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Asylum seekers, refugees and immigrants’ access to healthcare vary in South Africa and Cape Town due to unclear legal status. The purpose of this paper is to shed light on the source of this variation, the divergence between the 1996 South African Constitution, the immigration laws, and regulations and to describe its harmful consequences.

Based on legal and ethnographic research, this paper documents the disjuncture between South African statutes and regulations and the South African Constitution regarding refugees and migrants’ access to healthcare. Research involved examining South African jurisprudence, the African Charter, and United Nations’ materials regarding rights to health and health care access, and speaking with civil society organizations and healthcare providers. These sources inform the description of the immigrant access to healthcare in Cape Town, South Africa.

Asylum-seekers and refugees are entitled to health and emergency care; however, hospital administrators require documentation (up-to-date permits) before care can be administered. Many immigrants – especially the undocumented – are often unable to obtain care because of a lack of papers or because of “progressive realization,” the notion that the state cannot presently afford to provide treatment in accordance with constitutional rights. These explanations have put healthcare providers in an untenable position of not being able to treat patients, including some who face fatal conditions.

The research is limited by the fact that South African courts have not adjudicated a direct challenge to being refused care at healthcare facility on the basis of legal status. This limits the ability to know how rights afforded to “everyone” within the South African Constitution will be interpreted with respect to immigrants seeking healthcare. The research is also limited by the non-circulation of healthcare admissions policies among leading facilities in the Cape Town region where the case study is based.

Articulation of the disjuncture between the South African Constitution and the immigration laws and regulations allows stakeholders and decision-makers to reframe provincial and municipal policies about healthcare access in terms of constitutional rights and the practical limitations accommodated through progressive realization.

In South Africa, immigration statutes and regulations are inconsistent and deemed unconstitutional with respect to the treatment of undocumented migrants. Hospital administrators are narrowly interpreting the laws to instruct healthcare providers on how to treat patients and whom they can treat. These practices need to stop. Access to healthcare must be structured to comport with the constitutional right afforded to everyone, and with progressive realization pursued through a non – discriminatory policy regarding vulnerable immigrants.

This paper presents a unique case study that combines legal and social science methods to explore a common and acute question of health care access. The case is novel and instructive insofar as South Africa has not established refugee camps in response to rising numbers of refugees, asylum seekers and immigrants. South Africans thus confront a “first world” question of equitable access to healthcare within their African context and with limited resources in a climate of increasing xenophobia.

Aware that “those who aren't counted don't count” in health program planning, a community coalition, called African Partnership for Health, attempts a current estimate of the African community living in Portland, Oregon, USA. This paper seeks to describe the findings.

The paper's definition of the “African community” was crucially informed by community participation in the research process. The authors drew on existing publicly available data sources to estimate the size of the target population and identified the strengths and weaknesses of each source.

Conservative estimations are of a 2010 African community population of 11,500‐15,500 for the Portland metropolitan area. No data source on its own would have resulted in this estimate.

Areas for further research include creating practical systems to collect data on country of origin and to address an existing data bias towards refugees over immigrants. In the USA, more robust data collection systems are needed to estimate the impact of secondary migration on the size and characteristics of refugee and immigrant communities.

Health program planners should be aware that existing data may include more information about some groups (refugees as opposed to immigrants) and emphasize some characteristics (race as opposed to country of origin).

Including immigrant and refugee community members in the research process can result in more relevant definition of that community, which may lead to more effective program targeting and design.

The purpose of this study is to examine the information needs and seeking behaviors of African refugees in the Midwest United States. The research also investigates the sources participants consulted and their satisfaction with their information seeking and the information found.

This qualitative research study recruited 18 African refugees to participate in one or more data collection modes used in the study (questionnaire, interview, focus group). The data were analyzed using qualitative open, axial and selective coding approaches to identify themes.

The analysis of the data collected provides evidence that refugees had specific information needs centered on housing, health care, employment and education. They were not necessarily satisfied with the information they were able to find. Participants reported initially relying heavily on their caseworkers as sources of information when they first arrived in the United States until they were able to establish larger networks of contacts, which then expanded their information behaviors.

