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Alshamary S, Bashir E, Salami B. Barriers and facilitators to health care access for migrant children in Canada: A scoping review. J Pediatr Nurs 2024; 77:e602-e615. [PMID: 38824079 DOI: 10.1016/j.pedn.2024.05.029] [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: 08/09/2022] [Revised: 05/24/2024] [Accepted: 05/25/2024] [Indexed: 06/03/2024]
Abstract
PROBLEM Migrant children face numerous challenges when settling in their new home. One of the challenges that exists is difficulties accessing health care, with many barriers existing and few facilitators to ease access. The goal of this paper is to analyze previous literature related to migrants' access to access to health care in Canada to better understand the barriers they face, and the factors that help them access services, or the facilitators. ELIGIBILITY CRITERIA Arksey and O'Malley's stages in scoping reviews was employed to search CINAHL, PubMed, Sociological Abstract, SocIndex, Scopus, Cochrane Library, Ovid MEDLINE(R), and Ovid Embase from 1997 to February 2020. SAMPLE A total of 26 Canadian studies met the inclusion criteria. RESULTS The review revealed the following barriers: language and culture barriers, low socioeconomic status, lack of health insurance, transportation, shortage of social support, lack of knowledge, fear of service providers/authorities, and discrimination. The facilitators for accessing health care for this population included outreach, benefit and assistance programs, cultural training, strengthening education, and various services. CONCLUSION The abundance of barriers to health care access and the existence of few facilitators may worsen migrant children's health, however further research is required to understand the impact. IMPLICATION There is a need to increase the understanding of migrant children's experiences with accessing health care services in order to inform policy, educate providers, and improve access and health outcomes.
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Affiliation(s)
| | - Elhan Bashir
- Faculty of Nursing, University of Alberta, Canada.
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Fong M, Liu A, Lung B, Alayche I, Sayfi S, Kirenga RY, Chomienne MH, Saad A, Grenier J, Kassam A, Ahmed R, Pottie K. From struggle to strength in African and Middle Eastern newcomers' integration stories to Canada: A participatory health equity research study. PLoS One 2024; 19:e0302591. [PMID: 38687776 PMCID: PMC11060515 DOI: 10.1371/journal.pone.0302591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 04/08/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Newcomers (immigrants, refugees, and international students) face many personal, gender, cultural, environmental and health system barriers when integrating into a new society. These struggles can affect their health and social care, reducing access to mental health care. This study explores the lived experiences of African and Middle Eastern newcomers to Ontario, Canada. An understanding of newcomer integration challenges, successes and social justice issues is needed to improve health equity and social services. METHODS In this qualitative study, we used a participatory research approach to collect stories reflecting participants' integration perspectives and experiences. Beginning with our immigrant community network, we used snowball sampling to recruit newcomers, ages 18 to 30, originating from Africa or the Middle East. We used qualitative narrative analysis to interpret stories, identifying context themes, integrating related barriers and facilitators, and resolutions and learnings. We shared our findings and sought final feedback from our participants. FINDINGS A total of 18 newcomers, 78% female and approximately half post-secondary students, participated in the study. Participants described an unknown and intimidating migration context, with periods of loneliness and isolation aggravated by cold winter conditions and unfamiliar language and culture. Amidst the struggles, the support of friends and family, along with engaging in schoolwork, exploring new learning opportunities, and participating in community services, all facilitated integration and forged new resilience. CONCLUSIONS Community building, friendships, and local services emerged as key elements for future immigrant service research. Utilizing a participatory health research approach allowed us to respond to the call for social justice-oriented research that helps to generate scientific knowledge for promoting culturally adaptive health care and access for marginalized populations.
