Journal of Migration and Health最新文献

{"title":"Healthcare provision for displaced people in transit: Analyses of routinely collected data from INTERSOS clinics at the Ukrainian border with Moldova and Poland","authors":"Saleh Aljadeeah , Seyed-Moeen Hosseinalipour , Nataliia Khanyk , Eszter Szocs , Aliki Traianou , Ana Tomas , Chrysanthi Tatsi , Elżbieta Czapka , Alessandro Verona , Tessa van Boekholt , Ion Chesov , Apostolos Veizis","doi":"10.1016/j.jmh.2024.100287","DOIUrl":"10.1016/j.jmh.2024.100287","url":null,"abstract":"<div><h3>Background</h3><div>The Russian military invasion of Ukraine has sparked Europe's largest forced displacement since World War II, bringing about significant health vulnerabilities for migrants and refugees. European health information systems lack comprehensive data coverage, especially in underrepresented migration stages like transit. This study aims to address this gap by analyzing data from INTERSOS clinics at the Moldovan and Polish borders with Ukraine to identify the common health conditions prompting people to seek healthcare services during transit.</div></div><div><h3>Methods</h3><div>From 6th March to 31st May 2022, this cross-sectional study observed migrants and refugees receiving INTERSOS services at two mobile clinics in Moldova, and a facility in Poland. We analyzed data by age, sex, nationality, and reported disease frequencies and care provided.</div></div><div><h3>Results</h3><div>This study used routinely collected data from 1756 patients. The majority of the adult population seeking healthcare were females (76.5 %), 26.1 % were children and 18.7 % were older individuals. Noncommunicable diseases (NCDs) were the primary reason for seeking healthcare at these clinics, with 23.3 % of the study population being diagnosed with at least one chronic disease, and 3.4 % of people having multimorbidity. Mental and behavioural disorders were diagnosed in 12.6 % of the population, and somatoform disorders and related stress (F40-F48) in 10.8 %.</div></div><div><h3>Discussion</h3><div>Our study indicates the diversity of forcibly displaced populations and the corresponding diversity of their healthcare needs. In the shadow of a forced displacement crises triggered by the conflict in Ukraine, there is an urgent need to give more attention to subgroups of the population that are often neglected in humanitarian crises. These include older adults, females, and ethnic minorities. Additional attention should also be given to NCDs and sexual and reproductive health (SRH) care needs, especially given the high numbers of older adults and females in this population. Early medical support, psychological first aid and interventions in transit centers that promote survivor resilience and recovery are required.</div></div><div><h3>Conclusion</h3><div>Our findings shed light on the healthcare needs of forcibly displaced populations during transit, a stage often overlooked in migration health research. They underscore the diverse healthcare needs of forcibly displaced populations, emphasizing the necessity for humanitarian aid programs to acknowledge and address this diversity. Accessing data on displaced populations' healthcare needs in transit can help the preparing and planning of healthcare services for these populations in host or destination countries. Ensuring objective anonymization and preventing patient re-identification are essential, particularly in safeguarding refugee privacy and data protection to avoid the misuse of their data.</","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100287"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers and drivers to COVID-19 protective behaviours of forcibly displaced myanmar nationals (FDMN)/ rohingya refugees in Cox's bazar, Bangladesh: A scoping review","authors":"Sarah Reda ,&nbsp;Zarah Yusuf ,&nbsp;Basel Karo ,&nbsp;Balwinder Singh Chawla ,&nbsp;Andreas Jansen ,&nbsp;Saskia Lange ,&nbsp;Jorge Martinez ,&nbsp;Emily Dorothee Meyer ,&nbsp;Julia Neufeind ,&nbsp;Aarti Shrikrishana Singh ,&nbsp;Elisa Wulkotte ,&nbsp;Cath Jackson","doi":"10.1016/j.jmh.2024.100295","DOIUrl":"10.1016/j.jmh.2024.100295","url":null,"abstract":"<div><div>About 900.000 Forcibly Displaced Myanmar Nationals (FDMN)/ Rohingya refugees live in makeshift camps in Cox's Bazar, Bangladesh. During the COVID-19 pandemic, protective behaviors were particularly important in this setting of previous severe infectious disease outbreaks. To identify barriers, drivers and interventions for those behaviors, a scoping review of MEDLINE, Embase, Web of Science, Global Health and grey literature was conducted in October 2021 and updated in June 2024. The modified Capability-Opportunity-Motivation-Behavior (COM-B) framework and Behavior Change Wheel were used to organize available evidence. A total of 4014 (3654 in 2021, 360 in 2024) records were reviewed