Journal of Migration and Health最新文献

Venezuelan migrant and refugee women and girls (VMRWG) face risks of exposure to and infection from HIV and threats of multiple forms of violence (including GBV) during and after migration. Yet, there is a lack of evidence on barriers and facilitators to VMRWGs’ access to HIV prevention and care services this population at all stages of their migration. We addressed this evidence gap by conducting a qualitative study composed of fifty-four semi-structured interviews with practitioners (n = 24) and VMRWG (n = 30) in the two largest receiving cities of migrants in Colombia. We sought to identify perceived barriers and facilitators to HIV prevention and care to inform policies and programmatic efforts. Analysis followed a theory-informed approach using the Socioecological Model. Findings describe multi-level barriers to access to HIV prevention and care related to discrimination, gender-based violence, rigid gender norms, lack of information and system fragmentation. Policies that integrate community-based networks and support intersectoral work are pivotal to breach the gaps between services and communities and develop a gender-sensitive approach that tackles the relationship between gender-based violence and HIV risk.

Background

Colombia hosts a large number of Venezuelan migrants and refugees who are uniquely vulnerable and have been markedly impacted by the COVID-19 pandemic. It is necessary to understand their experiences to inform future policy decisions both in Colombia and during disease outbreaks in other humanitarian contexts in the future. As part of a larger study focused on HIV among Venezuelans residing in Colombia, qualitative interviews were conducted to understand this population's experiences and access to healthcare.

Methods

Interviews were conducted with Venezuelan migrants and refugees as well as stakeholders such as care providers, humanitarian workers, and government officials. Interviews were recorded, transcribed, and coded using thematic content analysis. Select quotes were translated and edited for length and/or clarity.

Results

Venezuelan migrants and refugees reported high levels of housing instability, job instability, increased barriers to accessing healthcare, and complications in engaging in the HIV care continuum, among other impacts of the COVID-19 pandemic. Stakeholders reported complications in provision of care and obtaining medicines, difficulty maintaining contact with patients, increased discrimination and xenophobia targeting Venezuelan migrants and refugees, increased housing instability among Venezuelan migrants and refugees, and other impacts as a result of the COVID-19 pandemic.

Conclusions

This study demonstrates the unique impacts of the COVID-19 pandemic among Venezuelans residing in Colombia by both compounding extant vulnerabilities and introducing new challenges, such as high rates of eviction. Colombia has enacted increasingly inclusive migration policies for Venezuelan refugees and migrants within the country; findings from this study underscore the necessity for such policies both in and outside of the Colombian context.

While scholars have noted the deeply unequal effects of the pandemic containment, there has been limited attempt to map the socio-political lives of vaccination policies, particularly from the perspective of undocumented persons moving at state margins. This paper explores how undocumented migrants, who were predominantly male travellers attempting to cross Italy's Alpine borders, encountered Covid-19 vaccines and contemporary legislation. Based on ethnographic observations and qualitative interviews with migrants, doctors, and activists at safehouses both on the Italian and French sides of the Alpine border, we trace how mobility centred decisions to accept or reject vaccines were significantly shaped by exclusionary border regimes. We move beyond the exceptional focus of the Covid-19 pandemic to show how centring visions of health connected to viral risk diverted attention from migrants’ wider struggles to move to obtain safety. Ultimately, we argue for a recognition of how health crises are not merely unequally experienced, but may result in the reconfiguration of violent governance practices at state borders.

Background

The 1.5 generation, brought to the U.S. prior to age 16, faces barriers that the second generation, U.S.-born to immigrant parents, does not, including only temporary legal protection through the Deferred Action for Childhood Arrivals (DACA) Program. Little is known about how legal status and uncertainty shape cisgender immigrant young women's reproductive aspirations.