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Affiliation(s)
- Maggie Fong
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
| | - Amy Liu
- Department of Interdisciplinary Medical Sciences, Western University, London, Ontario, Canada
| | - Bryan Lung
- Department of Anatomy and Cell Biology, Western University, London, Ontario, Canada
- Department of Biochemistry, Western University, London, Ontario, Canada
| | - Ibrahim Alayche
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Shahab Sayfi
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Ryan Yuhi Kirenga
- The Vulnerability, Trauma, Resilience and Culture Research Laboratory (V-TRaC), University of Ottawa, Ottawa, Ontario, Canada
| | - Marie Hélène Chomienne
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Ottawa, Ontario, Canada
| | - Ammar Saad
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Jean Grenier
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Institut du Savoir Montfort, Ottawa, Ontario, Canada
- School of Psychology, University of Ottawa, Ottawa, Ontario, Canada
| | - Azaad Kassam
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada
| | - Rukhsana Ahmed
- Department of Communication, University at Albany, State University of New York, Albany, New York, United States of America
| | - Kevin Pottie
- Institut du Savoir Montfort, Ottawa, Ontario, Canada
- Department of Family Medicine, Western University, London, Ontario, Canada
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Gyan C, Chireh B, Chuks-Eboka N, Yeboah AS. Reconsidering the Conceptualization of Resilience: The Experiences of Refugee and Immigrant Youth in Montreal. APPLIED RESEARCH IN QUALITY OF LIFE 2023; 18:1-25. [PMID: 36844904 PMCID: PMC9942027 DOI: 10.1007/s11482-023-10154-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 02/15/2023] [Indexed: 06/18/2023]
Abstract
Over the last two decades, immigrant and refugee integration service agencies in Canada have been incorporating a focus on resiliency in their work and hold "fostering resilience" as a primary goal of services. These agencies focus on helping their clients enhance resilience in response to their integration challenges. Refugee and immigrant youth (RIY) face intersectional vulnerabilities during their resettlement process. These challenges make the concept of resilience vital to their success. However, resettlement service providers associate RIY's resilience with their assimilation into the Western culture such as integrating into the dominant culture. This definition is insensitive to cultural and social factors that contextualize RIY's definition of resilience. Drawing from in-depth interviews of Refugees and Immigrant youths in Montreal, and using Resilience as a conceptual framework, the research study investigated the barriers to the integration of RIY and their conceptualization of resilience. The study found social isolation, cultural differences between the host and home communities, racism, hostility, aggression, and language to be barriers to RIY's integration. The youth conceptualized resilience as a form of adaptability to any situation; as the ability to integrate into a new society while remaining deeply rooted in one's culture and past experiences; and overcoming marginalization. The paper contributes to a nuanced critical understanding in the field of refugee and migration studies and further throws light on a growing triangular interrelationship between social and economic integration of refugees, cultural factors of host communities, and resilience.
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Affiliation(s)
- Charles Gyan
- School of Social Work, McGill University, 550 Sherbrook Street West, East wing, Room 130, H3A 1E3 Montréal, QC Canada
| | - Batholomew Chireh
- EPID@Work Research Institute, Lakehead University, Thunder Bay, Canada
| | - Noelle Chuks-Eboka
- School of Social Work, McGill University, 550 Sherbrook Street West, East wing, Room 130, H3A 1E3 Montréal, QC Canada
| | - Ata Senior Yeboah
- School of Social Work, McGill University, 550 Sherbrook Street West, East wing, Room 130, H3A 1E3 Montréal, QC Canada
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Segneri MC, Di Napoli A, Costanzo G, Mirisola C, Cavani A, Castaldo M. Anthropological Research Study of Migrants at the First Aid and Reception Center (CPSA) of Lampedusa. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5337. [PMID: 35564734 PMCID: PMC9105405 DOI: 10.3390/ijerph19095337] [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: 12/22/2021] [Revised: 03/23/2022] [Accepted: 04/15/2022] [Indexed: 02/06/2023]
Abstract
A medical anthropology research study was conducted in 2015 at the First Aid and Reception Center (CPSA) on the island of Lampedusa (Italy) as part of a larger health project carried out by the National Institute for Health, Migration and Poverty (INMP) in Rome. The study investigated the health conditions of migrants at the moment of their departure and on arrival, their migration journey, and their life plans and expectations for the future. The ethnographic method adopted for the study was based on participant observation and on data collection by means of a semi-structured interview (51 items simultaneously translated by cultural mediators into Tigrinya, Arabic, English, and French). Interviewed were 112 adults (82 men and 30 women) from the Gulf of Guinea and the Horn of Africa. The cooccurrence of forced migration and economic concerns was confirmed; violence and torture were constants throughout the migration journey in 81% of cases. Ethnographic data detailed the timing, countries, settings, perpetrators, and types of violence endured. A combination of qualitative and quantitative findings can both facilitate the identification of fragile health conditions and support clinicians in the diagnostic, therapeutic, and rehabilitation pathways. These data illustrate the importance and feasibility of multidisciplinary collaboration even in emergency contexts.