and 51 (38 in 2021, 13 in 2024) articles included. Articles reported on protective behaviors (as a general concept), handwashing, social distancing, isolation/quarantine, mask wearing, testing, treatment and vaccination. Barriers and drivers to these behaviors spanned all four COM factors reflecting both individual and environmental influences. Most frequently cited barriers and drivers were found in the motivation (e.g. belief, fear, trust) and physical opportunity (e.g. information, the physical camp environment) factors. Gaps in the evidence were views of health service providers, and differences between camps and population groups. Most interventions focused on information, education or training (e.g. campaigns, community engagement) and environmental restructuring (e.g. increased provision of WASH facilities, COVID-19 isolation and treatment centres). Most articles reported recommendations for interventions. There was some evidence of implementation but little evaluation. This review identified complex and inter-related barriers and drivers to COVID-19 protective behaviors in Cox's Bazar, and many interventions to address these. Addressing the above-mentioned evidence gaps would assist future development of effective targeted interventions, tailored to the needs of specific population groups.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100295"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accessible services for deaf immigrants and refugees in the United States: Exploring the capacity of deaf-serving organizations","authors":"Alina Engelman,&nbsp;Alexia Izquierdo","doi":"10.1016/j.jmh.2025.100326","DOIUrl":"10.1016/j.jmh.2025.100326","url":null,"abstract":"<div><div>In an era of climate change, war, economic crises and grave political and social challenges, migration and resettlement are increasing in unprecedented numbers. Deaf immigrants and refugees entering the United States resettle as a result of war, persecution, human rights violations or migrate as a result of economic necessity. Yet, deaf and disabled migrants face unique and often little understood barriers that mainstream refugee resettlement agencies may be less equipped to tackle. Deaf serving organizations and deaf refugee serving organizations are well positioned to fill in the gap in providing accessible services taking into account language deprivation, sign language of the countries of origin, educational considerations, mental health needs and deaf community support. Furthermore, such efforts to elevate the well-being of deaf refugees can foster resilience, empowerment and a sense of agency. This manuscript explores the capacity of key organizations serving deaf immigrants and refugees in the United States, including deaf refugee non-profits as well as deaf organizations that have specific programs for deaf refugees. Organizations include one that is founded, led by and staffed by deaf refugees, a model that highlights the benefit of leadership by those most impacted. Findings can benefit large scale immigrant and refugee non-profits targeted to specific immigrant demographics aiming to improve their services for deaf immigrants and refugees. Deaf immigrant and refugee-serving organizations are well-positioned to be advocates agitating for deaf and disability rights in the midst of accessibility hurdles in the immigration legal system, healthcare, housing and social service systems.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100326"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of psychosocial stressors on type 2 diabetes among migrants and non-migrants in The Netherlands: The HELIUS study","authors":"Daniela Del Carlo Gonçalves ,&nbsp;Charles Agyemang ,&nbsp;Eva L. van der Linden ,&nbsp;Charles Hayfron Benjamin ,&nbsp;Anja Lok ,&nbsp;Henrike Galenkamp ,&nbsp;Eric Moll van Charante ,&nbsp;Felix P. Chilunga","doi":"10.1016/j.jmh.2025.100330","DOIUrl":"10.1016/j.jmh.2025.100330","url":null,"abstract":"<div><h3>Background</h3><div>Migrant populations in Europe have a type 2 diabetes (T2D) burden two to five times that of non-migrants. However, the role of psychosocial stressors—whose experiences can uniquely vary across population groups—remains underexplored. We examined associations between work stress, home stress, and adverse life events with T2D across major ethnic groups in The Netherlands.</div></div><div><h3>Methods</h3><div>We used baseline data from HELIUS cohort (2011–2015), including 21,501 adults of Dutch, Moroccan, Turkish, South-Asian Surinamese, African Surinamese, and Ghanaian origin. Psychosocial stress was assessed using validated measures in preceding 12 months. T2D was defined by World Health Organization criteria. Robust Poisson regression estimated prevalence ratios (PRs), adjusting for age, sex, and education. Mediation and moderation analyses explored behavioural pathways and role of social support.