Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100254
Background
Incidence of sexual violence among recently arrived asylum-seeking women in France (INCIDAVI) is a French study which found a past year incidence of 26 % for postarrival sexual violence (SV) among asylum-seeking women (ASW). It reported that fewer than 1 out of 10 victims consulted a healthcare professional when SV occurred. These findings raise the question of how ASW who have been victims of SV get involved in care. We aimed to explore the mechanisms and obstacles to seeking care in the host country among this population.
Methods
This qualitative phase of INCIDAVI was based on a grounded theory approach. Twenty semi structured interviews were conducted between February 1, 2022, and July 29, 2022. The interviews explored the conditions under which women talk about SV, the care pathway in France and the perceived consequences of care. We performed an inductive analysis using NVivo® 14 software.
Findings
Life paths of ASW are traversed by SV which influence their health and safety behaviour and can re-expose them to SV. Talking about SV is a rare choice focused on seeking protection. When appropriate care is used, it is perceived as beneficial and leads to a change in the perception of a possible recovery.
Interpretation
The failure of ASW to seek care for SV is shaped by the fact that SV is initially perceived as ordinary. A proactive attitude on the part of carers towards detecting such violence leads to positive experiences of care, which in turn influence women's initial perceptions of SV, enabling them to envisage health recovery.
{"title":"Strategies for seeking care in the host country among asylum-seeking women who have been victims of sexual violence: A French qualitative study","authors":"","doi":"10.1016/j.jmh.2024.100254","DOIUrl":"10.1016/j.jmh.2024.100254","url":null,"abstract":"<div><h3>Background</h3><p>Incidence of sexual violence among recently arrived asylum-seeking women in France (INCIDAVI) is a French study which found a past year incidence of 26 % for postarrival sexual violence (SV) among asylum-seeking women (ASW). It reported that fewer than 1 out of 10 victims consulted a healthcare professional when SV occurred. These findings raise the question of how ASW who have been victims of SV get involved in care. We aimed to explore the mechanisms and obstacles to seeking care in the host country among this population.</p></div><div><h3>Methods</h3><p>This qualitative phase of INCIDAVI was based on a grounded theory approach. Twenty semi structured interviews were conducted between February 1, 2022, and July 29, 2022. The interviews explored the conditions under which women talk about SV, the care pathway in France and the perceived consequences of care. We performed an inductive analysis using NVivo® 14 software.</p></div><div><h3>Findings</h3><p>Life paths of ASW are traversed by SV which influence their health and safety behaviour and can re-expose them to SV. Talking about SV is a rare choice focused on seeking protection. When appropriate care is used, it is perceived as beneficial and leads to a change in the perception of a possible recovery.</p></div><div><h3>Interpretation</h3><p>The failure of ASW to seek care for SV is shaped by the fact that SV is initially perceived as ordinary. A proactive attitude on the part of carers towards detecting such violence leads to positive experiences of care, which in turn influence women's initial perceptions of SV, enabling them to envisage health recovery.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000436/pdfft?md5=2f22992b7b16df2e259f3c6a66707b8d&pid=1-s2.0-S2666623524000436-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141838567","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}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100249
Purpose
To survey community-based migrant-serving organizations (MSOs) in New York City (NYC) regarding their early experiences during the COVID-19 pandemic and perspectives on academic collaborations.
Methods
We developed and emailed a survey via Qualtrics (12/2020-1/2021) to 122 MSOs in NYC collecting data about the organizations; challenges posed by COVID-19; and interest in potential intersectoral collaboration. Descriptive analysis focused on the pandemic's impact on service provision, type of MSO, and organizational capacity.
Results
Thirty-eight MSOs participated (RR=31%). COVID-19-related challenges included limited staff capacity, organizational funding, and technological and resource limitations of communities served. Organizational capacity correlated with types of services offered: smaller organizations offered health and social services, while larger organizations focused on education and employment. MSOs indicated interest in collaboration on migrant policy advocacy and communications, access to interns, and resources regarding best practices and policies.
