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Open Access
Article
Publication date: 15 September 2020

Linda Vikdahl, Göran Ståhle, David Gunnarsson and Fredrik Saboonchi

In general, newly resettled refugees have poorer physical and mental health than native-born Swedes. This indicates that the society must make special efforts to enable…

Abstract

Purpose

In general, newly resettled refugees have poorer physical and mental health than native-born Swedes. This indicates that the society must make special efforts to enable refugees to attain health that is on a par with the rest of the population. The challenges rest primarily with employees in the public sector. But what resources do professionals need to meet the refugeeshealth needs? This paper is about the need to develop strategies for professionals working with diversity and health, with a focus on the establishment of newly resettled refugees in Sweden. Thus, the purpose of this paper is to identify the needs and obstacles in working with diversity and health for the newly resettled.

Design/methodology/approach

The paper is based on focus group interviews with 40 professionals working in three large municipalities and one County Administrative Board, all of whom work with challenges related to migration and health on a daily basis.

Findings

The needs expressed by the interviewees are primarily about developing and improving communications. Three important areas of communication were expressed: how information can be transferred from sender to receiver, institutionalization and interactions at different levels.

Originality/value

This paper identifies important needs and obstacles when working with diversity and health in Sweden, with a focus on the establishment of newly resettled refugees. It is an important contribution because refugees in general have poorer physical and mental health than native-born Swedes and strategies to improve their health, therefore, need to be further developed.

Details

International Journal of Migration, Health and Social Care, vol. 16 no. 3
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 10 December 2020

Helen Jane Liebling, Hazel Rose Barrett and Lillian Artz

This British Academy/Leverhulme-funded research (Grant number: SG170394) investigated the experiences and impact of sexual and gender-based violence (SGBV) and torture on…

Abstract

Purpose

This British Academy/Leverhulme-funded research (Grant number: SG170394) investigated the experiences and impact of sexual and gender-based violence (SGBV) and torture on South Sudanese refugeeshealth and rights and the responses of health and justice services in Northern Uganda.

Design/methodology/approach

It involved thematic analysis of the narratives of 20 men and 41 women refugees’ survivors of SGBV and torture; this included their experiences in South Sudan, their journeys to Uganda and experiences in refugee settlements. In total, 37 key stakeholders including health and justice providers, police, non-government and government organisations were also interviewed regarding their experiences of providing services to refugees.

Findings

All refugees had survived human rights abuses carried out in South Sudan, on route to Uganda and within Uganda. Incidents of violence, SGBV, torture and other human rights abuses declined significantly for men in Uganda, but women reported SGBV incidents. The research demonstrates linkages between the physical, psychological, social/cultural and justice/human rights impact on women and men refugees, which amplified the impact of their experiences. There was limited screening, physical and psychological health and support services; including livelihoods and education. Refugees remained concerned about violence and SGBV in the refugee settlements. While they all knew of the reporting system for such incidents, they questioned the effectiveness of the process. For this reason, women opted for family reconciliation rather than reporting domestic violence or SGBV to the authorities. Men found it hard to report incidences due to high levels of stigma and shame.

Research limitations/implications

Refugees largely fled South Sudan to escape human rights abuses including, persecution, SGBV and torture. Their experiences resulted in physical, psychological, social-cultural and justice effects that received limited responses by health and justice services. An integrated approach to meeting refugees’ needs is required.

Practical implications

The authors make recommendations for integrated gender sensitive service provision for refugees including more systematic screening, assessment and treatment of SGBV and torture physical and emotional injuries combined with implementation of livelihoods and social enterprises.

Social implications

The research demonstrates that stigma and shame, particularly for male refugee survivors of SGBV and torture, impacts on ability to report these incidents and seek treatment. Increasing gender sensitivity of services to these issues, alongside provision of medical treatment for injuries, alongside improved informal justice processes, may assist to counteract shame and increase disclosure.