</div></div><div><h3>Results</h3><div>Occasional work stress was inversely associated with T2D in total population (aPR 0.82; 95 % CI 0.75–0.93) and among Moroccan-origin participants [0.76 (0.63–0.97)]. Regular home stress was positively associated with T2D in total population [1.15 (1.03–1.28)], but not across ethnic groups. Adverse life events were linked to higher T2D risk overall [1.22 (1.03–1.41)], and among Dutch [1.48 (1.21–1.76)] and African Surinamese [1.43 (1.09–1.89)] origin populations. BMI and alcohol use partially mediated these associations. Social support buffered work and home stress.</div></div><div><h3>Conclusion</h3><div>Work stress, home stress, and adverse life events differentially influence T2D risk in diverse populations, with effects pronounced in Dutch, Moroccan and African Surinamese origin groups. Interventions targeting psychosocial stress may help reduce T2D in diverse populations.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100330"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migrant workers’ access to medical service providers in Pennsylvania","authors":"Philip Decicco ,&nbsp;Jaya Prakash ,&nbsp;Erica Nelson ,&nbsp;Gonzalo Martínez de Vedia ,&nbsp;Hanni Stoklosa","doi":"10.1016/j.jmh.2025.100335","DOIUrl":"10.1016/j.jmh.2025.100335","url":null,"abstract":"<div><div>The H-2A Temporary Agricultural Workers program brings hundreds of thousands of foreign workers into the United States to work in the agricultural sector each year. It is well documented that H-2A workers are susceptible and subjected to unsafe working conditions and other workplace abuses. Employed in the agricultural sector, H-2A workers are exposed to higher rates of workplace hazards and riskier workplace settings, including risk for human trafficking. As foreign-born workers living on the same farms in which they are employed, they face language and information barriers when accessing resources outside of those provided by their employer. All these factors contribute to creating significant barriers for H-2A workers when accessing healthcare. This paper uses ArcGIS software and publicly available information to analyze the proximity and accessibility of healthcare resources to H-2A workers in Pennsylvania. We find that less than half of H-2A workers in Pennsylvania in 2021 resided within a 15-minute drive of the types of healthcare providers best suited to address their particular needs. We also posit that this methodology could be used in the future to better allocate and prioritize resources to create intervention points and address the unique needs of this at-risk worker population, including health care interventions for human trafficking victims.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100335"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144211860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Researching health and internal displacement: Introduction to the special series","authors":"Jina Swartz ,&nbsp;Bayard Roberts ,&nbsp;David Cantor","doi":"10.1016/j.jmh.2023.100208","DOIUrl":"10.1016/j.jmh.2023.100208","url":null,"abstract":"<div><div>This special series on ‘health and internal displacement’ is concerned primarily with the health needs of internally displaced persons (IDPs) in conflict contexts. Curated by editors from the recently established Health and Internal Displacement Network (HIDN), the series brings together a selection of thirteen new research articles from among many submitted in response to an open call for papers by HIDN and the <em>Journal of Migration and Health</em>. The aims of this series are to increase engagement with the health needs of IDPs and to support research, policy and programming in this relatively neglected area. The series focuses on IDP health but is not prescriptive in terms of health conditions, age groups, geographic region, or camp or urban setting, and reflects the diversity of IDP populations, contexts and needs.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100208"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139013985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol consumption and environmental influences on social relationships among Myanmar migrant workers in southern Thailand: A comprehensive study","authors":"Kanit Hnuploy ,&nbsp;Kittipong Sornlorm ,&nbsp;Nirachon Chutipattana ,&nbsp;Roshan Kumar Mahato ,&nbsp;Rajitra Nawawonganun","doi":"10.1016/j.jmh.2025.100376","DOIUrl":"10.1016/j.jmh.2025.100376","url":null,"abstract":"<div><h3>Background</h3><div>Myanmar migrant workers in Southern Thailand contribute significantly to the local economy but face challenges including harmful drinking patterns and poor environmental conditions that negatively impact their social interactions. Understanding these factors is crucial for developing effective interventions.