Claude-Bernard University Hospital, Department of Infectious and Tropical Diseases, 46 rue Henri Huchard, 75018, Paris, France; Université de Paris, IAME, INSERM, UMR 1137, 16 rue Henri Huchard, 75018, Paris, France
| | - Abdon Goudjo
- Samusocial de Paris, 35 avenue Courteline, 75012, Paris, France
| | - Laure Guenneau
- Samusocial de Paris, 35 avenue Courteline, 75012, Paris, France
| | - Françoise Riou
- Samusocial de Paris, 35 avenue Courteline, 75012, Paris, France
| | - Minerva Cervantes-Gonzalez
- Assistance Publique - Hôpitaux de Paris, Nord - Université de Paris, Bichat - Claude-Bernard University Hospital, Department of Infectious and Tropical Diseases, 46 rue Henri Huchard, 75018, Paris, France; Université de Paris, IAME, INSERM, UMR 1137, 16 rue Henri Huchard, 75018, Paris, France
| | - Maëlle Prioux
- Samusocial de Paris, 35 avenue Courteline, 75012, Paris, France
| | - Yazdan Yazdanpanah
- Assistance Publique - Hôpitaux de Paris, Nord - Université de Paris, Bichat - Claude-Bernard University Hospital, Department of Infectious and Tropical Diseases, 46 rue Henri Huchard, 75018, Paris, France; Université de Paris, IAME, INSERM, UMR 1137, 16 rue Henri Huchard, 75018, Paris, France
| | - Adrien Galy
- Assistance Publique - Hôpitaux de Paris, Nord - Université de Paris, Bichat - Claude-Bernard University Hospital, Department of Infectious and Tropical Diseases, 46 rue Henri Huchard, 75018, Paris, France
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Buch Mejsner S, Kristiansen M, Eklund Karlsson L. Civil Servants and Non-Western Migrants' Perceptions on Pathways to Health Care in Serbia-A Grounded Theory, Multi-Perspective Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:10247. [PMID: 34639551 PMCID: PMC8547138 DOI: 10.3390/ijerph181910247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/15/2021] [Accepted: 09/26/2021] [Indexed: 11/16/2022]
Abstract
(1) Background: Informal patient payments continue to persist in the Serbian health care system, exposing vulnerable groups to private spending on health care. Migrants may in particular be subject to such payments, as they often experience barriers in access to health care. Little is known about migrants paying informally to access health care in Serbia. The study aims to explore pathways of accessing health care, including the role of informal patient payments, from the perspectives of civil servants and non-western migrants in Serbia. (2) Methods: Respondents (n = 8 civil servants and n = 6 migrants) were recruited in Belgrade in 2018, where semi-structured interviews were conducted. The interviews were analysed applying the grounded theory methodological steps. (3) Results: Data reveal different pathways to navigate the Serbian health care system, and ultimately whether paying informally occurs. Migrants appear less prone to paying informally and receive the same or better-quality health care. Locals experience the need to pay informal patient payments, quasi-formal payments and to bring medicine, materials or equipment when in health facilities. (4) Conclusions: Paying informally or using private care in Serbia appear to have become common. Despite a comprehensive health insurance coverage, high levels of out-of-pocket payments show barriers in accessing health care. It is highly important to not confuse the cultural beliefs with forced spending on health care and such private spending should be reduced to not push people into poverty.
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Affiliation(s)
- Sofie Buch Mejsner
- Unit for Health Promotion Research, University of Southern Denmark, Degnevej 14, 6705 Esbjerg, Denmark;
| | - Maria Kristiansen
- Department of Public Health, Center for Healthy Aging, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen, Denmark;
| | - Leena Eklund Karlsson
- Unit for Health Promotion Research, University of Southern Denmark, Degnevej 14, 6705 Esbjerg, Denmark;
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Ur Rehman A, Zakar R, Zakar MZ, Hani U, Fischer F. Protocol for a cross-sectional study on factors affecting health-related quality of life among Afghan refugees in Pakistan. F1000Res 2021; 10:971. [PMID: 38827571 PMCID: PMC11140308 DOI: 10.12688/f1000research.73005.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/17/2021] [Indexed: 06/04/2024] Open
Abstract
Background: Pakistan served as a host for more than 1.4 million Afghan refugees for more than 40 years. Access to health care is the most important issue faced by refugees, because they might be at a higher risk for certain diseases. This risk can be attributed to a lack of awareness of health care facilities, health beliefs, inadequate hygiene, cultural differences, and malnutrition. Health of individuals is closely associated with their quality of life. Quality of life over the whole lifespan is pivotal to overall life satisfaction. It includes physical wellbeing, mental health, education, occupation, income, personal safety, as well as (religious) freedom. Until now, the health status of Afghan refugees has never been comprehensively investigated in Pakistan. Therefore, an assessment in this regard is needed to explore their health-related quality of life, for securing their human right to health. Methods: A cross-sectional study has been designed to describe and explain the health-related quality of life of Afghan refugees in Pakistan. Multistage cluster sampling was applied for selection of study participants. The number of respondents from two regions in Pakistan was drawn through a proportionate sampling technique. A quantitative research method using pre-validated questionnaires was used for data collection. The questionnaire included items to assess well-being, mental health, health literacy, and factors affecting health and health care. Descriptive analysis was used, whereas inferential statistical tests (binary logistic regression model) was also performed. The study received ethically permission by the Advanced Studies and Research Board of the University of the Punjab, Lahore, Pakistan. Discussion: The assessment of Afghan refugee's quality of life in Pakistan should lead to recommendations disseminated to public and health care officials. This evidence is needed for policymaking related to adequate measures for improving health conditions of Afghan refugees in Pakistan.
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Affiliation(s)
- Atta Ur Rehman
- Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | - Rubeena Zakar
- Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan
| | | | - Ume Hani
- Holy Family Hospital, Rawalpindi Medical University, Rawalpindi, Pakistan
| | - Florian Fischer
- Institute of Public Health, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Institute of Gerontological Health Services and Nursing Research, Ravensburg-Weingarten University of Applied Sciences, Weingarten, Germany
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Yendaw E, Tampah-Naah AM. Health-seeking behaviour and practices among immigrant retail traders in an urban setting in North-Western Ghana. INTERNATIONAL JOURNAL OF MIGRATION, HEALTH AND SOCIAL CARE 2021. [DOI: 10.1108/ijmhsc-04-2020-0040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to investigate the health-care-seeking behaviour and practices of West African migrants who reside and operate in Wa, Ghana, as itinerant retailers.