Conclusions
MSOs in NYC have struggled with funding, staffing, and service provision. They specified fruitful areas for collaboration with academic research institutions.
Implications
Development of an academic-based migrant health resource hub will serve an identified need among MSOs in NYC.
{"title":"Supporting organizations to improve migrants’ access to health services in New York City","authors":"","doi":"10.1016/j.jmh.2024.100249","DOIUrl":"10.1016/j.jmh.2024.100249","url":null,"abstract":"<div><h3>Purpose</h3><p>To survey community-based migrant-serving organizations (MSOs) in New York City (NYC) regarding their early experiences during the COVID-19 pandemic and perspectives on academic collaborations.</p></div><div><h3>Methods</h3><p>We developed and emailed a survey via Qualtrics (12/2020-1/2021) to 122 MSOs in NYC collecting data about the organizations; challenges posed by COVID-19; and interest in potential intersectoral collaboration. Descriptive analysis focused on the pandemic's impact on service provision, type of MSO, and organizational capacity.</p></div><div><h3>Results</h3><p>Thirty-eight MSOs participated (RR=31%). COVID-19-related challenges included limited staff capacity, organizational funding, and technological and resource limitations of communities served. Organizational capacity correlated with types of services offered: smaller organizations offered health and social services, while larger organizations focused on education and employment. MSOs indicated interest in collaboration on migrant policy advocacy and communications, access to interns, and resources regarding best practices and policies.</p></div><div><h3>Conclusions</h3><p>MSOs in NYC have struggled with funding, staffing, and service provision. They specified fruitful areas for collaboration with academic research institutions.</p></div><div><h3>Implications</h3><p>Development of an academic-based migrant health resource hub will serve an identified need among MSOs in NYC.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000382/pdfft?md5=480a30f631d7bfa39fdd44fd9bd56da4&pid=1-s2.0-S2666623524000382-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141639143","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}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100241
Monica A. Ghabrial , Tatiana Ferguson , Ayden I. Scheim , Noah J. Adams , Moomtaz Khatoon (Imptiaz Popat) , Greta R. Bauer
Objective
Trans and non-binary (TNB) immigrants, refugees, and newcomers (IRN) face intersecting challenges and barriers, including stigma and persecution in countries of origin, and others unique to the Canadian resettlement process. The present study aimed to investigate factors that are associated with having a primary healthcare provider among TNB IRN.
Design
Trans PULSE Canada was a community-based, national study of health and wellbeing among 2,873 TNB people residing in Canada, aged 14 and older, who were recruited using a multi-mode convenience sampling approach.. The survey asked questions about identity, community, service access, health – and IRN were asked questions specific to immigration/settlement.
Results
Of the 313 IRN participants who completed the full survey version (age M = 34.1, SE=0.75), 76.4 % had a primary healthcare provider. TNB IRN largely reported being Canadian citizens (59.8 %), gender non-binary or similar (46.9 %), currently living in Ontario (35.5 %), and having immigrated from the United States (32.1 %). Chi-square analyses revealed that having a primary healthcare provider was associated with age, gender identity, citizenship status, region of origin, current location in Canada, length of time since immigrating to Canada, status in gender affirming medical care, and having extended health insurance. With modified Poisson regression, we found that TNB IRN who were non-permanent residents, originating from European, African, and Oceania regions, or living in Quebec and the Prairie provinces were less likely to have a primary healthcare provider.
Conclusion
Results may inform settlement organizations of the unique needs and barriers of TNB IRN. Schools and LGBTQ+ organizations may better serve this population – especially those originating from highlighted regions, who live in Quebec or the Prairie provinces, and/or are non-permanent residents – by offering programs that connect them to primary healthcare providers who are competent in cross-cultural trans health.