</div></div><div><h3>Objectives</h3><div>To examine how alcohol consumption and environmental conditions affect social relationship problems among Myanmar migrant workers in Southern Thailand.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted among 516 Myanmar migrant workers who consume alcohol. Data were collected through structured interviews covering demographic characteristics, drinking patterns, and social relationship issues. Statistical analysis using Generalized Linear Mixed Models identified factors associated with social relationship problems.</div></div><div><h3>Results</h3><div>Nearly two-thirds of participants (63.37 %, 95 %CI: 59.11–67.43) experienced at least one social relationship problem. Major risk factors included harmful drinking patterns (AOR=2.61, 95 %CI: 2.26–3.01), working in agriculture (AOR=2.04, 95 %CI: 1.17–3.55), and insufficient income (AOR=2.01, 95 %CI: 1.18–3.41). Workers living in rural communities (AOR=3.58, 95 %CI: 1.81–7.06) and those facing moderate-to-high workplace environmental problems (AOR=3.14, 95 %CI: 2.52–3.91) also showed significantly higher risks.</div></div><div><h3>Conclusion</h3><div>This study highlights the critical roles of alcohol consumption and environmental factors in shaping social relationships among Myanmar migrant workers. Interventions should target harmful drinking behaviors, improve workplace conditions, and promote social integration to enhance the well-being of this vulnerable population.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"12 ","pages":"Article 100376"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145473457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical xenophobia and healthcare exclusion of refugees and migrants in Africa: A scoping review","authors":"Alexis Harerimana ,&nbsp;Julian David Pillay ,&nbsp;Gugu Mchunu","doi":"10.1016/j.jmh.2025.100343","DOIUrl":"10.1016/j.jmh.2025.100343","url":null,"abstract":"<div><h3>Background</h3><div>Medical xenophobia, manifesting as discrimination and exclusion from healthcare based on nationality or documentation, threatens migrants’ and refugees’ rights and public health. This study maps evidence of what is known about medical xenophobia and healthcare exclusion of refugees and migrants in Africa.</div></div><div><h3>Methodology</h3><div>The framework established by Levac et al. offered a structured method for executing this scoping review. This research implemented a comprehensive search strategy to identify academic papers and grey literature. Databases such as CINAHL, Emcare, Medline Ovid, Scopus and Web of Science were utilised, focusing on the period from 2014 to 2024. A total of 20 articles were selected for data extraction and thematic synthesis.</div></div><div><h3>Results</h3><div>The scoping review identified pervasive medical xenophobia and exclusion of refugees and migrants in African healthcare systems. This phenomenon included discriminatory attitudes from healthcare personnel, cultural insensitivity, verbal abuse, poor or denial of care due to documentation status of refugees and migrants, financial exploitation, and linguistic discrimination in healthcare settings. Refugees and migrants often avoided healthcare services due to fear of harassment or deportation, worsening their physical, mental and maternal health outcomes. Interventions highlighted in the literature encompassed policy reforms, cultural sensitivity training for providers, community engagement, enhanced service accessibility, and ongoing monitoring to address systemic inequalities.</div></div><div><h3>Conclusion</h3><div>Addressing healthcare access inequities for refugees and migrants necessitates structural reforms to ensure accountability for inadequate treatment, uphold human rights and promote equity and culturally and linguistically inclusive practices.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"12 ","pages":"Article 100343"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144653102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of humanitarian actors on interprofessional care for persons living with diabetes: Lessons from Aleppo, Syria","authors":"Sigiriya Aebischer Perone ,&nbsp;Kinda Khamasmie ,&nbsp;Ranim Doukki ,&nbsp;Claudine Dauby ,&nbsp;Catherine Savoy ,&nbsp;François Chappuis ,&nbsp;Nicolas Perone ,&nbsp;David Beran","doi":"10.1016/j.jmh.2025.100355","DOIUrl":"10.1016/j.jmh.2025.100355","url":null,"abstract":"<div><h3>Background</h3><div>Proper management of persons living with chronic diseases including diabetes requires collaboration between different health care providers. Yet in humanitarian settings, care is essentially provided by health services organised in silos, without coordination and inclusion of people living with various conditions. Interprofessional teamwork could be a means to address this, but this approach is rarely implemented in such contexts.