1
|
Ng SH, Kaur S, Cheah PY, Ong ZL, Lim J, Voo TC. Migration health ethics in Southeast Asia: a scoping review. Wellcome Open Res 2024; 8:391. [PMID: 38595706 PMCID: PMC11002524 DOI: 10.12688/wellcomeopenres.19572.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2024] [Indexed: 04/11/2024] Open
Abstract
Background Asia hosts the second-largest international migrant population in the world. In Southeast Asia (SEA), key types of migration are labour migration, forced migration, and environmental migration. This scoping review seeks to identify key themes and gaps in current research on the ethics of healthcare for mobile and marginalised populations in SEA, and the ethics of research involving these populations. Methods We performed a scoping review using three broad concepts: population (stateless population, migrants, refugees, asylum seekers, internally displaced people), issues (healthcare and ethics), and context (11 countries in SEA). Three databases (PubMed, CINAHL, and Web of Science) were searched from 2000 until May 2023 over a period of four months (February 2023 to May 2023). Other relevant publications were identified through citation searches, and six bioethics journals were hand searched. All searches were conducted in English, and relevant publications were screened against the inclusion and exclusion criteria. Data were subsequently imported into NVivo 14, and thematic analysis was conducted. Results We identified 18 papers with substantial bioethical analysis. Ethical concepts that guide the analysis were 'capability, agency, dignity', 'vulnerability', 'precarity, complicity, and structural violence' (n=7). Ethical issues were discussed from the perspective of research ethics (n=9), clinical ethics (n=1) and public health ethics (n=1). All publications are from researchers based in Singapore, Thailand, and Malaysia. Research gaps identified include the need for more research involving migrant children, research from migrant-sending countries, studies on quality of migrant healthcare, participatory health research, and research with internal migrants. Conclusions More empirical research is necessary to better understand the ethical issues that exist in the domains of research, clinical care, and public health. Critical examination of the interplay between migration, health and ethics with consideration of the diverse factors and contexts involved is crucial for the advancement of migration health ethics in SEA.
Collapse
Affiliation(s)
- Shu Hui Ng
- School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, 47500, Malaysia
| | - Sharon Kaur
- Faculty of Law, University Malaya, Kuala Lumpur, Federal Territory of Kuala Lumpur, 50603, Malaysia
| | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit, Bangkok, 10400, Thailand
- Centre for Tropical Medicine and Global Health, Oxford, OX3 7LG, UK
| | - Zhen Ling Ong
- Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, University Malaya, Kuala Lumpur, Federal Territory of Kuala Lumpur, 50603, Malaysia
- Department of Global Health and Development, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK
| | - Jane Lim
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
| | - Teck Chuan Voo
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, 117597, Singapore
| |
Collapse
|
2
|
Battineni G, Chintalapudi N, Gagliardi G, Amenta F. The Use of Radio and Telemedicine by TMAS Centers in Provision of Medical Care to Seafarers: A Systematic Review. J Pers Med 2023; 13:1171. [PMID: 37511784 PMCID: PMC10381421 DOI: 10.3390/jpm13071171] [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: 06/12/2023] [Revised: 07/09/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
Objective: From medicine via radio to telemedicine, personalized medical care at sea has improved significantly over the years. Currently, very little research has been conducted on telemedicine services and tools at sea. This study aims to review real-time case studies of seafarers' personalized treatment via telemedical devices published in medical journals. Methods: A literature search was conducted using three libraries such as PubMed (Medline), Cumulative Index to Nursing and Allied Health Literature (CINAHL), BioMed Central, and Google Scholar. The Medical Subject Headings (MeSH) were used for information retrieval and document selection was conducted based on the guidelines of preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 flowchart. Selected articles were subjected to quality checks using the Newcastle-Ottawa scale (NOS). Results: The literature search produced 785 papers and documents. The selection was conducted in three stages such as selection, screening, and inclusion. After applying predefined inclusion and exclusion criteria, only three articles on real-time medical assistance with telemedical tools were identified. It is reported that medical attention is delivered to seafarers in real time thanks to advancements in telemedicine, satellite technology, and video conferencing. Conclusions: By improving the quality of medical care and reducing response times for medical emergencies at sea, lives have been saved. There are still several gaps despite these advancements. Medical assistance at sea should therefore be improved to address many of the still unsolved issues.