Design/methodology/approach
The study was cross-sectional and used the quantitative research approach. The analysis was done on a target population comprising 122 itinerant immigrant retail traders in Wa, Ghana. Fisher’s exact test and logistic regression were used to analyse the data.
Findings
Malaria was the commonest disease among them. Five in ten of the migrants preferred to report malaria episodes to a private health facility than to a government facility. Significant associations were identified between four dimensions (health facility, self-medication, home remedy and consult others) of health-seeking behaviour, and some background characteristics. The main reason why migrants prefer government health facilities was because of their better health personnel. They self-medicated because of easy accessibility of over-the-counter medicine shops. Also, when ill, the migrants usually consulted family members who would be in a position to take them home when their ailment worsens.
Research limitations/implications
Snowball sampling was used to select the respondents which could potentially lead to a sample that is not fully representative of the population in general.
Originality/value
Studies concerning migration and health in Ghana have been focused on internal migrants. Yet, minority immigrant traders equally encounter adverse health conditions but limited studies have been conducted to espouse their health-seeking behaviour. This study imperatively contributes to the subject matter that has limited literature in the country.
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Ponce-Blandón JA, Romero-Castillo R, Jiménez-Picón N, Palomo-Lara JC, Castro-Méndez A, Pabón-Carrasco M. Lived Experiences of African Migrants Crossing the Strait of Gibraltar to Europe: A Cross-Cultural Approach to Healthcare from a Qualitative Methodology. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9379. [PMID: 34501968 PMCID: PMC8431138 DOI: 10.3390/ijerph18179379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/31/2021] [Accepted: 09/02/2021] [Indexed: 02/08/2023]
Abstract
BACKGROUND The migratory flow from the African continent to Europe is intense and the European countries should apply a humanitarian, health and social response to this emerging problem. Migrants coming from Africa to Europe are a very vulnerable population. Healthcare professionals should be prepared for answering their needs from a transcultural approach, which requires a better understanding of this phenomenon. Thus, the aim of this study was to improve nursing and healthcare professionals' awareness and better understanding of migrant life experiences during the migration journey. An exploratory descriptive qualitative research was conducted. In-depth interviews were conducted involving four key informants and content analysis were performed with the transcriptions. RESULTS Three themes merged: life situations in their countries of origin; motivations that led them to undertake the migratory journey; and experiences they lived during the migratory journey. The results described the dramatic experience and motivations for crossing the strait of Gibraltar from Africa to Europe, including feelings, fears, hopes and lived experiences. The determination of immigrants to fight for a better life opportunity and the physical damage and psychological consequences they suffer were revealed. CONCLUSIONS This study would help healthcare professionals to better understand this complex reality and deliver culturally adapted care. Knowledge of the starting reality of these populations can help health professionals to incorporate a cross-cultural approach that improves the relational, ethical and affective competences to provide quality care to the migrant population, as well as the development of health measures to fight against inequalities suffered by these population groups.
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Affiliation(s)
- José Antonio Ponce-Blandón
- Red Cross Nursing University Center, University of Seville, 41009 Seville, Spain; (N.J.-P.); (J.C.P.-L.); (M.P.-C.)
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
| | - Rocío Romero-Castillo
- Red Cross Nursing University Center, University of Seville, 41009 Seville, Spain; (N.J.-P.); (J.C.P.-L.); (M.P.-C.)
| | - Nerea Jiménez-Picón
- Red Cross Nursing University Center, University of Seville, 41009 Seville, Spain; (N.J.-P.); (J.C.P.-L.); (M.P.-C.)
| | - Juan Carlos Palomo-Lara
- Red Cross Nursing University Center, University of Seville, 41009 Seville, Spain; (N.J.-P.); (J.C.P.-L.); (M.P.-C.)
| | - Aurora Castro-Méndez
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
| | - Manuel Pabón-Carrasco
- Red Cross Nursing University Center, University of Seville, 41009 Seville, Spain; (N.J.-P.); (J.C.P.-L.); (M.P.-C.)
- Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, 41009 Seville, Spain;
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Halley E, Giai J, Chappuis M, Tomasino A, Henaine R, Letrilliart L. Health Profile of Precarious Migrants Attending the Médecins Du Monde's Health and Social Care Centres in France: a Cross-Sectional Study. Int J Public Health 2021; 66:602394. [PMID: 34456664 PMCID: PMC8386651 DOI: 10.3389/ijph.2021.602394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The present study aimed to compare the precarious migrants' health problems managed in Médecins du Monde's health and social care centres (CASO) with those of patients attending general practice in France. Methods: We compared the most frequent health problems managed in the 19 CASO in metropolitan France with those of a national sample of usual general practice consultations, after standardisation for age and sex. Results: Precarious migrants had fewer health problems managed per consultation than other patients (mean: 1.31 vs. 2.16), and these corresponded less frequently to chronic conditions (21.3% vs. 46.8%). The overrepresented health problems among CASO consultations were mainly headache (1.11% vs. 0.45%), viral hepatitis (1.05% vs. 0.20%), type 1 diabetes (1.01% vs. 0.50%) and teeth/gum disease (1.01% vs. 0.23%). Their underrepresented health problems were mainly lipid disorder (0.39% vs. 8.20%), depressive disorder (1.36% vs. 5.28%) and hypothyroidism (0.50% vs. 3.08%). Prevention issues were nominal in precarious migrants (0.16%). Conclusion: Both chronic somatic and mental conditions of precarious migrants are presumably underdiagnosed. Their screening should be improved in primary care.
