A qualitative study of a mental health awareness intervention for Jordanian and resettled Syrian refugees in host communities

Barriers and facilitators to primary healthcare utilization among immigrants and refugees of low and middle-income countries: a scoping review

INTRODUCTION

Primary health care (PHC) is the most common model for providing primary care, and PHC services are the most common points of care that immigrants and refugees attend as a first step. Most immigrants travel to low- and middle-income countries (LMICs), yet only a few studies have examined their health conditions and their access to PHC in these countries. We have attempted to identify the barriers and facilitators that immigrants and refugees encounter when using PHC in these countries.

METHODS

We searched PubMed, Scopus, Web of Science, Embase, ProQuest, Google Scholar, Microsoft Academic, and OpenGrey in this scoping review from its inception to the end of October 2023. Moreover, we manually searched key journals, reference lists, and citations from included studies to identify any missed studies. We extracted data from each selected study using a predefined form. Finally, a thematic analysis approach was utilized to synthesize the collected data from the included qualitative studies.

RESULTS

17 qualitative studies were included in this review, which were from Iran (n = 3), Brazil (n = 3), Kenya (n = 2), Jordan (n = 2), Eastern Sudan (n = 1), Lebanon (n = 1), Bangladesh (n = 1), India (n = 1), Turkey (n = 1), Thailand (n = 1), and Malaysia (n = 1). Among the most common and important reported barriers are language differences, insufficiency of trained carers, unemployment, inability to pay the costs of hospital and medicines, no insurance coverage for immigrants, no clear referral and care system for immigrants, discrimination against women, and improper residence locations. Insurance coverage, awareness programs, and the study of immigrants' needs, along with their social and financial support from family, are among the most essential facilitators.

CONCLUSION

For LMICs, funding is always a limitation, and increasing PHC utilization is the best choice for improving health. Knowing the challenges and facilitators of PHC utilization from the point of view of each stakeholder is a promising way to decide and make policies that can improve the health of both immigrants and refugees, as well as society as a whole.

Mental health and psychosocial support programmes for displaced populations in low- and middle-income countries (LMICs): A systematic review of process, perspectives and experiences

Displacement exerts an ongoing negative impact on people's mental health. The majority of displaced populations are hosted in the global south, yet there is a paucity of evidence synthesis on the implementation of mental health and psychosocial support (MHPSS) programmes in those contexts. We undertook a systematic review of factors influencing the delivery and receipt of MHPSS programmes for displaced populations in low- and middle-income countries to address this gap. A comprehensive search of 12 bibliographic databases, 25 websites and citation checking were undertaken. Studies published in English from 2013 onwards were included if they contained evidence on the perspectives of adults or children who had engaged in, or programmes providers involved in delivering, MHPSS programmes. Fifteen studies were critically appraised and synthesised. Studies considered programme safety as a proxy for acceptability. Other acceptability themes included stigma, culture and gender. Barriers to the accessibility of MHPSS programmes included language, lack of literacy of programme recipients and location of services. To enhance success, future delivery of MHPSS programmes should address gender and cultural norms to limit mental health stigma. Attention should also be given to designing flexible programmes that take into consideration location and language barriers to ensure they maximise accessibility.

A mixed methods systematic review of mental health self-care strategies for Arabic-speaking refugees and migrants

BACKGROUND

Self-care strategies can improve mental health and wellbeing, however, the evidence on preferred strategies among Arabic-speaking refugees and migrants is unclear. This mixed methods systematic review aimed to identify and synthesise the global research on mental health self-care strategies used by these populations.

METHODS

English and Arabic language studies reporting on positive mental health self-care strategies to address symptoms of posttraumatic stress disorder, generalised anxiety and depression in the target populations were identified by systematically searching eight electronic databases and grey literature. Studies were deemed eligible if they were published from 2000 onwards and included Arabic-speaking migrants, refugees or asylum seekers aged 12 years and above. A narrative synthesis of study characteristics and relevant key findings was undertaken. The review protocol was registered on PROSPERO (registration number CRD42021265456).

RESULTS

Fifty-nine records reporting 57 studies were identified, the majority appearing after 2019. There were 37 intervention studies that incorporated a self-care component and 20 observational studies that reported on self-generated self-care practices. Across both study types, four broad groups of mental health self-care were identified-social, psychological, religious/spiritual, and other (e.g., expressive arts and exercise). Psychological strategies were the most reported self-care practice overall and featured in all intervention studies. Religious/spiritual and social strategies were more common in the observational studies. Intervention studies in diverse settings reported statistical improvements on a range of outcome measures. Observational studies reported a range of individual and community benefits. Linguistic, cultural and religious considerations, inherent in the observational studies, were variably addressed in the individual and group interventions.

CONCLUSION

Overall, study participants experienced self-care as helpful although some encountered challenges in practicing their preferred strategies. Further research on mental health self-care strategies among Arabic-speaking refugees and migrants is needed in Western resettlement countries to guide mental health service delivery and primary healthcare initiatives for new arrivals and in transit countries.