Originality/value

There is currently a lack of empirical investigation of this subject area, therefore this research makes a contribution to the subject of understanding refugees’ experiences of SGBV and torture, as well as their perceptions of service provision and response. This subject is strategically important due to the pressing need to develop integrated, gendered and culturally sensitive services that listen to the voices and draw on the expertise of refugees themselves while using their skills to inform improvements in service responses and policy.

Details

International Journal of Migration, Health and Social Care, vol. 16 no. 4
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 31 December 2008

David Palmer, Ermias Alemu and Julian Hopwood

This research project explored how refugee community organisations (RCOs) could become more involved in the government's health agenda to improve the level of consultation…

Abstract

This research project explored how refugee community organisations (RCOs) could become more involved in the government's health agenda to improve the level of consultation and responsiveness in the design and provision of mental health services for ethnic minorities. The method involved a review of relevant literature, interviews with refugee community organisation leaders and community workers, and a survey of refugee service users' involvement with RCOs. The research found that the causes and effects of mental ill health in refugees as understood by interviewees were consistent with much of the literature in this area. The mental health needs of refugees are very similar across nationalities and ethnicities, and distinct from those of the general population and of other migrant groups. Appropriate responses, as understood by community leaders and professional community workers, are currently only partly and insufficiently provided by statutory health services, and there is extensive unmet need.

Details

International Journal of Migration, Health and Social Care, vol. 4 no. 4
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 7 March 2016

Sarah J. Hoffman and Cheryl L. Robertson

The purpose of this paper is to provide a comprehensive perspective of the documented physical and mental health issues Karen refugees from Burma face as a result of war…

1451

Abstract

Purpose

The purpose of this paper is to provide a comprehensive perspective of the documented physical and mental health issues Karen refugees from Burma face as a result of war and refugee trauma, and migration. The review will address the question: What is the impact of trauma and migration on the physical and mental health of Karen refugees?

Design/methodology/approach

A total of 18 articles were systematically selected for inclusion in the final review. The focal content for included articles includes qualitative and quantitative research representative of the health and migration experiences of Karen refugees.

Findings

The findings of this review demonstrate significance for health providers from a public health standpoint as programs and services are targeted to meet the specific health needs of the Karen community. It also highlights the contribution of the Karen forced migration experience to the complexity of individual and community health needs, particularly as a result of the protracted conflict.

Originality/value

This critical appraisal of the body of literature describing the health experiences of Karen refugees from Burma, with a particular focus on outcomes relevant to resettlement, demonstrates value as programs are developed with an integrated refugee perspective.

Details

International Journal of Migration, Health and Social Care, vol. 12 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 1 March 2006

David Palmer

This article is concerned with strategies for combating health inequalities for refugees. It explores a service provider's (St Pancras Refugee Centre) response to the…

Abstract

This article is concerned with strategies for combating health inequalities for refugees. It explores a service provider's (St Pancras Refugee Centre) response to the mental health and social care needs of refugees in the London Borough of Camden. Drawing on primary and secondary research, the article presents relevant findings and theoretical discourse in this area. It also draws on my own experience of working with refugees, providing a holistic approach to their social care requirements. The main focus is an examination of how social care and mental health needs are addressed. The article argues that providers need to develop services which engage with users on a mutually beneficial level in order to combat health inequalities and provide adequate health and social care provision.

Details

International Journal of Migration, Health and Social Care, vol. 2 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

Article
Publication date: 22 February 2022

Kayla Halsey, Salameh Alarood, Mohammed Nawaiseh and Ghazala Mir

Refugees commonly face inequitable access to health care services in their host country. This study aimed to identify factors influence refugee access to health services…

Abstract

Purpose

Refugees commonly face inequitable access to health care services in their host country. This study aimed to identify factors influence refugee access to health services and to assess perceptions of barriers to health care for different refugee groups in Jordan.

Design/methodology/approach

In-depth interviews were combined with document analysis and analyzed using thematic and framework methods.