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Affiliation(s)
- Emeraude Halley
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Univ. Lyon, Lyon, France
| | - Joris Giai
- Service de Biostatistique-Bioinformatique, Hospices Civils de Lyon, Pierre-Bénite, France
| | | | | | - Roland Henaine
- Unité d'enseignement Libre Médecine Humanitaire et SAMU Social, Université Claude Bernard Lyon 1, Lyon, France.,Service de chirurgie cardiaque C, Hôpital Cardiologique Louis Pradel, Bron, France
| | - Laurent Letrilliart
- Collège universitaire de médecine générale, Université Claude Bernard Lyon 1, Univ. Lyon, Lyon, France.,Research on Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
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80
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Lambert JF, Stete K, Balmford J, Bockey A, Kern W, Rieg S, Boeker M, Lange B. Reducing burden from respiratory infections in refugees and immigrants: a systematic review of interventions in OECD, EU, EEA and EU-applicant countries. BMC Infect Dis 2021; 21:872. [PMID: 34445957 PMCID: PMC8390210 DOI: 10.1186/s12879-021-06474-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 07/26/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Respiratory diseases are a major reason for refugees and other immigrants seeking health care in countries of arrival. The burden of respiratory diseases in refugees is exacerbated by sometimes poor living conditions characterised by crowding in mass accommodations and basic living portals. The lack of synthesised evidence and guideline-relevant information to reduce morbidity and mortality from respiratory infections endangers this population. METHODS A systematic review of all controlled and observational studies assessing interventions targeting the treatment, diagnosis and management of respiratory infections in refugees and immigrants in OECD, EU, EEA and EU-applicant countries published between 2000 and 2019 in MEDLINE, CINAHL, PSYNDEX and the Web of Science. RESULTS Nine of 5779 identified unique records met our eligibility criteria. Seven studies reported an increase in vaccine coverage from 2 to 52% after educational multilingual interventions for respiratory-related childhood diseases (4 studies) and for influenza (5 studies). There was limited evidence in one study that hand sanitiser reduced rates of upper respiratory infections and when provided together with face masks also the rates of influenza-like-illness in a hard to reach migrant neighbourhood. In outbreak situations of vaccine-preventable diseases, secondary cases and outbreak hazards were reduced by general vaccination strategies early after arrival but not by serological testing after exposure (1 study). We identified evidence gaps regarding interventions assessing housing standards, reducing burden of bacterial pneumonia and implementation of operational standards in refugee care and reception centres. CONCLUSIONS Multilingual health literacy interventions should be considered to increase uptake of vaccinations in refugees and immigrants. Immediate vaccinations upon arrival at refugee housings may reduce secondary infections and outbreaks. Well-designed controlled studies on housing and operational standards in refugee and immigrant populations early after arrival as well as adequate ways to gain informed consent for early vaccinations in mass housings is required to inform guidelines.
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Affiliation(s)
- Jan-Frederic Lambert
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany.
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany.
| | - Katarina Stete
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
| | - James Balmford
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Annabelle Bockey
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
| | - Winfried Kern
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
| | - Siegbert Rieg
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
| | - Martin Boeker
- Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg im Breisgau, Germany
| | - Berit Lange
- Division of Infectious Diseases, Department of Medicine II, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetter Straße 55, 79106, Freiburg im Breisgau, DE, Germany
- Department of Epidemiology, Helmholtz Centre for Infection Research, Inhoffenstr.7, 38124, Braunschweig, DE, Germany
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Local and regional politicians’ considerations of newly arrived migrants’ health in political decision-making: a public health study in northern Sweden. J Public Health (Oxf) 2021. [DOI: 10.1007/s10389-021-01637-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Abstract
Background and aim
Early action is important for promoting newly arrived migrants’ health. Politicians are major actors in decision-making that affects health outcomes in the population. Therefore, the aim of this study was to explore local and regional politicians’ considerations of newly arrived migrants’ health in political decision-making: whether politicians reflect on or discuss the effects of decision-making specifically on newly arrived migrants’ health, whether considerations differ between municipality and regional politicians, and how knowledge and attitudes are associated with such considerations.
Subject and methods
A cross-sectional quantitative study was conducted. A total of 667 municipality and regional politicians from northern Sweden responded to a questionnaire developed based on interviews with politicians. Bivariate analyses were performed using χ2 tests, the independent samples t-test, and the Wilcoxon signed-rank test. Multivariate analysis was performed using binary logistic regression.
Results
Politicians considered the effects on newly arrived migrants’ health significantly less frequently than those on the total population’s health. Regional politicians discussed such effects more often than municipality politicians. Knowledge (odds ratio [OR] = 1.343), attitude (OR = 5.962), previous experience working on public health issues (OR = 1.784), and female gender (OR = 1.787) were positively associated with considering effects on newly arrived migrants’ health in decision-making.
Conclusion
Politicians play important roles in health promotion, and most consider health-related effects in their decision-making. However, about a third do not consider such effects. General health-related knowledge and attitude are important factors that could be affected or changed during political assignments.
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Caputo J, Li P, Kühn M, Brønnum-Hansen H, Oksuzyan A. Immigration Background and the Widowhood Effect on Mortality. J Gerontol B Psychol Sci Soc Sci 2021; 76:2155-2168. [PMID: 34313712 PMCID: PMC8599013 DOI: 10.1093/geronb/gbab090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Indexed: 12/02/2022] Open
Abstract
Objectives Widowhood is a stressful life event with one of the most profound negative effects on health and longevity. Immigrant populations are growing and aging throughout Western nations, and marginalization and cultural differences may make some immigrants especially vulnerable to the stressors of widowhood. However, studies have yet to systematically explore whether the widowhood effect differs between immigrant and native-born individuals. Methods Using Danish population register data from 1980 to 2014, this study assesses whether the relationship between widowhood and mortality differs between immigrants from 10 countries and native-born Danes aged 50 and older at 0–2, 3–5, and 6 and more years post-widowhood. Results We find that immigrant men are at higher risk of dying in the first 2 years after experiencing widowhood than Danish-born men, but these mortality differences dissipate over longer periods. Immigrant women have a higher risk of having died 3 and more years after a spouse’s death than Danish women. Patterns vary further by country of origin. Discussion The results suggest that some immigrants may suffer more from widowhood than native-born individuals, giving insight into how immigration background may influence the health effects of negative life events. They also underscore the potential vulnerabilities of aging immigrant populations to stressors encountered in older age.