Collapse
Affiliation(s)
- Gopi Battineni
- Clinical Research Centre, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy
| | - Nalini Chintalapudi
- Clinical Research Centre, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy
| | - Giulio Gagliardi
- Research Department, International Radio Medical Centre (C.I.R.M.), 01444 Rome, Italy
| | - Francesco Amenta
- Clinical Research Centre, School of Medicinal and Health Products Sciences, University of Camerino, 62032 Camerino, Italy
- Research Department, International Radio Medical Centre (C.I.R.M.), 01444 Rome, Italy
| |
Collapse
|
3
|
Farahat RA, Rackimuthu S, Umar TP, Siddiqui JA, Shrestha AB, Essar MY. Preparedness of South East Asia countries in view of monkeypox emergence: A call for action. THE LANCET REGIONAL HEALTH - SOUTHEAST ASIA 2022; 6:100074. [PMID: 36249534 PMCID: PMC9534127 DOI: 10.1016/j.lansea.2022.100074] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
4
|
Razali DRM, Duraisingam DTJ, Xuan NLN. Digitalisation of Birth Registration System in Malaysia: Boon or Bane for the Hard-to-reach and Marginalised? J Migr Health 2022; 6:100137. [PMID: 36217505 PMCID: PMC9547304 DOI: 10.1016/j.jmh.2022.100137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/09/2022] [Accepted: 09/26/2022] [Indexed: 10/29/2022] Open
|
5
|
A Systematic Scoping Review on Migrant Health Coverage in Thailand. Trop Med Infect Dis 2022; 7:tropicalmed7080166. [PMID: 36006258 PMCID: PMC9415742 DOI: 10.3390/tropicalmed7080166] [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: 06/16/2022] [Revised: 07/25/2022] [Accepted: 07/28/2022] [Indexed: 02/05/2023] Open
Abstract
(1) Background: Thailand is a major migrant receiving country and pioneer of migrant health policy in the ASEAN region. However, on the ground, coverage of migrants is faced with multiple barriers. (2) Objectives: We aim to scope and analyse the types of available evidence on migrant health coverage in Thailand and identify knowledge gaps. Specifically, we characterise the literature along year of publication, migrant subpopulation, health domain, scope of coverage, methods, study design, objectives and results. (3) Methods: We searched PubMed, Web of Science, Google Scholar, Cochrane Database, Worldwide Science and the Asian Citation Index for peer-reviewed and grey literature in October 2021 for studies analysing original data on health coverage of migrants in Thailand. To conceptualise health coverage, we used the three dimensions availability, accessibility and acceptability. (4) Results: 101 articles were included in the final analysis. Sixty-three were published after 2016, 39 focused on migrant workers and 18 on migrants in general. Forty-two concentrated on health in broader terms, followed by reproductive and maternal health (n = 31). Thirty-eight assessed coverage of specific services and 36 health coverage in general. Migrants themselves and key informants were the main data sources in 80 and 43 of the articles, respectively. Forty publications were qualitative, while 38 applied quantitative methods (22% descriptive; 7% analytical). Among the health coverage components, 79 articles included aspects of accessibility, followed by acceptability (n = 59) and availability (n = 30). (5) Conclusions: While there is a high number and broad range of studies on migrant health coverage in Thailand, we found that research on migrant subgroups, such as victims of trafficking and migrant children, as well as on the health domains, non-communicable diseases and occupational and mental health is neglected.