{"title":"Factors associated with primary healthcare provider access among trans and non-binary immigrants, refugees, and newcomers in Canada","authors":"Monica A. Ghabrial , Tatiana Ferguson , Ayden I. Scheim , Noah J. Adams , Moomtaz Khatoon (Imptiaz Popat) , Greta R. Bauer","doi":"10.1016/j.jmh.2024.100241","DOIUrl":"https://doi.org/10.1016/j.jmh.2024.100241","url":null,"abstract":"<div><h3>Objective</h3><p>Trans and non-binary (TNB) immigrants, refugees, and newcomers (IRN) face intersecting challenges and barriers, including stigma and persecution in countries of origin, and others unique to the Canadian resettlement process. The present study aimed to investigate factors that are associated with having a primary healthcare provider among TNB IRN.</p></div><div><h3>Design</h3><p>Trans PULSE Canada was a community-based, national study of health and wellbeing among 2,873 TNB people residing in Canada, aged 14 and older, who were recruited using a multi-mode convenience sampling approach.. The survey asked questions about identity, community, service access, health – and IRN were asked questions specific to immigration/settlement.</p></div><div><h3>Results</h3><p>Of the 313 IRN participants who completed the full survey version (age <em>M</em> = 34.1, <em>SE</em>=0.75), 76.4 % had a primary healthcare provider. TNB IRN largely reported being Canadian citizens (59.8 %), gender non-binary or similar (46.9 %), currently living in Ontario (35.5 %), and having immigrated from the United States (32.1 %). Chi-square analyses revealed that having a primary healthcare provider was associated with age, gender identity, citizenship status, region of origin, current location in Canada, length of time since immigrating to Canada, status in gender affirming medical care, and having extended health insurance. With modified Poisson regression, we found that TNB IRN who were non-permanent residents, originating from European, African, and Oceania regions, or living in Quebec and the Prairie provinces were less likely to have a primary healthcare provider.</p></div><div><h3>Conclusion</h3><p>Results may inform settlement organizations of the unique needs and barriers of TNB IRN. Schools and LGBTQ+ organizations may better serve this population – especially those originating from highlighted regions, who live in Quebec or the Prairie provinces, and/or are non-permanent residents – by offering programs that connect them to primary healthcare providers who are competent in cross-cultural trans health.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S266662352400031X/pdfft?md5=07124b156fe4bd5caf0acb473a68c1f9&pid=1-s2.0-S266662352400031X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141486104","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}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100225
Ebrahim Masoudnia, Fatemeh Rahmati Farmani
Background
Post-traumatic stress disorder (PTSD) is one of the most important and common disorders caused by war trauma. The aim of this study was to determine the relationship between psychosocial factors and PTSD in war-torn immigrants in Mehran, Iran.
Method
The present study was conducted by descriptive and correlational method. The data were collected from 245 people (121 women and 124 men) from war-torn immigrants 45 years and older who migrated from Mehran to Ilam during the Iran–Iraq war. The measuring tools were as follows: Post Traumatic Stress Disorder Scale, Multidimensional Scale of Perceived Social Support (MDPSS), Coping Strategies Scale (CSS-R), Multidimensional Health Locus of Control scale.
Results
The prevalence rate of PTSD among war-torn immigrants in Mehran was 35.1 %. A significant negative correlation was observed between perceived social support and PTSD (p < .01). Coping strategies, including seeking social support, reappraisal/adaptation, problem-focused coping, and active coping, all showed significant negative correlations with PTSD (p < .01). Conversely, a significant positive correlation was found between avoidance coping strategies and self-control and PTSD (p < .01). In addition, there was a significant positive correlation between the external locus of control (believing in chance) and PTSD (P < 0.01) and significant negative correlation between internal locus of control and PTSD (P < .01).
Conclusion
Weakness in social support, locus of control and also inappropriate coping strategies against war trauma were among the strong risk factors for PTSD. Therefore, social and behavioral interventions are recommended to increase social support, teaching problem-solving skills and strengthen individual control among war-torn immigrants to reduce the risk of developing PTSD.