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Affiliation(s)
- Jennifer Caputo
- Department of Sociology, University of Chicago, Illinois, USA
| | - Peng Li
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Mine Kühn
- Max Planck Institute for Demographic Research, Rostock, Germany
| | - Henrik Brønnum-Hansen
- Section for Social Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - Anna Oksuzyan
- Max Planck Institute for Demographic Research, Rostock, Germany
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83
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Zinah E, Al-Ibrahim HM. Oral health problems facing refugees in Europe: a scoping review. BMC Public Health 2021; 21:1207. [PMID: 34162351 PMCID: PMC8223339 DOI: 10.1186/s12889-021-11272-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/09/2021] [Indexed: 02/19/2023] Open
Abstract
Introduction Europe has been experiencing a flow of refugees and asylum seekers driven by conflicts or poverty. Their oral health is often neglected despite its clear impact on quality of life. Objective To explore the status of oral health among refugees and asylum seekers groups by examining the available literature and to determine which evidence exists regarding the problems they face in terms of oral health. Methods The current paper followed PRISMA guidelines. A scoping review methodology was followed to retrieve 2911 records from five databases and grey literature. Twelve articles met the following inclusion criteria: experimental research concentrated on the oral and dental health of refugees and/or asylum seekers between 1995 and 2020 in English. Analysis was both descriptive and thematic, whilst a critical appraisal was applied using the Critical Appraisal Skills Program (CASP). Results Seven studies (58,3%) were quantitative, while five studies (41,6%) were qualitative. In general, the quality of most of the studies (83.3%) was good. Limited access to oral health care services was shown with a higher prevalence of oral diseases compared to the native populations of the host countries. Approaches to improve oral health have been implemented in some studies and have shown positive outcomes. Conclusions Oral health care strategies should consider the oral health problems facing refugees in Europe, and oral health promotion campaigns are essential to give adequate guidance on how to access oral health care in the host countries. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11272-z.
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Affiliation(s)
- Eiad Zinah
- Dental Public Health Department, University College London, London, UK.
| | - Heba M Al-Ibrahim
- Department of Orthodontics, University of Damascus Dental School, Damascus, Syria
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Fiorini G, Cerri C, Magri F, Chiovato L, Croce L, Rigamonti AE, Sartorio A, Cella SG. Risk factors, awareness of disease and use of medications in a deprived population: differences between indigent natives and undocumented migrants in Italy. J Public Health (Oxf) 2021; 43:302-307. [PMID: 31705141 DOI: 10.1093/pubmed/fdz123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 08/25/2019] [Accepted: 09/02/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Undocumented migrants experience many health problems; a comparison with a suitable control group of natives living in the same socio-economic conditions is still lacking. METHODS Demographic data and data on risk factors, chronic conditions and dietary habits were obtained for 6933 adults (2950 Italians and 3983 undocumented migrants) receiving medical assistance from 40 non-governmental organizations all over the country. RESULTS Attributed to the fact that these were unselected groups, differences were found in their demographic features, the main ones being their marital status (singles: 50.5% among Italians and 42.8% among migrants; P < 0.001). Smokers were more frequent among Italians (45.3% versus 42.7% P = 0.03); the same happened with hypertension (40.5% versus 34.5% P < 0.001). Migrants were more often overweight (44.1% versus 40.5% P < 0.001) and reporting a chronic condition (20.2% versus 14.4% P < 0.001). Among those on medications (n = 1354), Italians were fewer (n = 425) and on different medications. Differences emerged also in dietary habits. CONCLUSIONS Differences in health conditions exist between native-borns and undocumented migrants, not because of a bias related to socio-economic conditions. Further studies are needed to design sustainable health policies and tailored prevention plans.
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Affiliation(s)
| | - Cesare Cerri
- Department of Medicine and Surgery, University of Bicocca, 20100 Milano, Italy
| | - Flavia Magri
- Department of Internal Medicine and Medical Therapy, University of Pavia, Internal Medicine and Endocrinology, ICS Maugeri, 27100 Pavia, Italy
| | - Luca Chiovato
- Department of Internal Medicine and Medical Therapy, University of Pavia, Internal Medicine and Endocrinology, ICS Maugeri, 27100 Pavia, Italy
| | - Laura Croce
- Department of Internal Medicine and Medical Therapy, University of Pavia, Internal Medicine and Endocrinology, ICS Maugeri, 27100 Pavia, Italy
| | - Antonello E Rigamonti
- Department of Clinical Sciences and Community Health (Pharmacology), University of Milan, 20129 Milan, Italy
| | - Alessandro Sartorio
- Auxo-Endocrinological Department, IRCCS Istituto Auxologico Italiano, 20100 Milan and Verbania, Italy
| | - Silvano G Cella
- Department of Clinical Sciences and Community Health (Pharmacology), University of Milan, 20129 Milan, Italy.,Osservatorio Povertà Sanitaria, Banco Farmaceutico Onlus, 20100 Milan, Italy
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85
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Delgado-Flores C, Cutire OS, Cvetkovic-Vega A, Nieto-Gutierrez W. Perceived discrimination as a barrier for the adequate treatment of chronic diseases in Venezuelan migrants from Peru. REVISTA BRASILEIRA DE EPIDEMIOLOGIA 2021; 24:e210029. [PMID: 34076091 DOI: 10.1590/1980-549720210029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 03/11/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To determine the association between perceived discrimination and receiving adequate treatment for chronic diseases in Venezuelan migrants. METHODOLOGY A cross-sectional study was performed. This is a secondary analysis of the ENPOVE national survey from Peru. The association between the perceived discrimination and receiving adequate treatment for chronic diseases was evaluated using a Poisson regression model, considering the adjusted effect of the multistage sampling. RESULTS A total of 865 migrants were evaluated (age: 36.6 ± 0.7 years and 58.2% women). Of these, 54.8% perceived discrimination, and 89.2% did not receive adequate treatment for chronic diseases. Perceived discrimination was significantly associated with a lower prevalence of receiving adequate treatment for chronic diseases (PRa = 0.49; 95%CI 0.25 - 0.97). CONCLUSION This study evidenced that perceived discrimination decreases the prevalence of receiving adequate treatment for chronic diseases by approximately 50% compared with those who did not perceive discrimination.