Methods

Drawing on the Theory of Conjunctural Action with attention to the immigrant optimism and bargain hypotheses, we conducted an exploratory qualitative study using semi-structured interviews with seven 1.5 generation DACA recipients and eleven second generation Mexican-origin women, 21-33 years old in 2018. Interviews focused on reproductive and life aspirations, migration experiences, and childhood and current economic disadvantage. We conducted a thematic analysis using a deductive and inductive approach.

Results

Data resulted in a conceptual model on the pathways through which uncertainty and legal status shape reproductive aspirations. Participants aspired to complete higher education and have a fulfilling career, financial stability, a stable partnership, and parents’ support prior to considering childbearing. For the 1.5 generation, uncertainty of their legal status makes the thought of parenting feel scary, while for the second generation, the legal status of their parents makes parenting feel scary. Achieving desired stability before childbearing is more challenging and uncertain for the 1.5 generation.

Conclusions

Temporary legal status constrains young women's reproductive aspirations by limiting their ability to achieve desired forms of stability prior to parenting and making the thought of parenting frightening. More research is needed to further develop this novel conceptual model.

Background

Mental illness is common among refugees displaced by conflict and war. While evidence points to the relatively good health in terms of longevity of migrants resettled in the destination country, less is known about the mortality of the most vulnerable migrants with a trauma-related diagnosis alone and those with an additional comorbid psychotic disorder. This study aimed to provide an overview of the number and mortality of foreign-born individuals diagnosed with Post-Traumatic Stress Disorder or Enduring Personality Change after a Catastrophic Event (PTSD/EPCACE), a psychotic disorder or both.

Methods

A nationwide register-based cohort study, including residents in Denmark, followed from 1 January 1995 to 31 December 2016. The exposure was PTSD/EPCACE and psychotic disorders as well as region of origin. Relative all-cause mortality was estimated using Cox proportional hazards regression models and calculated for migrants with one or both groups of disorders compared to those from the same region without the disorder.

Results

During the study period, 6,580,000 individuals (50.4% women) were included in the cohort. Of these 1,249,654 (50.5% women) died during follow-up. For men and women from the former Yugoslavia, the Middle East and Northern Africa, a PTSD/EPCACE diagnosis alone or with comorbid psychotic disorder was not associated with increased mortality after adjusting for region of origin. A psychotic disorder alone, however, was associated with an increased mortality rate.

Conclusion

Despite the severity of many refugees’ traumatic experiences, a diagnosis of a trauma-related psychiatric disorder did not appear to increase the mortality rates.

Environmental change is often accompanied by non-tangible, non-economic losses, including loss of valued attributes, connection to place, and social cohesion through migration in the face of such changes. Over two studies we sought to test whether imagining the loss of valued environmental characteristics influences intentions to migrate elsewhere and/or engage in place-protective actions, and whether this can be accounted for by changes to place attachment, using the city of Perth, Western Australia as a case study. In Study 1 (N = 148) we found imagined environmental loss significantly increased intentions to move away, and significantly decreased place attachment. There was no influence of imagining loss on place-protective action intentions. We replicated these findings in a representative community sample (Study 2: N = 333). In addition, we found that changes to moving intentions and place attachment related to the type of valued characteristic imagined loss, with characteristics that went beyond the explicitly environmental to encompass social relationships and lifestyle dimensions related to a tendency to stay, and lower reductions to place attachment. The implications of these findings include the inseparability of responses to environmental changes and perceptions of socio-cultural loss.