The number of participants and regional focus of the study do not allow for generalization of the findings to all African refugees in the United States. Still, the findings shed light on how to better serve the information needs of African refugees to help them adjust to life in their new environment.

The findings of the study provide guidance for agencies that assist African refugees in adjusting to life in the United States.

This study represents one of the few investigations of the information needs and seeking behaviors of African refugees in the United States.

The purpose of this paper is to examine health issues among Liberian refugees living in Staten Island and access potential barriers to accessing healthcare.

Qualitative methods including interviews (n=68) with West African immigrants, predominantly Liberian refugees, and long-term ethnography were employed to elicit West Africans’ views on health, acculturation, and access to service providers. Framework analysis was employed to analyze the data thematically.

Chronic health diseases, depression, isolation, and inadequate access to healthcare were the main concerns of the population studied. The findings are in contrast to the public health experts’ concentration on infectious diseases.

The barriers to access proper healthcare have implications for healthcare providers and government institutions and information about these barriers can help them to refocus their health efforts to better address the needs of West African refugees.

Africans are among the newest immigrants in the USA and are considerably understudied compared to other groups such as Latin Americans and Asians. Additionally, there is an abundance research about refugees’ health status when they first arrive in the USA, but there is little data on their health after their resettlement.

According to the U.S. Committee for Refugees (2002) there were approximately 15 million refugees in the world in 2001, of which over three million were African. Refugees are persons who flee to a different country to escape persecution based on personal or group characteristics such as race, ethnicity, religion, nationality, social group, political opinion, or armed conflict, and lack of a durable solution (U.S. Committee for Refugees, 2001). For example, in Burundi, a small African country of about 6 million people, the civil war between the Tutsi and the Hutu has forced over half a million refugees to seek shelter in other African countries, Europe, and the United States (UNHCR, 2000).

This study aims to test the efficacy of the awareness of a transformative health service communication intervention targeted to African refugees in Australia, designed to increase their intentions to participate in blood donation and reduce any identified barriers.

Following the intervention launch, a survey was administered to African refugees. The data were analysed with structural equation modelling.

Intervention awareness increases refugees’ blood donation knowledge and intentions. Although it has no direct effect on refugees’ medical mistrust or perceived discrimination, intervention awareness indirectly reduces medical mistrust. The findings, thus, suggest that the intervention was transformative: it directly and indirectly reduced barriers to refugee participation in blood donation services.

Limitations include a relatively small sample size, single-country context and measures that address blood donation intentions versus behaviours.

Addressing health service inequities through intervention awareness, via the mere exposure effect, can facilitate refugees’ health service participation and inclusion.

This study contributes to transformative service research and responds to calls to improve individual and community well-being by testing a transformative intervention targeted towards vulnerable consumers. Not all targeted refugees donated blood, but being encouraged to participate in this health service within the host society can foster their greater inclusion.

This paper aims to explore the intersection of cultural processes and immigration in parental understanding of adolescent mental health and mental health seeking behaviors among African immigrants in Western countries. The present study examines the perspectives of Congolese immigrant parents on adolescent mental health in Brussels, Belgium, and Raleigh, North Carolina, USA – two geographic regions with relatively large Congolese migrant populations. This study highlights a needed understanding of cultural and acculturative context in shaping the beliefs of Congolese immigrants and explores potential barriers of seeking health services. Additionally, it recognizes health issues among this underrepresented and underserved population.

Fifteen Congolese immigrant parents, eight in the USA and seven in Belgium, participated in structured qualitative interviews using an adapted version of Kleinman Questions and behavioral scenarios on depression, post-traumatic stress disorder and oppositional defiant disorder. Interviews were audio recorded, and participants were assigned pseudonyms to de-identify responses. English interviews were transcribed verbatim by a trained team of undergraduate research assistants, and French interviews were transcribed verbatim by the first author and a graduate research assistant. Following transcription, the first and second authors used a rapid analytic approach (Hamilton, 2013). The first and second authors conducted a matrix analysis to observe thematic patterns.