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Affiliation(s)
| | | | | | - Wendy Nieto-Gutierrez
- Universidad San Ignacio de Loyola, Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud - Lima, Peru
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KABDUNASSOVA R, ZHAKSYBEKOVA I, BERDALIEVA L, VALISHINA G, BEISENOVA S, TURGAMBAYEVA A. Healthcare problems of the receiving countries and health of migrants under the European migration crisis. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2021. [DOI: 10.23736/s0393-3660.20.04428-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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87
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Dayrit JF, Sugiharto A, Coates SJ, Lucero-Prisno DE, Davis MDD, Andersen LK. Climate change, human migration, and skin disease: is there a link? Int J Dermatol 2021; 61:127-138. [PMID: 33971021 DOI: 10.1111/ijd.15543] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 02/22/2021] [Accepted: 02/26/2021] [Indexed: 02/06/2023]
Abstract
Climate change, exemplified by higher average global temperatures resulting in more frequent extreme weather events, has the potential to significantly impact human migration patterns and health. The consequences of environmental catastrophes further destabilize regions with pre-existing states of conflict due to social, political, and/or economic unrest. Migrants may carry diseases from their place of origin to their destinations and once there may be susceptible to diseases in which they had not been previously exposed to. Skin diseases are among the most commonly observed health conditions observed in migrant populations. To improve awareness among dermatologists of the burden of skin diseases among migrants, the group searched the English language scientific literature to identify articles linking climate change, migration, and skin disease. Skin diseases associated with human migration fall into three major categories: (i) communicable diseases, (ii) noncommunicable diseases, and (iii) environmentally mediated diseases. Adopting comprehensive global strategies to improve the health of migrants requires urgent attention.
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Affiliation(s)
- Johannes F Dayrit
- De La Salle University Medical and Health Sciences Institute, Dasmarinas City, Philippines.,Department of Dermatology, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Audi Sugiharto
- Department of Dermatology, Research Institute for Tropical Medicine, Muntinlupa City, Philippines
| | - Sarah J Coates
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - Don Eliseo Lucero-Prisno
- Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | | | - Louise K Andersen
- Department of Dermatology, Aleris-Hamlet Private Hospitals, Esbjerg, Denmark
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88
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Yaman Sözbir Ş, Erenoğlu R, Ayaz Alkaya S. Birth Experience in Syrian Refugee Women in Turkey: A Descriptive Phenomenological Qualitative Study. Women Health 2021; 61:470-478. [PMID: 33957842 DOI: 10.1080/03630242.2021.1922570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A negative birth experience affects the woman's subsequent pregnancy, and delivery processes negatively, decreases patient satisfaction, and the high anxiety/stress experienced during pregnancy/delivery is transferred to the next generations by epigenetic transmission. In this study, women's birth experiences of Syrian refugees in Turkey aimed to describe in-depth. It was designed as a descriptive phenomenological qualitative study. Fifteen refugee women included in the sample gave birth in Turkey, living in Turkey's southern city. In-depth interviews were conducted with women. Six themes were formed in the results: "quantitatively enough but unsatisfactory service," "not providing autonomy," "think that she was neglected," "no respect to privacy," "feeling loneliness/fear in the delivery room," and "prejudice." The factors that negatively affect the pregnancy and birth experiences of Syrian refugee women are language/communication barriers, the provision of care services that are incompatible with their religious and cultural values, and their prejudice regarding discrimination.
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Affiliation(s)
- Şengül Yaman Sözbir
- Faculty of Health Sciences, Nursing Department, Gyneacology and Obstetric Nursing Department, Gazi University, Ankara, Turkey
| | - Rabiye Erenoğlu
- Faculty of Health Sciences, Nursing Department, Gyneacology and Obstetric Nursıng Department, Mustafa Kemal Universtiy, Hatay, Turkey
| | - Sultan Ayaz Alkaya
- Faculty of Health Sciences, Nursing Department, Public Health Nursing Department, Gazi University, Ankara, Turkey
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89
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Gil-Salmeron A, Smith L, Yang L, Rieder A, Grabovac I. Differences in health status, health behaviour and healthcare utilisation between Immigrant and native homeless people in Spain: An exploratory study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:856-866. [PMID: 33586224 DOI: 10.1111/hsc.13313] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/09/2020] [Accepted: 01/11/2021] [Indexed: 06/12/2023]
Abstract
Few studies have examined the differences between immigrant and native-born homeless populations. Our aim was to conduct an exploratory study to examine the differences in health status, health behaviour and healthcare utilisation in a sample of Spanish immigrant and native homeless people. Study was conducted in eight different temporary accommodations in the Valencia region in August 2018. Overall, 86 participants were included in the analysis who answered questionnaires concerning socio-demographic characteristics, immigration status, health status and behaviour, healthcare utilisation and experienced discrimination in healthcare and health literacy. In total, 76.7% were men with a mean age of 41.91 (14.17) years, with 60.4% having immigration background with an average of 4.8 (4.2) years since arrival in Spain. No differences were found in the subjective health status, however, native homeless participants reported significantly higher prevalence of heart disease (87.5% vs. 12.5%), hypertension (84.6% vs. 15.4%), psychological illness (63.6% vs. 36.4%) and were also more often smokers (73.5% vs. 28.8%), reported smoking more cigarettes per day (12.0 vs. 7.4) and were more often illegal drug users (17.6% vs. 2.0%). Immigrant participants were significantly more often not insured, reported more problems in healthcare access and had lower rates of visits to general practitioners and less hospital admissions. Differences were also observed in social status with the native homeless more often reporting receiving income, and living in less crowded accommodations. Our results show a variety of issues that the immigrant homeless population in Spain is confronted with that also prevents adequate social inclusion and achieving good health. However, the immigrant population engaged less often in risky health behaviour. More, and continuous, monitoring of social, mental and physical health of the homeless population is necessary. Public health interventions aiming at health promotion in the immigrant homeless populations need to focus on increasing overall social integration.