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Affiliation(s)
- Maria Concetta Segneri
- Medical Anthropological Unit, Department of Mental Health, National Institute for Health, Migration and Poverty (INMP), 00153 Rome, Italy;
| | - Anteo Di Napoli
- Department of Epidemiology, National Institute for Health, Migration and Poverty (INMP), 00153 Rome, Italy;
| | - Gianfranco Costanzo
- Health Directorate, National Institute for Health, Migration and Poverty (INMP), 00153 Rome, Italy;
| | - Concetta Mirisola
- INMP Directorate, National Institute for Health, Migration and Poverty (INMP), 00153 Rome, Italy;
| | - Andrea Cavani
- Scientific Coordination Unit, National Institute for Health, Migration and Poverty (INMP), 00153 Rome, Italy;
| | - Miriam Castaldo
- Medical Anthropological Unit, Department of Mental Health, National Institute for Health, Migration and Poverty (INMP), 00153 Rome, Italy;
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Veronese G, Pepe A, Sala G, Vigliaroni M. Measuring subjective well-being in an understudied population of young Western-African IDPs and refugees. INTERNATIONAL JOURNAL OF MIGRATION HEALTH AND SOCIAL CARE 2019. [DOI: 10.1108/ijmhsc-07-2018-0043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to report a real-life empirical case and discuss some caveats emerged in measuring subjective well-being (SWB) in an understudied population of adolescents refugees from West Africa.
Design/methodology/approach
During the process of translation and cultural adaptation of the subjective well-being assessment scale in the target population, the model of measurement presented some weakness with regard to content validity criteria.
Findings
This leads to a partial revision of the model and the development of new locally-based domains of SWB.
Originality/value
Context-specific factors’ robustness showed the dynamic and culture-informed nature of the SWB construct. Practical and theoretical implications of using quantitative questionnaires in non-western contexts characterized by high grades of insecurity and instability will be discussed.
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Ezeonwu M. Baccalaureate Nursing Education Experiences of African-Born Nurses in the United States. J Nurs Educ 2019; 58:281-289. [PMID: 31039262 DOI: 10.3928/01484834-20190422-06] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 02/20/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND African-born nurses are valuable members of the U.S. nursing workforce. The majority begin their nursing education in community colleges and practice as licensed practical nurses/vocational nurses (LPN/VNs) and RNs before obtaining their Bachelor of Science in Nursing (BSN) degree. For African-born nursing students, the environment of 4-year institutions, although exciting and promising, may be overwhelming and challenging. METHOD In this qualitative descriptive study, 25 African-born nurses who graduated from accredited RN-to-BSN programs over a period of 5 years were interviewed. Qualitative content analysis was used to analyze the data. RESULTS Several factors including flexible curricular designs and helpful campus resources supported students' educational experiences. Factors such as financial difficulties and difficult work-family-school balances challenged them. CONCLUSION The BSN curriculum is especially rigorous and demanding for foreign-born minority students. Such programs must provide appropriate resources to support students who are new to U.S. education system. [J Nurs Educ. 2019;58(5):281-289.].
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