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with a purposive sample of 12 health care professionals from the International Committee of the Red Cross in Syria and in headquarters Switzerland, to explore their perceptions and experiences of factors influencing the work across professional teams. Qualitative analysis was conducted using an inductive and deductive thematic approach.</div></div><div><h3>Main findings</h3><div>The perspectives of humanitarian actors on interprofessional care for persons living with diabetes in a humanitarian setting identified four key factors that influence interprofessional collaboration: i) person focused inclusive leadership to overcome competing demands and competition between health teams, ii) reorganisation of health services with a clear structure, appropriate resources and processes for interprofessional collaboration, iii) commitment and openness of the individual health professional to work collaboratively and iv) the key role and capacities of people with diabetes, who need to be included as team members. These four elements interact and need to come together to ensure successful interprofessional care.</div></div><div><h3>Implications</h3><div>The findings advocate for an inclusive leadership of the interprofessional team, reorganisation of work, empowerment of all team members, and inclusion of people with a chronic condition in the team. Health care providers are thus encouraged to support interprofessional care to address the needs of people living with a chronic condition in a humanitarian context.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"12 ","pages":"Article 100355"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145043898","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delivering obstetric care to maritime migrants: The Lampedusa protocol","authors":"Alexandra A. Sansosti ,&nbsp;Tania Macaluso ,&nbsp;Sanjay Saint ,&nbsp;M. Todd Greene ,&nbsp;Fabio Genco ,&nbsp;Alessandra Diodati ,&nbsp;Leuconoe Grazia Sisti ,&nbsp;Alessandro Bartoloni ,&nbsp;Francesco D’Arca ,&nbsp;Giuseppe Canzone","doi":"10.1016/j.jmh.2025.100362","DOIUrl":"10.1016/j.jmh.2025.100362","url":null,"abstract":"<div><h3>Background</h3><div>While Lampedusa Island has long represented the “Doorway to Europe,” migration is considered an emergent phenomenon rather than a constant occurrence. Vulnerable populations – particularly pregnant women – arriving there require both routine and urgent medical services. We describe a novel approach to triaging pregnant migrant women, observed clinical presentations, and the effects on healthcare resource utilization.</div></div><div><h3>Methods</h3><div>The Lampedusa Protocol was implemented in March 2023 by the Agenzia Sanitaria Provinciale (ASP) of Palermo and the Italian National Institute for Health, Migration and Poverty (INMP). Clinical and demographic data from 28 March 2023 to 31 May 2024 were collected and analyzed by cross-referencing the clinical databases of the policlinic of Lampedusa and the Italian Red Cross, the managing entity of the migrant hotspot. Resource utilization data were collected from the helicopter transfer data recorded by the emergency medical service for the island. Associations between patient characteristics and need for helicopter evacuation were assessed using multivariable logistic regression.</div></div><div><h3>Findings</h3><div>A total of 571 pregnant patients were assessed and treated between 3/28/2023-5/31/2024. Patients represented 23 nationalities, average age was 26 years (SD=6.6 years), and average ultrasound-estimated gestational age was 25.2 weeks (SD=9.6 weeks). The most common causes for needing helicopter transfer were late gestational age or concern for, or symptoms of, labor. Compared to the pre-implementation period, the proportion of patients requiring any flight decreased by 23% (24.5% to 18.9%, <em>p</em>= 0.027) and the proportion requiring dedicated urgent flights decreased by 52% (8.3% to 4.0%, <em>p</em>= 0.003) in the post-implementation period. No association was found between Multidimensional Global Poverty Index of origin country and requiring helicopter evacuation. Women with known nationality had reduced odds (OR = 0.49, 95% CI = 0.27-0.90, p = 0.02) of requiring urgent helicopter evacuation.</div></div><div><h3>Interpretation</h3><div>We demonstrate improved resource utilization with protocolized care pathways for maritime migrants in European borderlands.</div></div><div><h3>Funding</h3><div>Dr. Alexandra Sansosti, MD was funded in part by a research grant from the US-Italy Fulbright Commission for this project.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"12 ","pages":"Article 100362"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145227195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}