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Haworth S, Cranshaw O, Xerri M, Stannard J, Clark R, Pacey E, Leng G, Campos-Matos I. A systematic review of the international evidence on the effectiveness of COVID-19 mitigation measures in communal rough sleeping accommodation. J Public Health (Oxf) 2023; 45:804-815. [PMID: 37477219 PMCID: PMC10788840 DOI: 10.1093/pubmed/fdad114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/11/2023] [Accepted: 06/27/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Accommodations with shared washing facilities increase the risks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection for people experiencing rough sleeping and evidence on what interventions are effective in reducing these risks needs to be understood. METHODS Systematic review, search date 6 December 2022 with methods published a priori. Electronic searches were conducted in MEDLINE, PubMed, Cochrane Library, CINAHL and the World Health Organization (WHO) COVID-19 Database and supplemented with grey literature searches, hand searches of reference lists and publication lists of known experts. Observational, interventional and modelling studies were included; screening, data extraction and risk of bias assessment were done in duplicate and narrative analyses were conducted. RESULTS Fourteen studies from five countries (USA, England, France, Singapore and Canada) were included. Ten studies were surveillance reports, one was an uncontrolled pilot intervention, and three were modelling studies. Only two studies were longitudinal. All studies described the effectiveness of different individual or packages of mitigation measures. CONCLUSIONS Despite a weak evidence base, the research suggests that combined mitigation measures can help to reduce SARS-CoV-2 transmission but are unlikely to prevent outbreaks entirely. Evidence suggests that community prevalence may modify the effectiveness of mitigation measures. More longitudinal research is needed. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42021292803.
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Affiliation(s)
- Steven Haworth
- Addictions and Inclusion Directorate, Office for Health Improvement and Disparities, London SW1H 0EU, UK
- Institute for Social and Economic Research, University of Essex, Essex CO4 3SQ, UK
| | - Owen Cranshaw
- Institute for Social and Economic Research, University of Essex, Essex CO4 3SQ, UK
| | - Mark Xerri
- Addictions and Inclusion Directorate, Office for Health Improvement and Disparities, London SW1H 0EU, UK
| | - Jez Stannard
- Addictions and Inclusion Directorate, Office for Health Improvement and Disparities, London SW1H 0EU, UK
| | - Rachel Clark
- Policy, Systems and Innovations Directorate, Office for Health Improvement and Disparities, London SW1H 0EU, UK
| | - Emma Pacey
- Addictions and Inclusion Directorate, Office for Health Improvement and Disparities, London SW1H 0EU, UK
| | - Gill Leng
- Addictions and Inclusion Directorate, Office for Health Improvement and Disparities, London SW1H 0EU, UK
| | - Ines Campos-Matos
- Addictions and Inclusion Directorate, Office for Health Improvement and Disparities, London SW1H 0EU, UK
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2
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Fujita M, Kanda M, Kiyohara H, Ikeda S, Iwamoto A, Sudo K, Teshima Y, Nii M, Murata Y, Kato J, Komatsu A, Yumino A, Sawada T, Sato H, Nakasa T. Migrants' access to COVID-19 vaccination in Japan: Progress and challenges. J Migr Health 2023; 7:100169. [PMID: 36814897 PMCID: PMC9932756 DOI: 10.1016/j.jmh.2023.100169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 10/17/2022] [Accepted: 02/08/2023] [Indexed: 02/18/2023] Open
Abstract
Objectives This study aimed to review the progress and challenges of COVID-19 vaccine roll-out for migrants in Japan and discuss the approaches to address the challenges and better prepare for future waves of COVID-19 and other pandemics. Methods We conducted a literature review using an assessment framework which we developed building upon existing frameworks and tools on access to health services and COVID-19 vaccination among migrants. Results COVID-19 vaccination coverage among foreigners might be lower than that of nationals although the data on foreigners were not widely available. A gap appeared to exist between the government's efforts to disseminate vaccine-related information through multi-lingual websites and migrant communities as recipients. A series of barriers for migrants were identified at different stages of the vaccination process. While efforts were made by different units of local governments, NGOs, migrant communities, and international exchange associations, linkages across sectors and scaling-up appeared to be an issue. No foreigners were explicitly excluded from the entitlements of COVID-19 vaccination. The national level guidance, however, allowed sub-national levels to make a decision on whether or not undocumented foreigners should be reported to the immigration office or law enforcement when providing the services. In consequence, units in charge of public health and vaccination of some municipalities did not offer vaccination to those in need. Conclusion Migrants, especially those unregistered face various barriers in accessing COVID-19 vaccination. It is critical to assess and address challenges concerning channels of information dissemination, pathways to access services, obstacles for vulnerable migrants, and data for evidence-based actions.
