Culture, Structure, and Health: Narratives of Low-income Bangladeshi Migrant Workers from the United Arab Emirates

Factors influencing health-seeking behavior among Sudanese immigrants in Saudi Arabia

BACKGROUND

Health-seeking behavior (HSB) involves any action or inaction taken by individuals who perceive themselves to have a health problem or illness aimed at finding appropriate medical treatments. Studies suggest a positive relationship between the availability and quality of health services and their utilization. This study aimed to identify the factors influencing health-seeking behavior among Sudanese immigrants in Saudi Arabia, to improve healthcare access and health outcomes.

METHOD

A cross-sectional study was conducted targeting Sudanese residents of the Kingdom of Saudi Arabia (KSA). Participants were recruited using convenient sampling. A self-administered questionnaire was distributed electronically. A total of 494 participants were recruited for the study.

RESULTS

This study showed that the majority of the participants (66.6%) visited a primary healthcare center when faced with a medical problem. However, the prevalence of self-medication in the past three months was 45.7%. Significant factors influencing health-seeking behavior included age (OR [95% CI]: 1.032 [1.000-1.066]) and lack of health insurance (OR = 1.01, 95% CI [1.00-1.02], p = 0.019).

CONCLUSIONS

This study emphasizes the importance of understanding healthcare-seeking behavior among immigrant groups, particularly Sudanese immigrants in Saudi Arabia. It highlights the significance of insurance as a determinant of healthcare-seeking behavior and calls for reforming current policies to reduce disparities in accessing healthcare services.

Experiences of Providers and Immigrants/Refugees with Health Care: A Meta-Synthesis of the Latin American Context

INTRODUCTION

The experiences of providers and immigrants/refugees related to healthcare in the Latin American context have not yet been aggregated. This study aimed to synthesize the qualitative evidence on this theme.

METHOD

A systematic review of qualitative evidence with meta-synthesis. After identification, eligible studies were evaluated for methodological quality, and information was systematically analyzed.

RESULTS

The sample comprised 26 articles. The meta-theme shows that the experiences of providers and immigrants/refugees are determined by multilevel factors. In a macro-context, these factors involve the vulnerabilities of immigrants/refugees and the healthcare system/model, and in a closer context, they involve the lack of professional training in cultural skills and communication; language barriers; and prejudice/xenophobia. Within healthcare, the relationship is mostly conflictual, asymmetric, and unable to solve problems, leading to negative repercussions for both.

CONCLUSIONS

Managers involved in developing public policies and providers must consider improving the interrelationship between healthcare services and the migrant population.

Decolonizing Impact Through the Culture-Centered Approach to Health Communication: Mobilizing Communities to Transform the Structural Determinants of Health

In this issue, we outline the central tenets of the culture-centered approach to health communication. What does the culture-centered approach address when suggesting the co-creation of voice infrastructures? What is the theory's methodological emphasis for mobilizing and transforming structures that shape health inequalities for communities at the margins? Drawing on examples of culture-centered interventions in over fifty communities spread across 17 countries and three continents, a large number of them housed under the umbrella of the Center for Culture-centered Approach to Research and Evaluation (CARE) at Massey University in Aotearoa, New Zealand, we articulate the communicative processes (referring to actionable sources and targets of communicative action) that shape the building of voice infrastructures mobilizing toward structural transformation. For instance, African American communities organizing under the framework of the culture-centered approach, documented in Dutta, Collins, and colleagues study in 2019, discuss the building of voice infrastructures where community members participate in co-creating heart health information based on comparative effectiveness research, building an African American media ecosystem disseminating the information alongside community-led initiatives growing healthy food, community-led youth activities, and activism addressing the racist structural drivers that adversely impact African American heart health. In this essay, we describe the impact of culture-centered interventions reflected in the voice infrastructures within communities that witness and articulate the oppressions that threaten human health at the margins and in the transformations of these structures that organize various facets of life and livelihood at the global margins linked to health.

"I Learned Myself": Using Structuration Theory to Uncover Korean Immigrants' Health Literacy Development in the U.S. as an Agentic Behavior During the COVID-19 Pandemic

The health literacy of immigrants has been often viewed in a deficit model. By using structuration theory as a theoretical lens, this study aimed to uncover the health literacy development of Korean immigrants in the U.S. as an agentic behavior during the COVID-19 pandemic. A total of 20 semi-structured interviews were conducted with Korean immigrants in the U.S. Findings reveal how the participants' experience was shaped by structural forces such as conflicting but co-existing public health systems between the U.S. and Korea, information overload, and the uncertainty surrounding the pandemic. Participants also employed strategies such as constantly comparing the public health guidelines from the two countries, critically appraising the information, deliberately choosing which guideline to follow, combating misinformation, and regulating media consumption. These strategies enabled them to develop health literacy by leveraging their immigrant status as an advantage. Theoretical, practical, and policy implications are discussed.