Findings

Findings highlighted inequitable access to health services between different refugee groups. Unlike Palestinian refugees from the West Bank, Palestinian refugees from Gaza faced financial barriers to access health care as a result of citizenship status, which affected their health insurance, referrals for health care and legal right to work. Syrian refugees similarly lacked Jordanian citizenship and health insurance and mainly depended on UNHCR for health services, though some were able to acquire work permits and pay for private care.

Originality/value

This study demonstrates a need for politically and economically appropriate policies to minimize the disparity of health care access among these refugee groups.

Details

International Journal of Migration, Health and Social Care, vol. 18 no. 1
Type: Research Article
ISSN: 1747-9894

Keywords

Book part
Publication date: 7 January 2019

Magdalena Szaflarski and Shawn Bauldry

Discrimination has been identified as a major stressor and influence on immigrant health. This study examined the role of perceived discrimination in relation to other…

Abstract

Discrimination has been identified as a major stressor and influence on immigrant health. This study examined the role of perceived discrimination in relation to other factors, in particular, acculturation, in physical and mental health of immigrants and refugees. Data for US adults (18 +  years) were derived from the National Epidemiologic Survey on Alcohol and Related Conditions. Mental and physical health was assessed with SF-12. Acculturation and perceived discrimination were assessed with multidimensional measures. Structural equation models were used to estimate the effects of acculturation, stressful life effects, perceived discrimination, and social support on health among immigrants and refugees. Among first-generation immigrants, discrimination in health care had a negative association with physical health while discrimination in general had a negative association with mental health. Social support had positive associations with physical and mental health and mediated the association of discrimination to health. There were no significant associations between discrimination and health among refugees, but the direction and magnitude of associations were similar to those for first-generation immigrants. Efforts aiming at reducing discrimination and enhancing integration/social support for immigrants are likely to help with maintaining and protecting immigrants’ health and well-being. Further research using larger samples of refugees and testing moderating effects of key social/psychosocial variables on immigrant health outcomes is warranted. This study used multidimensional measures of health, perceived discrimination, and acculturation to examine the pathways between key social/psychosocial factors in health of immigrants and refugees at the national level. This study included possibly the largest national sample of refugees.

Details

Immigration and Health
Type: Book
ISBN: 978-1-78743-062-4

Keywords

Article
Publication date: 10 June 2021

Ibraheem Khaled Abu Siam and María Rubio Gómez

Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing…

Abstract

Purpose

Access to health-care services for refugees are always impacted by many factors and strongly associated with population profile, nature of crisis and capacities of hosing countries. Throughout refugee’s crisis, the Jordanian Government has adopted several healthcare access policies to meet the health needs of Syrian refugees while maintaining the stability of the health-care system. The adopted health-care provision policies ranged from enabling to restricting and from affordable to unaffordable. The purpose of this paper is to identify the influence of restricted level of access to essential health services among Syrian refugees in Jordan.

Design/methodology/approach

This paper used findings of a cross-sectional surveys conducted over urban Syrian refugees in Jordan in 2017 and 2018 over two different health-care access policies. The first were inclusive and affordable, whereas the other considered very restricting policy owing to high inflation in health-care cost. Access indicators from four main thematic areas were selected including maternal health, family planning, child health and monthly access of household. A comparison between both years’ access indicators was conducted to understand access barriers and its impact.

Findings

The comparison between findings of both surveys shows a sudden shift in health-care access and utilization behaviors with increased barriers level thus increased health vulnerabilities. Additionally, the finding during implementation of restricted access policy proves the tendency among some refugees groups to adopt negative adaptation strategies to reduce health-care cost. The participants shifted to use a fragmented health-care, reduced or delayed care seeking and use drugs irrationally weather by self-medication or reduce drug intake.

Originality/value

Understanding access barriers to health services and its negative short-term and long-term impact on refugeeshealth status as well as the extended risks to the host communities will help states that hosting refugees building rational access policy to protect whole community and save public health gains during and post crisis. Additionally, it will support donors to better mobilize resources according to the needs while the humanitarian actors and service providers will better contribute to the public health stability during refugee’s crisis.