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Affiliation(s)
- Masami Fujita
- Bureau of International Health Cooperation, National Center for Global Health and Medicine (NCGM), Japan,Migrants’ Neighbor Network & Action (MINNA), Tokyo, Japan
| | - Miwa Kanda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine (NCGM), Japan,Migrants’ Neighbor Network & Action (MINNA), Tokyo, Japan,Corresponding author.
| | - Hiroyuki Kiyohara
- Bureau of International Health Cooperation, National Center for Global Health and Medicine (NCGM), Japan,Migrants’ Neighbor Network & Action (MINNA), Tokyo, Japan
| | - Saki Ikeda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine (NCGM), Japan,Migrants’ Neighbor Network & Action (MINNA), Tokyo, Japan
| | - Azusa Iwamoto
- Bureau of International Health Cooperation, National Center for Global Health and Medicine (NCGM), Japan,Migrants’ Neighbor Network & Action (MINNA), Tokyo, Japan
| | - Kyoko Sudo
- Bureau of International Health Cooperation, National Center for Global Health and Medicine (NCGM), Japan,Migrants’ Neighbor Network & Action (MINNA), Tokyo, Japan
| | - Yuko Teshima
- Migrants’ Neighbor Network & Action (MINNA), Tokyo, Japan,University of Tokyo, Japan
| | - Midori Nii
- Citizen's Network for Global Activities (CINGA), Japan
| | - Yoji Murata
- Bureau of Citizens and Cultural Affairs, Tokyo Metropolitan Government, Japan
| | | | - Aiko Komatsu
- Migrants’ Neighbor Network & Action (MINNA), Tokyo, Japan,Nagasaki University, Japan
| | - Aya Yumino
- Migrants’ Neighbor Network & Action (MINNA), Tokyo, Japan,University of Tokyo, Japan
| | - Takashi Sawada
- Migrants’ Neighbor Network & Action (MINNA), Tokyo, Japan,Minatomachi Medical Center, Japan,SHARE, Japan
| | - Hiroshi Sato
- Migrants’ Neighbor Network & Action (MINNA), Tokyo, Japan,Institute of Developing Economies, Japan
| | - Tamotsu Nakasa
- Migrants’ Neighbor Network & Action (MINNA), Tokyo, Japan,SHARE, Japan
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Wakata S, Nishioka D, Takaki Y. Changes in health-related quality of life scores among low-income patients on social welfare programs in Japan during the COVID-19 pandemic: a single-center repeated cross-sectional study. BMC Public Health 2022; 22:2147. [PMID: 36419068 PMCID: PMC9682633 DOI: 10.1186/s12889-022-14597-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Low-income is one of the well-established determinants of people's health and health-related behavior, including susceptibility to the coronavirus disease 2019 (COVID-19) infection. Two social welfare services are available in Japan to support financial and medical care among low-income patients: Public Assistance (PA), which provide both minimum income and medical costs; and Free/Low-Cost Medical Care (FLCMC), wherein only medical costs were covered. In this study, changes in Health-Related Quality of Life (HRQOL) scores of low-income patients on PA and FLCMC, before and after COVID-19 pandemic, were described and compared against those that are not utilizing the said services (comparison group) to evaluate the contribution of social welfare services in protecting the HRQOL of the beneficiaries during the pandemic. METHODS We used repeated cross-sectional data of adult beneficiaries of FLCMC and PA, as well as those without social welfare services, who regularly visit the Kamigyo clinic in Kyoto, Japan. We collected the data from 2018 and 2021 using a questionnaire on patients' socioeconomic attributes and the Japanese version of Medical Outcomes Study 12-Item Short Form Health Survey (SF-12). The Japanese version of SF-12 can calculate the three components scores: physical health component summary (PCS), the mental health component summary (MCS), and the role-social component summary (RCS), which can be transformed to a 0-100 range scale with a mean of 50 and standard deviation of 10. RESULTS Data of 200 and 174 beneficiaries in 2018 and 2021, respectively, were analyzed. Low-income patients on social welfare services had