Thailand is a migration hub in ASEAN (Association of Southeast Asian Nations), with more than 3.9 million migrant workers, accounting for 10% of the country's workforce. The government of Thailand has moved from a pandemic to an endemic state of living with the SAR-CoV2 virus as a new normal since over half of the population has been vaccinated. There is, however, an estimated 1.3 million irregular migrant workers in Thailand who are not covered by Social Security Schemes (SSS) and are likely to have not been vaccinated. This study examines the socio-ecological barriers to accessing vaccination among Burmese irregular migrant workers in Thailand. Qualitative and quantitative data were collected from NGO (Non-Government Organizations) workers and Burmese irregular migrants through an online survey and in-depth interviews. The study reported that over 90% of Burmese irregular migrants were unvaccinated. The main reasons for the low vaccination rate include exclusion from the vaccine distribution program, high cost of the vaccine, perceived low quality of vaccine, language barriers, lack of vaccine information, private and public discrimination against migrants, fear of being detained and deported, and difficulties in finding time and transportation to go to vaccination centres. The Thai government should employ culturally competent interpreters to disseminate vaccine information and potential side effects to encourage vaccinations in order to prevent further casualties and curb the global health crisis. Moreover, it is imperative that the Thai government provide free vaccines to all immigrants regardless of their status and amnesty from deportation and detention during the vaccination period.

Background

Adolescent substance use is a significant issue which occurs during a critical period of life of youth. Perceived stress is a risk factor for adolescent substance use, and life events such as low family support, and community and familial turmoil often lead to ongoing feelings of stress and uncertainty. Similarly, structural factors such as poverty, local neighborhood disinvestment and disrepair, and exposure to racism and discrimination are linked to feelings of stress. The US-Mexico border region is favorable for drug smuggling. Such a context exacerbates stressful life events during adolescence and increases the risk of adolescent substance use. This study aims to investigate the impact family support has on substance use in adolescents living on either side of the U.S./Mexico border who self-reported high perceptions of disordered neighborhood stress, border community and immigration stress, or normalization of drug trafficking.

Methods

This study used data from the cross-sectional BASUS survey. Logistic regression was used to study the association between family support and past 30-day use of alcohol, tobacco, marijuana, and any substance in a sample restricted to students who self-reported high perceptions of disordered neighborhood stress, border community and immigration stress, or normalization of drug trafficking.

Results

Participants with low family support were at higher risk of using any substance compared to participants with high family support (aOR= 1.58, 95% CI: 1.02; 2.45). Similar results were found for alcohol (aOR= 1.79, 95% CI: 1.13, 2.83). While the odds of using tobacco were higher for those with low social support as compared to participants with higher social support, this association was not statistically significant (aOR = 1.74, 95% CI: 0.93, 3.27)

Conclusion

Prevention programs tailored to the U.S.-Mexico border region should emphasize strengthening family support as a preventive factor against adolescent substance use. Family support should be considered in school counseling assessments, healthcare screenings and other social services.

While the healthcare facilities for the people is questionable in Bangladesh, Rohingya refugees is a burning issue for both Bangladesh and global community. Integrating Rohingya refugees into the framework of mHealth could be beneficial for both Bangladesh and Rohingya refugees in general, and in specific situation like COVID-19 outbreak. However, no research has been found on what motivates Rohingya refugees to accept mHealth in Bangladesh. Drawing on the UTAUT2 model, this study investigates the predictors of acceptance of mHealth services technologies among Rohingya refugees. The study also seeks to clarify the roles of mHealth developers, the Bangladesh government, and non-governmental organizations working with the 1.1 million Rohingya refugees in Bangladesh. Quantitative data were collected from refugee camps with the permission of the Refugee Relief and Repatriation Commissioner (RRRC). The data were analyzed in two stages using a mixed approach that combines PLS-SEM and Artificial Neural Network (ANN). This study revealed that Effort expectancy (EE, with t = 5.629, β = 0.313) and facilitating conditions (FC with t = 4.442, β = 0.269) in PLS-SEM, and FC (with 100 percent importance) and Health consciousness (HC, with 94.88 percent importance) in ANN analysis were found to be the most substantial predictors of mHealth adoption. The study also revealed that EE and FC are more important for low education group, while PE and Situational Constraint (SC) are more important for the high education group of refugees. In addition to providing insights for mHealth developers, this study particularly focuses on the role of government institutions and non-governmental social workers in working with the subjects to increase FC and HC among Rohingya refugees and bring them under mHealth services.