Collapse
|
6
|
Lokot M, Bou-Orm I, Zreik T, Kik N, Fuhr DC, El Masri R, Meagher K, Smith J, Asmar MK, McKee M, Roberts B. Health System Governance in Settings with Conflict-Affected Populations: A Systhematic Review. Health Policy Plan 2022; 37:655-674. [PMID: 35325120 DOI: 10.1093/heapol/czac027] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 03/09/2022] [Accepted: 03/21/2022] [Indexed: 11/13/2022] Open
Abstract
Health system governance has been recognised as critical to strengthening healthcare responses in settings with conflict-affected populations. The aim of this review was to examine existing evidence on health system governance in settings with conflict-affected populations globally. The specific objectives were: (i) to describe the characteristics of the eligible studies; (ii) to describe the principles of health system governance; (iii) to examine evidence on barriers and facilitators for stronger health system governance; and (iv) to analyse the quality of available evidence. A systematic review methodology was used following PRISMA criteria. We searched six academic databases, and used grey literature sources. We included papers reporting empirical findings on health system governance among populations affected by armed conflict, including refugees, asylum seekers, internally displaced populations, conflict-affected non-displaced populations and post-conflict populations. Data were analysed according to the study objectives and informed primarily by the Siddiqi et al. (2009) governance framework. Quality appraisal was conducted using an adapted version of the Mixed Methods Appraisal Tool. Of the 6,511 papers identified through database searches, 34 studies met eligibility criteria. Few studies provided a theoretical framework or definition for governance. The most frequently identifiable governance principles related to participation and coordination, followed by equity and inclusiveness and intelligence and information. The least frequently identifiable governance principles related to rule of law, ethics and responsiveness. Across studies, the most common facilitators of governance were collaboration between stakeholders, bottom-up and community-based governance structures, inclusive policies, and longer-term vision. The most common barriers related to poor coordination, mistrust, lack of a harmonised health response, lack of clarity on stakeholder responsibilities, financial support, and donor influence. This review highlights the need for more theoretically informed empirical research on health system governance in settings with conflict-affected populations that draws on existing frameworks for governance.
Collapse
Affiliation(s)
- Michelle Lokot
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH
| | - Ibrahim Bou-Orm
- Saint Joseph University of Beirut, B.P. 11-5076 Riad El Solh, Beyrouth 1107 2180, Lebanon
| | - Thurayya Zreik
- War Child Holland, Verdun, Hussein Oweini street, Beirut, Lebanon
| | - Nour Kik
- Ministry of Public Health, Lebanese University Central Directorate, 4th Floor, Museum Square, Beirut 9800, Lebanon
| | - Daniela C Fuhr
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH
| | - Rozane El Masri
- War Child Holland, Verdun, Hussein Oweini street, Beirut, Lebanon
| | | | - James Smith
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH
| | | | - Martin McKee
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH
| | - Bayard Roberts
- London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London WC1H 9SH
| |
Collapse
|
7
|
Roosen I, Salway S, Osei-Kwasi HA. Transnational social networks, health, and care: a systematic narrative literature review. Int J Equity Health 2021; 20:138. [PMID: 34118934 PMCID: PMC8196485 DOI: 10.1186/s12939-021-01467-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 05/04/2021] [Indexed: 11/10/2022] Open
Abstract
While transnational social ties and exchanges are a core concern within migration studies, health researchers have often overlooked their importance. Continuous and circular exchanges of information within transnational networks, also defined as social remittances, facilitate the diffusion of innovations, potentially driving contemporary social and cultural change. Influences on health, wellbeing, and care-seeking are important, but under-researched, dimensions for consideration. We undertook a systematic narrative evidence synthesis to describe the current state of knowledge in this area and to identify gaps and future directions for health researchers to take. Between April 2017 and May 2019, an iterative series of searches in Medline, Embase, PsycINFO and PubMed, plus backward and forward citation searches identified 1173 potential papers. Screening resulted in 36 included papers, eighteen focused on migrant populations and eighteen on those who remain behind. The top three health topics were health-seeking strategies, sexual and reproductive health issues, and healthcare support. And, while not always explicitly identified, mental health and wellbeing was a further prominent, cross-cutting theme. Articles on migrant populations were all conducted in the global North and 13 out of 18 used qualitative methods. Five main themes were identified: therapeutic effect of the continuing social relationships, disrupted social relationships, hybridisation of healthcare, facilitation of connections to healthcare providers, and factors encouraging or undermining transnational social exchanges. Papers concerned with those who remain behind were mainly focused on the global South and used a mix of qualitative and quantitative approaches. Four main themes were identified: transnational transfer of health-related advice, norms, and support; associations between migrant linkages and health behaviours/outcomes; transnational collective transfer of health knowledge; and power and resistance in exchanges. Findings suggest that transnational social exchanges can both support and undermine the health of migrants and those who remain behind. This review confirms that the volume and quality of research in this area must be increased so that health policy and practice can be informed by a better understanding of these important influences on the health of both migrants and those who remain behind.
Collapse
Affiliation(s)
- Inez Roosen
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands.
| | - Sarah Salway
- Department of Sociological Studies, University of Sheffield, Sheffield, UK
| | | |
Collapse
|