lower PCS, and RCS than the comparison group in both years. Multiple linear regression analyses with cluster-adjusted standard error estimator showed that the decline in MCS was significantly higher among FLCMC beneficiaries than in those without welfare services (Beta: -4.71, 95% Confidence Interval [CI]: -5.79 to -3.63, p < 0.01), and a decline in MCS among PA recipients was also observed (Beta: -4.27, 95% CI: -6.67 to -1.87 p = 0.02). CONCLUSIONS Low-income beneficiaries of social welfare may have experienced mental health deterioration during the COVID-19 pandemic. To maintain healthy lives during the pandemic, additional support on mental health for low-income recipients of social welfare services may be required.
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Affiliation(s)
- Satoshi Wakata
- Kamigyo Clinic, 482-2 Hanaguruma-Cho, Senbondori-Teranouchisagaru, Kamigyo-Ku, Kyoto, Japan
| | - Daisuke Nishioka
- Department of Medical Statistics, Research & Development Center, Osaka Medical and Pharmaceutical University, 2-7 Daigaku-Machi, Takatsuki, Osaka, Japan.
- Department of Social Epidemiology, Graduate School of Medicine and School of Public Health, Kyoto University, Yoshida-Konoe-Cho, Sakyo-Ku, Kyoto, Kyoto, Japan.
| | - Yukio Takaki
- Kamigyo Clinic, 482-2 Hanaguruma-Cho, Senbondori-Teranouchisagaru, Kamigyo-Ku, Kyoto, Japan
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4
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Miller R, Arita K, Igarashi NH, Fujii D, Yumino A, Jimba M. Social support as a bridge: A rapid realist review of migrant inclusion in the Japanese response to the COVID-19 pandemic. J Migr Health 2022; 6:100135. [PMID: 36117644 PMCID: PMC9472581 DOI: 10.1016/j.jmh.2022.100135] [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: 06/29/2021] [Revised: 06/24/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Inclusion of migrants in public health policy in Japan is rare. We synthesized the evidence on migrant inclusion during COVID-19. Vulnerability derived from movement restrictions and socioeconomic background. Access to support programs was conceptually equal, yet structurally inequitable. Structural gaps were bridged with social support from host society.
Government policy to address the COVID-19 pandemic has been complex with profound impacts on vulnerable minorities like international migrants. In Japan migrants are an important and growing community but their consideration in health policy is rare. We conducted a rapid realist review about ‘what works’ for the equitable inclusion of migrants during the pandemic as a case study for other public health emergencies. Due to the time-sensitive needs of policy-makers in the ongoing COVID-19 emergency, our evidence search was purposive, yet exploratory and iterative in nature. We assessed academic and gray literature sources, published in either English or Japanese, that examined the policy response to COVID-19 in Japan and its impact on migrants. A panel of external stakeholders was also consulted during the review process. This evidence synthesis suggests that, rather than illness alone, restrictions on movement and socioeconomic background lead to the considerable impact of policy on the well-being of migrants. Many policy responses, while conceptually inclusive and flexible, were often structurally inequitable for migrants. Poor outcomes included confusion about changing virus-related regulations and need for technical assistance to access support. Social support from volunteers and non-profit organizations were consistently left to connect migrants with unmet needs to available services. Using the diverse international community of Japan as an example, we show that, during public health emergencies, social support from civil society remains crucial for bridging structural inequities. For equitable inclusion of migrants, evidence-informed policy will be key for governments to better protect migrants’ right to health and well-being in future emergencies.