Details

International Journal of Human Rights in Healthcare, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2056-4902

Keywords

Content available
Article
Publication date: 25 January 2021

Fahimeh Allahi, Amirreza Fateh, Roberto Revetria and Roberto Cianci

The COVID-19 pandemic is a new crisis in the world that caused many restrictions, from personal life to social and business. In this situation, the most vulnerable groups…

1503

Abstract

Purpose

The COVID-19 pandemic is a new crisis in the world that caused many restrictions, from personal life to social and business. In this situation, the most vulnerable groups such as refugees who are living in the camps are faced with more serious problems. Therefore, a system dynamic approach has been developed to evaluate the effect of applying different scenarios to find out the best response to COVID-19 to improve refugeeshealth and education.

Design/methodology/approach

The interaction of several health and education factors during an epidemic crisis among refugees leads to behavioral responses that consequently make the crisis control a complex problem. This research has developed an SD model based on the SIER model that responds to the public health and education system of Syrian refugees in Turkey affected by the COVID-19 virus and considered three policies of isolation, social distance/hygiene behavior and financial aid using the available data from various references.

Findings

The findings from the SD simulation results of applying three different policies identify that public health and education systems can increase much more by implementing the policy of social distance/hygiene behavior, and it has a significant impact on the control of the epidemic in comparison with the other two responses.

Originality/value

This paper contributes to humanitarian organizations, governments and refugees by discussing useful insights. Implementing the policy of social distance and hygiene behavior policies would help in a sharp reduction of death in refugees group. and public financial support has improved distance education during this pandemic.

Details

Journal of Humanitarian Logistics and Supply Chain Management, vol. 11 no. 2
Type: Research Article
ISSN: 2042-6747

Keywords

Article
Publication date: 7 September 2020

Irina Ibragimova and Martina Žužak

The purpose of this paper is to map research literature on all aspects of refugee health in Europe (2015–2019): by research domain, study design, targeted population, type…

Abstract

Purpose

The purpose of this paper is to map research literature on all aspects of refugee health in Europe (2015–2019): by research domain, study design, targeted population, type of setting, host country, journal title. This will help to identify recent research trends in the field, provide policymakers with useful source of information and help researches to target important gaps in evidence.

Design/methodology/approach

WHO (with other international agencies) has developed strategic documents and produced technical guidance, which formulate priority issues of refugee health in Europe. These documents state the need for relevant information and research data to support effective decision-making at all levels of health care systems. Although recent bibliometric analysis of global migration health research (2000–2016) concluded that 25.4% of retrieved documents were about refugees and asylum seekers, still there remain critical gaps in the knowledge base on a wide range of determinants of health service delivery and access for refugees and asylum seekers in the WHO European Region. Mapping review design was chosen as it maps and categorizes existing literature from which to commission further reviews and/or primary research by identifying gaps in research literature. Search strategy was developed and searches were executed in six databases: PubMed Medline; Scopus; ProQuest (Thesis and Dissertations); Cochrane Library; BASE; eLibrary (Russian journal articles).

Findings

Mapping review revealed that although research in some domains of refugee health was growing (mental health, infectious diseases, access to health care), there are still gaps in evidence in many important aspects: maternal and reproductive health, NCD, nutrition and economic evaluations. Most of 1,291 retrieved studies used observational or quasi-experimental design (75%), while very few were experimental studies (1.8%). Secondary research constituted a significant portion of retrieved publications: systematic reviews and meta-analysis – 8%, other reviews with systematic approach – 16%.

Originality/value

Detailed mapping of research by a combination of setting, population and research domains and comparison of results with those from previous decades and with planned trials and systematic reviews.

Details

International Journal of Health Governance, vol. 25 no. 4
Type: Research Article
ISSN: 2059-4631

Keywords

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