Soliciting Social Support from Migrant Domestic Workers' Connections to Storytelling Networks during a Public Health Crisis

Guided by communication infrastructure theory and social support theory, this study scrutinizes how the storytelling networks of marginalized communities, particularly migrant domestic workers (MDWs), provided social support amid the COVID-19 pandemic. Data obtained from in-depth interviews with 32 Indonesian MDWs in Hong Kong revealed that the community storytelling networks, comprising interpersonal relationships, community organizations, and media outlets, played an essential role in assisting the coping efforts of MDWs during the pandemic. These storytelling networks offered various types of social support, including informational, emotional, and instrumental or tangible assistance. However, these connections to the storytelling networks were also sources of the spread of misinformation. Theoretical and practical implications are further discussed.

Migrant worker well-being as a struggle for meaningful work: Evidence from Bangladeshi migrants in a developing country

This article analyses the well-being of migrants in the global South for whom employment precarity has become normalized, and working and living conditions are associated with poor health, isolation, limited voice and a general lack of protection. Well-being in such contexts may be considered as a multifaceted phenomenon which manifests itself across work and other life domains to include collective sources of well-being. We also recognize the politics of working life in how precarious workers construct well-being, presenting them as engaged in a struggle for meaning in the absence of objectively meaningful work. First, we explore the objective constraints on well-being at multiple sites (personal, relational, organizational, communal) and, second, we draw from a sociological perspective of meaningful work to explore worker agency in deriving subjective autonomy, recognition and dignity. Qualitative data from 41 Bangladeshi migrants in Mauritian construction, food and textile manufacturing firms showed that despite considerable challenges to personal well-being, workers engaged in informal and agentic strategies which shaped their efficacy, voice and relationships to create meaningful work. The findings reveal mechanisms underlying the construction of meaning in precarious work, showing the implications for gendered and culturally-derived agency, and broadening theory on holistic and contextualized perspectives of well-being.

The Excluded Voices from Africa's Sahel: Alternative Meanings of Health in Narratives of Resistance to the Global Polio Eradication Initiative in Northern Nigeria

Although previous inquiry into resistance to the polio vaccines in northern Nigeria has been launched from several disciplines, inquiry has been limited to the 2003 revolt and has rarely been informed by theory. This study drew on the culture-centered approach to health communication to argue that the exclusion of marginalized communities from decision-making by the Global Polio Eradication Initiative (GPEI) resulted in a vaccine resistance which found expression in health activism that engaged the local news media. To recover the excluded voices, this study examined community members' narratives of resistance to the vaccines in Nigerian news from 2012 to 2018. Upon providing a backdrop for these narratives through a chronology of GPEI milestones in northern Nigeria developed from Nigerian newspapers, the study then engaged with 168 speech acts of resistance in Nigerian news to co-construct alternative meanings of health. Drawing on a local cultural meaning of the vaccines as covertly carrying out a Western family-planning agenda, narrators negligibly associated "family planning" with health. Narrators further articulated health as access to foods and as religious practice. These findings have implications for the inclusion of voices from sub-Saharan Africa in GPEI decision-making.

Psychological Distress and Homesickness Among Sudanese Migrants in the United Arab Emirates

Migration is a global phenomenon growing in scope, and it can be associated with negative emotions such as sense of impending loss, fear of the unknown, and anxiety about those left at home. The objective of this exploratory study was to examine psychological distress and homesickness among Sudanese migrants in the United Arab Emirates (UAE). Participants were 1444 Sudanese migrants (M_age = 40.20; SD = 10.98). The Second Version of the Dundee Relocation Inventory was used to assess homesickness, and the 28-item General Health Questionnaire was used to measure psychological distress, depressive and anxiety symptoms, somatic symptoms, and social dysfunction. The results showed that older age and longer duration of residence in the UAE were associated with lower levels of homesickness, psychological distress, and depressive and anxiety symptoms. Further, homesickness was associated with higher psychological distress, somatic symptoms, and depressive and anxiety symptoms. Women and unemployed migrants had higher psychological distress, somatic symptoms, and depressive and anxiety symptoms compared with men and those employed, respectively. Being unmarried was associated with higher levels of depressive symptoms and homesickness, while those married or divorced/widowed showed lower levels of depressive symptoms and homesickness. It was concluded that there is a need to tackle unemployment among migrants in the UAE and address family reunion issues.