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Affiliation(s)
- Alejandro Gil-Salmeron
- Polibenestar Research Institute, University of Valencia, Valencia, Spain
- International Foundation for Integrated Care, Oxford, UK
| | - Lee Smith
- The Cambridge Center for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada
- Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Anita Rieder
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
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90
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Georges D, Buber-Ennser I, Rengs B, Kohlenberger J, Doblhammer G. Health determinants among refugees in Austria and Germany: A propensity-matched comparative study for Syrian, Afghan, and Iraqi refugees. PLoS One 2021; 16:e0250821. [PMID: 33909696 PMCID: PMC8081210 DOI: 10.1371/journal.pone.0250821] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/15/2021] [Indexed: 11/19/2022] Open
Abstract
In recent years, Germany and Austria have been among the leading European receiving countries for asylum seekers and refugees (AS&R). The two countries have cultural and economic similarities, but differ, for example, in their health care systems, with AS&R having unrestricted access to health services upon arrival in Austria, but not in Germany. This study investigates the determinants of health among refugees in Austria and Germany, and how these determinants differ between the two countries. We analyze comparable and harmonized survey data from both countries for Syrian, Afghan, and Iraqi nationals aged 18 to 59 years who had immigrated between 2013 and 2016 (Germany: n = 2,854; Austria: n = 374). The study adopts a cross-sectional design, and uses propensity score matching to examine comparable AS&R in the two receiving countries. The results reveal that the AS&R in Germany (72%) were significantly less likely to report being in (very) good health than their peers in Austria (89%). Age and education had large impacts on health, whereas the effects of length of stay and length of asylum process were smaller. Compositional differences in terms of age, sex, nationality, education, and partnership situation explained the country differences only in part. After applying propensity score matching to adjust for structural differences and to assess non-confounded country effects, the probability of reporting (very) good health was still 12 percentage points lower in Germany than in Austria. We conclude that many of the determinants of health among AS&R correspond to those in the non-migrant population, and thus call for the implementation of similar health policies. The health disadvantage found among the AS&R in Germany suggests that removing their initially restricted access to health care may improve their health.
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Affiliation(s)
- Daniela Georges
- Department of Sociology and Demography, University of Rostock, Rostock, Germany
| | - Isabella Buber-Ennser
- Vienna Institute of Demography (OeAW), Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Vienna, Austria
| | - Bernhard Rengs
- Vienna Institute of Demography (OeAW), Wittgenstein Centre for Demography and Global Human Capital (IIASA, OeAW, University of Vienna), Vienna, Austria
| | - Judith Kohlenberger
- Institute for Social Policy, Vienna University of Economics and Business, Vienna, Austria
| | - Gabriele Doblhammer
- Department of Sociology and Demography, University of Rostock, Rostock, Germany
- German Center for Neurodegenerative Diseases, Bonn, Germany
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91
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Beza S, Mavrodi AG, Kyratso G, Aletras VH. Health-Related Quality of Life Among Refugees and Asylum Seekers in Northern Greece. J Immigr Minor Health 2021; 24:437-444. [PMID: 33830398 DOI: 10.1007/s10903-021-01199-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2021] [Indexed: 10/21/2022]
Abstract
We aimed at assessing the health-related quality-of-life (HRQoL) of refugees and asylum seekers in Northern Greece. The SF-36 Health Survey was used to assess participants' HRQoL. Participants were contacted in person. Correlation and dependence tests were employed to examine the association of participants' demographic, residence-related and medical-related characteristics with the two SF-36 component (physical-PCS/mental-MCS) scales. Regressions were conducted to investigate the effect of these characteristics on component scales. Refugees and asylum seekers (n = 161) living in urban apartments and camps in Northern Greece participated in the study reporting poor HRQoL (PCS = 43.9, MCS = 39.5). Age, gender, duration of stay, benefits offered by Non-Governmental Organisations (NGOs), type of accommodation, suffering from a serious health problem and receipt of medication were associated with HRQoL. This study constitutes the first research assessing HRQoL of refugees and asylum seekers in Northern Greece.
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Affiliation(s)
- Sofia Beza
- Department of Business Administration, University of Macedonia, 156 Egnatia Str, 546 36, Thessaloniki, Greece
| | - Afentoula G Mavrodi
- Department of Business Administration, University of Macedonia, 156 Egnatia Str, 546 36, Thessaloniki, Greece.
| | - Gima Kyratso
- Department of Business Administration, University of Macedonia, 156 Egnatia Str, 546 36, Thessaloniki, Greece
| | - Vassilis H Aletras
- Department of Business Administration, University of Macedonia, 156 Egnatia Str, 546 36, Thessaloniki, Greece
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92
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van Mierlo B, Nagel N, van de Put W. Inspiring Life in Frozen Communities: Supporting Migrant Women in Brussels to Regain Control over their Lives. Community Ment Health J 2021; 57:598-605. [PMID: 33165689 DOI: 10.1007/s10597-020-00743-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 11/03/2020] [Indexed: 11/29/2022]
Abstract
In Brussels, many migrant women without legal status have no or limited access to health care and other basic services. Their access to descent care is mainly hampered by a lack of information, limited financial resources and poor experiences in the past. Three non-governmental organisations joint efforts to help migrant women without legal status to come out of their isolation. Action research during the implementation process was conducted in order to know which elements contributed to increased feelings of trust and reinforced autonomy among the target group and more willingness to support migrants among a larger population. Our major conclusion is that mental health and well-being is largely defined by (the quality of) social relations and interactions - an aspect that is too often forgotten as a result of the medicalization of mental health related problems.
