The Health of Nepali Migrants in India: A Qualitative Study of Lifestyles and Risks

Relationships between experiences of humiliation on social networks, problematic phone use, and aggressive and altruistic behaviors in young adults

The purpose of this study was to analyze the relationships between cybervictimization in social networks, problematic smartphone use, aggressive behaviors, and prosocial altruistic tendencies in young adults. The sample consisted of 601 young adults (mean age = 19.96 years; SD = 2.27; 69.1% female) who were administered online assessments of experiences of humiliation on networks, problematic smartphone use, prosocial altruistic tendencies, and aggressiveness. Results indicated significant indirect effects of cyber victimization on aggressiveness and prosocial altruistic tendencies through problematic smartphone use. Problematic cell phone use explained the relationships between online humiliation and aggressive and prosocial altruistic behaviors. The results confirmed the positive relationship between cybervictimization and problematic cell phone use, consistent with previous research. However, the negative relationship between cybervictimization and altruistic prosocial tendencies was not corroborated. The findings emphasize the need to promote actions that foster social connectedness and interdependence among young individuals to develop their identity within the community.

Health service behaviors of migrants: A conceptual framework

Universal health coverage is vital to the World Health Organization's (WHO's) efforts to ensure access to health as a human right. However, it has been reported that migrants, including both international immigrants and internal migrants, underuse health services. Establishing a conceptual framework to facilitate research on the health service behaviors (HSB) of migrants is particularly important. Many theoretical frameworks explaining the general population's HSB have been published; however, most theoretical frameworks on migrants' HSB only focus on international immigrants without the inclusion of internal migrants. Of note, internal migrants are much more abundant than immigrants, and this group faces similar barriers to HSB as immigrants do. Based on theoretical frameworks of immigrants' HSB and Anderson's behavior model, the author proposes a new conceptual framework of migrants' HSB that includes both immigrants and internal migrants. The new conceptual framework divides the determinants into macro-structural or contextual factors, health delivery system characteristics, and characteristics of the population at risk and describes subgroup-specific factors. The author added some variables and reclassified variables in some dimensions, including characteristics of health delivery systems and access to healthcare. The characteristics of health delivery systems comprise the volume, organization, quality, and cost of the health delivery system, while the characteristics of access to healthcare include time accessibility, geographic accessibility, and information accessibility. The outcomes of HSB have been expanded, and relationships between them have been reported. The mediating effects of some variables have also been described. This conceptual framework can facilitate a deep and comprehensive understanding of the HSB determination process for migrants, including internal migrants.

Factors Related to Mental Health of Foreign Care Workers in Long-Term Care Facilities in Japan during the COVID-19 Pandemic-A Comparative Study

This study aimed to evaluate the factors related to the mental health of foreign care workers in Japan's long-term care (LTC) facilities and compare their results with those of native care workers. We conducted a cross-sectional survey covering 80 LTC facilities across Japan between August and November 2021. The survey mainly included mental health, workload, reward, sense of coherence, loneliness, COVID-19-specific factors and sociodemographic variables. The results show that workload was a distinct feature associated with the mental health of foreign care workers (n = 172) when compared with those of native care workers (n = 154). In addition, we found that the relationship between cultural adaptation and mental health in a sample of foreign care workers was mediated by loneliness and sense of coherence (SOC). Finally, we found that reward, loneliness, SOC, and COVID-19-specific factors had significant impacts on the mental health of both foreign and native care workers. These findings highlight the importance of support measures from the workplace for foreign care workers. Workplace interventions that focus on workload, reward, and sense of coherence strategies are required to address mental health improvement and may still be of value in dealing with the continuing COVID-19 pandemic.

Irregular Migrant Workers and Health: A Qualitative Study of Health Status and Access to Healthcare of the Filipino Domestic Workers in Mainland China

In public health research, the health issues of irregular and vulnerable migrant populations remain under-explored. In particular, while mainland China has become a new and popular job-seeking destination for Filipino domestic workers (FDWs), the health status of FDWs and their access to healthcare have been invisible to public and academic concerns. This paper fills this lacuna by conducting a qualitative study that investigates FDWs’ self-reported health status and their healthcare-seeking behaviors. The results show that: (1) respondents do not report significant abusive and exploitative experience because the scarcity of FDWs in China in relation to the high demand enables them a certain degree of agency in labour market; (2) while FDWs do report some health problems, they tend to resort to self-medication and food-healing; (3) the main factors influencing health-seeking behavior include the fear of deportation, language gaps, the lack of knowledge of the local healthcare system and dependence on co-ethnic networks which serves as a double-edged sword; (4) these factors also lead to hesitation in health-seeking choice between public and private hospitals, which sometimes result in delayed treatment. This paper contributes to revealing the health conditions of FDWs in mainland China and calls for more inclusive health policy to enroll foreign domestic workers into the local health system in China.

