Three myths of disseminating COVID-19 information to vulnerable migrants in Japan: lessons learned during the pandemic

Antecedents and Consequences of Health Literacy among Refugees and Migrants during the First Two Years of COVID-19: A Scoping Review

Supporting refugee and migrant health has become a critical focus of healthcare policy. Developing and designing health literacy interventions that meet the needs of refugees and migrants is core to achieving this objective. This literature review sought to identify antecedents and consequences of health literacy among refugees and migrants during the first two years of the COVID-19 pandemic. We systematically searched nine electronic databases and numerous grey literature sources to identify studies published between December 2019 and March 2022. The antecedents (societal and environmental determinants, situational determinants, and personal determinants) and consequences of health literacy among refugees and migrants were mapped to a validated integrated health literacy model. Social and environmental determinants (n = 35) were the most reported antecedent influencing health literacy among refugees and migrants during the first two years of COVID-19. Language (n = 26) and culture (n = 16) were these determinants' most frequently reported aspects. Situational determinants (n = 24) and personal determinants (n = 26) were less frequently identified factors influencing health literacy among refugees and migrants. Literacy (n = 11) and socioeconomic status (n = 8) were the most frequently reported aspects of personal determinants. Media use (n = 9) and family and peer influence (n = 7) were the most cited situational determinants reported. Refugees and migrants with higher levels of health literacy were more likely to use healthcare services, resulting in better health outcomes. The findings of this review reveal personal and situational factors that impacted health literacy among refugees and migrants during COVID-19 that require attention. However, the inadequate adaptation of health literacy interventions for linguistic and cultural diversity was a greater problem. Attention to this well-known aspect of public health preparedness and tailoring health literacy interventions to the needs of refugees and migrants during pandemics and other public health emergencies are paramount.

Migrants' access to COVID-19 vaccination in Japan: Progress and challenges

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.

Risk Communication Distributed among Migrant Workers during the COVID-19 Crisis in Thailand: Analysis on Structural and Networking Gaps

Language and cultural barriers among migrant workers hamper access to health risk information. This study aims to explore health risk communication structure and processes and identify the communication network of migrant workers during the COVID-19 pandemic in Thailand. This study used a parallel mixed-methods design combined with in-depth interviews and questionnaires for social network analysis from November 2020 to June 2021 in the headquarter district of Samut Sakhon, Ranong, and Phuket provinces. We conducted purposive sampling of representatives from public and non-public organisations and local communities. Thirty-six key informants participated in in-depth interviews, and fifty-six respondents completed the questionnaire for social network analysis. Although health risk communication included various activities, there was no formal governing body responsible for health risk communication among migrants, and monitoring and evaluation of communication process were not well-implemented. The health risk communication network was centralised, especially in the rural area; however, migrant health volunteers (MHVs) and local media were key sources of information for most migrants in communities. Overall, a governing body led by the government with intersectional collaboration and a health risk communication process should be promoted while considering migrants’ characteristics and concerns. The health risk communication network should identify key communicators such as MHVs and local media. This can be an effective strategy to fill the gap of information dependency.

Access to Health-Related Information, Health Services, and Welfare Services among South and Southeast Asian Immigrants in Japan: A Qualitative Study

Migrants face several challenges in their daily lives in the host country due to limited knowledge about the language, culture, and social system of the host country. Their vulnerability increases in a time of crisis. During the COVID-19 pandemic, migrant communities were severely affected. Evidence on migrants' access to COVID-19-related information and services is limited. We conducted a qualitative, descriptive study among migrants from Vietnam, Myanmar, and Nepal living in Japan to explore the barriers and promoting factors for their access to health-related information, health services, and welfare services during the first wave of COVID-19. We used a thematic analysis to identify key themes according to the study's objectives. Further, these themes were assessed using an adapted version of the ecological model. The migrants mainly relied on the information available on social networking sites and were not aware of formal sources of information. Language was a major barrier, followed by cognitive bottlenecks and time constraints for migrants accessing health-related information and services. Social media, short-form information provided using their native language or plain Japanese and illustrations, and supportive people around could help them to access health-related information and services. The findings from this study demonstrate how migrants can represent a vulnerable group in a host country, even more so in a time of crisis.