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Affiliation(s)
| | | | - Willem van de Put
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
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93
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Kikhia S, Gharib G, Sauter A, Vincens NCL, Loss J. Exploring how Syrian women manage their health after migration to Germany: results of a qualitative study. BMC Womens Health 2021; 21:50. [PMID: 33531000 PMCID: PMC7852358 DOI: 10.1186/s12905-021-01193-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 01/21/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In the recent years, the number of Syrians living in Germany increased drastically due to the massive displacement caused by the Syrian conflict. Syrian migrant women in Germany are challenged by both the migration process and the changing of social roles. Seeking out healthcare may be hampered by linguistic and cultural barriers, but the new context may offer opportunities for health and well-being (free access to health care, civil/human rights). Little is known about how Syrian women manage their health after their resettlement in Germany. METHODS In depth interviews in Arabic were conducted with 9 Syrian women who were recruited through purposive sampling (18-55 years, migrated in 2011-2017, different education levels), focusing on capabilities to control one's health and to navigate the German healthcare system, and social/environmental barriers and facilitators to effectively manage their health. Interview transcripts were analysed using qualitative content analysis. RESULTS The women reported their health to be impaired by post-migration stressors, such as perceived discrimination, loss of social status and worrying about the future. Many interviewees felt disempowered and incompetent to successfully and actively navigate the German healthcare system, lacking information and not understanding their rights and options under the health insurance plan. The language barrier added to feeling vulnerable. Many women experienced doctors declining to treat them for capacity reasons; when treated, they often did not feel taken seriously or were dissatisfied with the emotional/cultural aspects of care. If possible, Arabic doctors were sought out. Some women, however, described improved resources for health, and appreciated better women's rights as a source of power. CONCLUSIONS The lack of information about the structure and offers of the German healthcare system, language and culture specific barriers as well as socio-cultural challenges are undermining the ability of Syrian women to manage their health effectively after their resettlement in Germany. Providing tailored information on the German healthcare system, creating a health-literacy supportive environment, and improving cultural sensitivity in healthcare provision could help Syrian women better utilize medical care offered in Germany.
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Affiliation(s)
- Salma Kikhia
- Medical Sociology, Regensburg University, Regensburg, Germany.
| | | | | | | | - Julika Loss
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
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94
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Wilder-Smith A. COVID-19 in comparison with other emerging viral diseases: risk of geographic spread via travel. Trop Dis Travel Med Vaccines 2021; 7:3. [PMID: 33517914 PMCID: PMC7847598 DOI: 10.1186/s40794-020-00129-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/26/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE OF REVIEW The COVID-19 pandemic poses a major global health threat. The rapid spread was facilitated by air travel although rigorous travel bans and lockdowns were able to slow down the spread. How does COVID-19 compare with other emerging viral diseases of the past two decades? RECENT FINDINGS Viral outbreaks differ in many ways, such as the individuals most at risk e.g. pregnant women for Zika and the elderly for COVID-19, their vectors of transmission, their fatality rate, and their transmissibility often measured as basic reproduction number. The risk of geographic spread via air travel differs significantly between emerging infectious diseases. COVID-19 is not associated with the highest case fatality rate compared with other emerging viral diseases such as SARS and Ebola, but the combination of a high reproduction number, superspreading events and a globally immunologically naïve population has led to the highest global number of deaths in the past 20 decade compared to any other pandemic.
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Affiliation(s)
- A Wilder-Smith
- Department of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
- Heidelberg Institute of Global Health, University of Heidelberg, Heidelberg, Germany.
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95
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Neglected cardiovascular diseases and their significance in the Global North. Herz 2021; 46:129-137. [PMID: 33506326 DOI: 10.1007/s00059-021-05020-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2021] [Indexed: 10/22/2022]
Abstract
Due to increasing global migration, the spectrum of cardiovascular disease (CVD) is changing in developed countries. Up to 3% of migrants arriving in Europe have underlying CVD. Despite their high global prevalence, conditions such as rheumatic heart disease, Chagas disease, endomyocardial fibrosis, tuberculous pericarditis, peripartum cardiomyopathy, and pulmonary hypertension are often under-recognized, and, as a result, neglected in industrialized countries. Many of these conditions, and their causes, are often unfamiliar to the health-care providers in host countries. In this review, we summarize the epidemiology, etiology, clinical presentation, diagnostic work-up, and management of neglected CVDs that have an increasing prevalence in the Global North.
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96
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Kolomvotsou AI, Riza E. Management of Diabetes Mellitus in Refugee and Migrant Patients in a Primary Healthcare Setting in Greece: A Pilot Intervention. EPIDEMIOLGIA (BASEL, SWITZERLAND) 2021; 2:14-26. [PMID: 36417186 PMCID: PMC9620876 DOI: 10.3390/epidemiologia2010002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/18/2020] [Accepted: 12/28/2020] [Indexed: 12/14/2022]
Abstract
Over the past years there is a substantial wave of migrants and refugees all over the world. Europe accepts approximately one-third of the international migrant population with Greece, in particular, having received large numbers of refugees and migrants by land and sea since the beginning of the civil war in Syria. Diabetes, a non-communicable disease, is a global health problem, affecting people in developing countries, refugees and migrants, and its basic treatment tool includes self-management and education. In this pilot study, we organized educational, interactive group sessions for diabetic refugees, based on culture, health, and nutritional needs according to a questionnaire developed for the study. The sessions were weekly, for two months, in the context of primary healthcare, organized by a dietitian. Nine individuals completed the sessions, five of nine were diagnosed in Greece and seven of nine needed diabetes education. Their waist circumference was above normal and they were all cooking at home. Their nutritional habits improved by attending the sessions and the interaction helped their social integration. They all found the sessions useful, and felt more self-confident regarding diabetes control and healthier.
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Affiliation(s)
- Anastasia I Kolomvotsou
- Dietetic Department, Polyclinic of Olympic Village, 13672 Αxarnai, Attiki, Greece
- Correspondence: ; Tel.: +30-6973-204749
| | - Elena Riza
- Department of Hygiene, Epidemiology & Medical Statistics, School of Medical, National and Kapodistrian University of Athens, 75 Mikras Asias, 11527 Athens, Greece;
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97
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Opaas M, Wentzel-Larsen T, Varvin S. The 10-year course of mental health, quality of life, and exile life functioning in traumatized refugees from treatment start. PLoS One 2020; 15:e0244730. [PMID: 33382807 PMCID: PMC7775068 DOI: 10.1371/journal.pone.0244730] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Accepted: 12/15/2020] [Indexed: 11/19/2022] Open
Abstract
Refugee patients with severe traumatic experiences may need mental health treatment, but treatment results vary, and there is scarcity of studies demonstrating refugees' long-term health and well-being after treatment. In a 10-year naturalistic and longitudinal study, 54 multi-origin traumatized adult refugee patients, with a background of war and persecution, and with a mean stay in Norway of 10.5 years, were recruited as they entered psychological treatment in mental health specialist services. The participants were interviewed face-to-face with multiple methods at admittance, and at varying points in time during and after psychotherapy. The aim was to study the participants' trajectories of symptoms of post-traumatic stress, anxiety and depression, four aspects of quality of life, and two aspects of exile life functioning. Linear mixed effects analyses included all symptoms and quality of life measures obtained at different times and intervals for the participants. Changes in exile life functioning was investigated by exact McNemar tests. Participants responded to the quantitative assessments up to eight times. Length of therapy varied, with a mean of 61.3 sessions (SD = 74.5). The participants improved significantly in symptoms, quality of life, and exile life functioning. Improvement in symptoms of posttraumatic stress, anxiety, and depression yielded small effect sizes (r = .05 to .13), while improvement in quality of psychological and physical health yielded medium effect sizes (r = .38 and .32). Thus, long-time improvement after psychological therapy in these severely traumatized and mostly chronified refugee patients, was more notable in quality of life and exile life functioning than in symptom reduction. The results imply that major symptom reduction may not be attainable, and may not be the most important indication of long-term improvement among refugees with long-standing trauma-related suffering. Other indications of beneficial effects should be applied as well.