The Political Economy of Public Health Inequalities and Inequities in India: Complexities, Challenges, and Strategies for Inclusive Public Health Care Policy

This article examines the political economy of health inequalities and inequities in the public health care system in India and identifies potential areas for interventions to promote equal and equitable health care for marginalized people. Drawing on the Political Economy of Health Model of Research, this article reiterates the inadequacy of policy frameworks and programs in ensuring accessible, affordable, and quality public health care services to all. We argue that for policies to be successful, policymakers should consider the diverse social registries of class, caste, religion, gender, region, ethnicity, and age, as well as their intersections. We also argue that health care policies and programs need to be: (a) dynamic and flexible, (b) intersectional and backed up by sufficient grassroots research, and (c) equitable at every stage of policy formulation, implementation, and evaluation.

Perceptions of injury risk in the home and workplace in Nepal: a qualitative study

OBJECTIVE

Injuries are a global health problem. To develop context-specific injury prevention interventions, one needs to understand population perceptions of home and workplace injuries. This study explored a range of views and perceptions about injuries in a variety of settings and identified barriers and facilitators to injury prevention.

DESIGN

Qualitative study: interviews and focus groups.

SETTING

Three administrative areas: Hetauda submetropolitan city, Thaha municipality and Bakaiya rural municipality in Makwanpur, Nepal.

PARTICIPANTS

Nine focus groups (74 participants) and nine one-to-one interviews were completed; workers from diverse occupations, residents (slum, traditional or modern homes) and local government decision-makers participated in the study between May and August 2019. The interviews and discussions were audio-recorded, transcribed verbatim, translated to English and analysed thematically.

RESULTS

Six themes were developed: unsafe home and workplace environment; inadequate supervision and monitoring; perceptions that injuries are inevitable; safety takes low priority: financial and behavioural considerations; safety education and training; and government-led safety programmes and enforcement. Key barriers to injury prevention were perceived to be lack of knowledge about injury risk and preventive measures both at the community level and at the workplace. Facilitators were community-level educational programmes and health and safety training to employees and employers. Participants stressed the importance of the role of the government in planning future injury prevention programmes in different environments.

CONCLUSIONS

This study highlighted that both home and workplace injuries are complex and multifactorial. Lack of knowledge about injury risks and preventive measures, both at the community level and at the workplace, was found to be a common barrier to injury prevention, perceived to be mitigated by educational programmes. Together with previously published epidemiological evidence, the barriers and facilitators identified in this study offer useful basis to inform policy and practice.

Accessing health services in India: experiences of seasonal migrants returning to Nepal

Background

Migration to India is a common livelihood strategy for poor people in remote Western Nepal. To date, little research has explored the degree and nature of healthcare access among Nepali migrant workers in India. This study explores the experiences of returnee Nepali migrants with regard to accessing healthcare and the perspectives of stakeholders in the government, support organizations, and health providers working with migrant workers in India.

Methods

Six focus group discussions (FGDs) and 12 in-depth interviews with returnee migrants were conducted by trained moderators in six districts in Western Nepal in late 2017. A further 12 stakeholders working in the health and education sector were also interviewed. With the consent of the participants, FGDs and interviews were audio-recorded. They were then transcribed and translated into English and the data were analysed thematically.

Results

The interviewed returnee migrants worked in 15 of India’s 29 states, most as daily-wage labourers. Most were from among the lowest castes so called-Dalits. Most migrants had had difficulty accessing healthcare services in India. The major barriers to access were the lack of insurance, low wages, not having an Indian identification card tied to individual biometrics so called: Aadhaar card. Other barriers were unsupportive employers, discrimination at healthcare facilities and limited information about the locations of healthcare services.

Conclusions

Nepali migrants experience difficulties in accessing healthcare in India. Partnerships between the Nepali and Indian governments, migrant support organizations and relevant stakeholders such as healthcare providers, government agencies and employers should be strengthened so that this vulnerable population can access the healthcare they are entitled to.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-020-05846-7.

Responsible Agricultural Mechanization Innovation for the Sustainable Development of Nepal’s Hillside Farming System

Agricultural mechanization in developing countries has taken at least two contested innovation pathways—the “incumbent trajectory” that promotes industrial agriculture, and an “alternative pathway” that supports small-scale mechanization for sustainable development of hillside farming systems. Although both pathways can potentially reduce human and animal drudgery, the body of literature that assesses the sustainability impacts of these mechanization pathways in the local ecological, socio-economic, cultural, and historical contexts of hillside farms is either nonexistent or under-theorized. This paper addresses this missing literature by examining the case of Nepal’s first Agricultural Mechanization Promotion Policy 2014 (AMPP) using a conceptual framework of what will be defined as “responsible innovation”. The historical context of this assessment involves the incumbent trajectory of mechanization in the country since the late 1960s that neglected smallholder farms located in the hills and mountains and biased mechanization policy for flat areas only. Findings from this study suggest that the AMPP addressed issues for smallholder production, including gender inequality, exclusion of smallholder farmers, and biophysical challenges associated with hillside farming systems, but it remains unclear whether and how the policy promotes small-scale agricultural mechanization for sustainable development of agriculture in the hills and mountains of Nepal.