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Affiliation(s)
- Russell Miller
- Department of Community and Global Health, The University of Tokyo, Tokyo
- Corresponding author.
| | - Kuniko Arita
- Department of Community and Global Health, The University of Tokyo, Tokyo
| | | | - Daiki Fujii
- Department of Community and Global Health, The University of Tokyo, Tokyo
| | - Aya Yumino
- Department of Community and Global Health, The University of Tokyo, Tokyo
- Kawasaki Medical Cooperative Association, Asao Clinic, Kawasaki, Japan
| | - Masamine Jimba
- Department of Community and Global Health, The University of Tokyo, Tokyo
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Shinohara A, Kawasaki R, Kuwano N, Ohnishi M. Interview survey of physical and mental changes and coping strategies among 13 Vietnamese female technical interns living in Japan. Health Care Women Int 2021; 45:265-281. [PMID: 34586964 DOI: 10.1080/07399332.2021.1963966] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 07/30/2021] [Indexed: 10/20/2022]
Abstract
We conducted a case study to assess 1) physical and mental changes; 2) self-assessments of symptoms; 3) coping strategies; and 4) adaptation to physical and mental changes by semi-structured interview survey among Vietnamese female migrant workers working in Japan under the Technical Intern Training Program. We found they experienced female-specific physical changes, and some interns' symptoms worsened because they did not consult anyone about their symptoms. We propose increasing opportunities to learn about possible physical and mental changes caused by migration and to improve health literacy, including prevention, coping, help-seeking, and consultations about health concerns among female technical interns.
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Affiliation(s)
- Aya Shinohara
- The Center for Nursing Education, Research and Collaboration, Oita University of Nursing and Health Sciences, Oita, Japan
| | - Ryoko Kawasaki
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Noriko Kuwano
- Department of Community Health Nursing, International Nursing, Oita University of Nursing and Health Sciences, Oita, Japan
| | - Mayumi Ohnishi
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Fujita M, Umeda T, Fujita N, Nishioka T, Iwamoto A, Ohmagari N, Ishikane M, Akashi H, Kokudo N. Japanese WHO Collaborating Centres (WHO CCs) fight against COVID-19. Glob Health Med 2021; 3:115-118. [PMID: 33937576 DOI: 10.35772/ghm.2020.01093] [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: 10/22/2020] [Revised: 01/27/2021] [Accepted: 02/04/2021] [Indexed: 11/08/2022]
Abstract
WHO Regional Office for the Western Pacific (WPRO) organized an online meeting connecting WHO Collaborating Centres (WHO CCs) in the region on 25 August 2020, to share experiences and promote networking on COVID-19 response. The meeting shared regional update on situation and responses, and COVID-19 related experiences of selected WHO CCs, followed by discussions on opportunities for enhancing collaboration between WPRO and WHO CCs. Priorities of WPROs support to countries included a health systems approach rather than single intervention. On behalf of WHO CCs in Japan, the National Center for Global Health and Medicine (NCGM) delivered a presentation on the results of a survey about COVID-19 related activities of these WHO CCs. These activities were categorized into collaboration with WHO, research and development, public health responses, and clinical services. Collaboration with WHO included sending consultants through the scheme of GOARN, strengthening of COVID-19 testing, and contribution to development of WPRO guidelines. Research and development involved establishment of a nationwide registry of COVID-19 clinical data. Following the meeting, NCGM further enhanced its activities as WHO CC. Since WHO CCs in the country have a wide range of expertise that could contribute to health system strengthening, it is worthwhile for the WHO CCs to consider amending existing work plans for supporting countries in the region to incorporate a health systems approach as part of COVID-19 response strategies.
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Affiliation(s)
- Masami Fujita
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tamami Umeda
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Noriko Fujita
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Tomoko Nishioka
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Azusa Iwamoto
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Masahiro Ishikane
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Hidechika Akashi
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norihiro Kokudo
- National Center for Global Health and Medicine, Tokyo, Japan
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