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Affiliation(s)
- Marianne Opaas
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
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98
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A QUALITATIVE STUDY ON ACCESS BARRIERS TO MENTAL HEALTHCARE SERVICES BY SYRIAN REFUGEE WOMEN IN WINNIPEG, MANITOBA, CANADA. INTERNATIONAL JOURNAL OF HEALTH SERVICES RESEARCH AND POLICY 2020. [DOI: 10.33457/ijhsrp.798280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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99
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Santric-Milicevic M, Vasic M, Vasic V, Zivkovic-Sulovic M, Cirovic D, Lackovic M, Boskovic N. Uptake of Health Care Services by Refugees: Modelling a Country Response to a Western Balkan Refugee Crisis. Healthcare (Basel) 2020; 8:healthcare8040560. [PMID: 33327581 PMCID: PMC7765010 DOI: 10.3390/healthcare8040560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/05/2020] [Accepted: 12/09/2020] [Indexed: 11/16/2022] Open
Abstract
Planning and adjusting health capacities to meet the needs of refugees is a constant issue for transit and destination countries following the 2015/2016 Western Balkans refugee crisis. Understanding this crisis is important for taking the right steps in the future. The study informs about the prediction of the refugees’ health needs and demands for services in correspondence to political decision-making during 2015/2016 Western Balkan Refugee Crisis. Time series analysis, linear regression, and correlation analyses modelled the weekly flux of arrivals of more than half a million refugees to Serbia and the European Union, changes in the utilization of health care services, and disease diagnoses. With strategic planning, in the event of a recurrence of the refugee crises, the demand for health care services in the transit country could increase by 63 (95% CI: 21–105) for every additional 1000 refugees.
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Affiliation(s)
- Milena Santric-Milicevic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Correspondence:
| | - Milena Vasic
- Institute of Public Health of Serbia, 11000 Belgrade, Serbia; (M.V.); (M.Z.-S.)
| | - Vladimir Vasic
- Department of Statistics and Mathematics, Faculty of Economics, University of Belgrade, 11000 Belgrade, Serbia;
| | | | - Dragana Cirovic
- Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
- University Children’s Hospital, 11000 Belgrade, Serbia
| | - Milan Lackovic
- Clinical Hospital Center “Dr Dragiša Mišović”, 11000 Belgrade, Serbia;
| | - Nikolina Boskovic
- Fulbright Scholar at the Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia;
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100
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Socha A, Klein J. What are the challenges in the vaccination of migrants in Norway from healthcare provider perspectives? A qualitative, phenomenological study. BMJ Open 2020; 10:e040974. [PMID: 33234649 PMCID: PMC7689063 DOI: 10.1136/bmjopen-2020-040974] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 10/30/2020] [Accepted: 11/05/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Migrant populations in the European Union (EU) suffer a disproportionate burden of infectious diseases and may be particularly vulnerable due to poor conditions in countries of origin or throughout transit to the host country. Given the rising level of migration into Europe, the vaccination of migrant populations has become a key priority, with European countries committing to equitably extending the benefits of vaccination to all. However, in Norway, little is known about the vaccination of migrant populations. OBJECTIVE The aim of this qualitative research study was to explore the process of vaccinating migrant populations in Norway and elucidate any challenges as perceived by healthcare providers. This involved exploring the challenges faced by healthcare providers in delivering vaccinations to migrants as well as potential barriers faced by migrants in accessing vaccinations in Norway, from the perspectives of healthcare providers. METHODS In June 2019, the authors conducted semi-structured interviews with seven healthcare providers who are involved in vaccinating migrants in South-Eastern and Western Norway. This included healthcare providers working in general practice, public health and infectious disease clinics, migrant health clinics, and local public health institutes. RESULTS An inductive, exploratory analysis identified key themes that were reviewed and analysed in light of existing literature. According to the informants, the Childhood Immunisation Programme is effective in including migrant children within the national vaccination schedule. However, gaps in vaccination appear to exist with regards to adult migrants as well as working migrants. There is currently no consistent or structured approach to vaccinating adult migrants in Norway, including no guidelines from governing bodies on how to organise vaccination to adult migrants in municipalities. Furthermore, reasons why adult vaccination is not prioritised were provided, such as tuberculosis screening and treatment taking precedence and the common assumption among healthcare providers that vaccinations are dealt with in childhood. CONCLUSION The development of equitable immunisation programmes requires an understanding of the multifactorial barriers to immunisation, such as those posed by policies, structures and governance bodies, or lack thereof. It also entails understanding the administration of such policies and the perspectives of those who are responsible for the delivery of vaccination, namely healthcare providers. This qualitative research study demonstrated that challenges exist in the vaccination of migrants in Norway and that they are coherent with those experienced throughout the EU, principally the presence of gaps in vaccinating adult migrants, working migrants and internal EU migrants. This research provides direction for future investigations and highlights the need for the inclusion of migrant status in the Norwegian Immunisation Registry.
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Affiliation(s)
- Anna Socha
- Global Health Office, McMaster Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Jörn Klein
- Department of Nursing and Health Sciences, University of South-Eastern Norway, Kongsberg, Norway
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