Parents interpreted adolescent behavior to be more problematic when the scenarios were overtly outside of their cultural realm of values and beliefs. Parents preferred methods of intervention through religious practices and/or family and community efforts rather than seeking mental health services in their host countries as a secondary option. The authors’ findings provide an understanding of the values and beliefs of this underrepresented demographic, which may be useful to guide health professionals on how to support this community in a culturally responsive way.

Limitations to the current study include the structured nature of the interview guide that did not allow for in-depth qualitative exploration. Interviewed participants had lived in their host countries for more than 10+ years. Thus, the authors’ findings are not reflective of new immigrants’ experiences. Parents’ perspectives were likely shaped by exposure to Western beliefs related to support for mental health (e.g. knowledge of psychologists). Future studies should focus on recent refugees due to exposure to traumatic events and experiences reflective of the Democratic Republic of Congo’s (DRC’s) current socio-political situation, and how these are understood in the context of adolescent mental health. Further, due to the hypothetical nature of the scenarios, the authors cannot be sure that participants would engage in the identified approaches with their children. Additionally, hearing from the youth’s perspective would provide a clearer insight on how mental health and seeking professional help is viewed in a parent–child relationship. Finally, the data for this study were collected in 2019, prior to the COVID-19 pandemic. Although the authors cannot speak directly to Congolese refugee and immigrant experiences during this significant historical period, given the rise in mental health concerns in refugee populations more broadly (Logie et al., 2022), the authors’ findings speak to how parents may have responded to increased mental health symptoms and point to additional barriers that these populations may have faced in accessing support. The authors’ study emphasizes the need for dedicating resources and attention to this population, especially the development of culturally tailored messaging that invites community members to support the mental health needs of their community.

The authors’ findings provide important implications for mental health professionals. This study provides a clearer understanding of how Congolese immigrant parents view mental health and help-seeking within their cultural frame. Although parents may seek professional help, a distrust of mental health services was expressed across both cohorts. This suggests that mental health professionals should acknowledge potential distrust among this population and clarify their role in supporting the mental health of adolescent immigrants. Clinicians should inquire about familial cultural beliefs that are parent- and child-centered and modify their interventions to fit these belief structures.

This paper addresses the gap in knowledge about mental health perspectives of Sub-Saharan African immigrant populations, specifically those from the DRC.

In an extreme and intentional institutional void, African refugees in Israel are bricoleuring by building an entrepreneurship market next to an “open” detention camp. The purpose of this paper is to analyze how refugee entrepreneurs overcome institutional voids through bricolage in an illegal marketplace outside the detention camp.

In order to deal with the question of why and how people act entrepreneurial under extreme circumstances, the interpretive/social constructionist paradigm is applied in form of the multiple stories milieu case study pattern. Data were gathered via official reports, interviews and observations.

Outside the detention camp it is via bricolage that entrepreneurs address the economic detour in the intentional institutional void. At a place which is meant to make asylum seekers leave Israel by coining them “infiltrators” and by “making their lives miserable,” bricoleurs attend their own and the needs of fellow detainees providing goods and service and community space.

By contextualizing entrepreneurial practices, the paper contributes to the understanding of refugee entrepreneurship by demonstrating how refugees – within the pressure and constraints of context – initiate entrepreneurial activities. Theoretically the paper extends knowledge of minority entrepreneurs who are acting as bricoleurs, explaining how their entrepreneuring can be a kind of space creation process.

A refugee is a displaced person who has been forced to cross national boundary and who cannot return home safely. No one likes or chooses to be a refugee. Being a refugee means more than being an alien. It means living in exile and depending on others for such basic needs as food, clothing and shelter. The problem of refugees is the problem of human rights involving a flow of people from places of denial to the regions of guarantee. Today refugee problem is one of the core problems all over the world. It is the most complicated issue. When refugees are hosted in the neighbouring countries, economic, social, political and environment impacts are created on these host countries. The main objective of this chapter is to analyze these impacts created by refugees on the developing host countries. From the moment of arrival, refugees may compete with local citizens for scarce resources such as water, food, housing and medical services. Their presence increases the demands for education, health services, infrastructure such as water supply, sanitation and transportation, and also in some cases, for natural resources such as grazing and firewood.