{"title":"Psychosocial etiology of post-traumatic stress disorder caused by war trauma among Iran–Iraq war immigrants in Mehran, Iran","authors":"Ebrahim Masoudnia, Fatemeh Rahmati Farmani","doi":"10.1016/j.jmh.2024.100225","DOIUrl":"https://doi.org/10.1016/j.jmh.2024.100225","url":null,"abstract":"<div><h3>Background</h3><p>Post-traumatic stress disorder (PTSD) is one of the most important and common disorders caused by war trauma. The aim of this study was to determine the relationship between psychosocial factors and PTSD in war-torn immigrants in Mehran, Iran.</p></div><div><h3>Method</h3><p>The present study was conducted by descriptive and correlational method. The data were collected from 245 people (121 women and 124 men) from war-torn immigrants 45 years and older who migrated from Mehran to Ilam during the Iran–Iraq war. The measuring tools were as follows: Post Traumatic Stress Disorder Scale, Multidimensional Scale of Perceived Social Support (MDPSS), Coping Strategies Scale (CSS-R), Multidimensional Health Locus of Control scale.</p></div><div><h3>Results</h3><p>The prevalence rate of PTSD among war-torn immigrants in Mehran was 35.1 %. A significant negative correlation was observed between perceived social support and PTSD (<em>p</em> < .01). Coping strategies, including seeking social support, reappraisal/adaptation, problem-focused coping, and active coping, all showed significant negative correlations with PTSD (<em>p</em> < .01). Conversely, a significant positive correlation was found between avoidance coping strategies and self-control and PTSD (<em>p</em> < .01). In addition, there was a significant positive correlation between the external locus of control (believing in chance) and PTSD (<em>P</em> < 0.01) and significant negative correlation between internal locus of control and PTSD (<em>P</em> < .01).</p></div><div><h3>Conclusion</h3><p>Weakness in social support, locus of control and also inappropriate coping strategies against war trauma were among the strong risk factors for PTSD. Therefore, social and behavioral interventions are recommended to increase social support, teaching problem-solving skills and strengthen individual control among war-torn immigrants to reduce the risk of developing PTSD.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000151/pdfft?md5=a8ce671d159a8d6443ca3720fd00dcb6&pid=1-s2.0-S2666623524000151-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140052733","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}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100270
Although a growing body of literature has focused on the experience of young people with migration experience with Swedish sexual and reproductive health (SRH) services, there is a lack of deep qualitative exploration. The study aims to explore the encounters of young people with migration experience with SRH services and their understandings of factors that affect their use of these services. The findings of this study were drawn from 18 interviews conducted between October 2021 and May 2023 in Southern Sweden. A combination of convenient and snowball sampling strategies was used. Participants included in the study self-identified as Middle Eastern, migrated to Sweden, and were aged between 17 and 26. Data were analyzed using reflexive thematic analysis approach.
Three themes were generated during the analysis. The first SRH services: dual perceptions and experiences shows how participants had ambivalent perceptions of SRH services, mainly the youth clinic. Some perceived the youth clinic as a stigmatized place associated with shame and SRH concerns like unwanted pregnancy and sexually transmitted infections, while others viewed the youth clinic as a safe space. The negative perceptions along with the difficulties with accessing the youth clinic contributed to low service use. The second Sexuality education: an eye-opener or a joke? reflects participants’ both positive and negative experiences and attitudes when receiving sexuality education in schools. The third SRH information: beyond formal services and education captures participants’ ways of accessing SRH information that go beyond information provided at the traditional SRH services and sexuality education in schools. These sources include the family, friends, and the internet. The study points to the need for multicomponent strategies to improve the accessibility of SRH services and draws attention to the importance of challenging norms related to Swedishness in sexuality education to foster the engagement of youth with migration experience and ensure their sexual citizenship.
{"title":"Young people with migration experience and their (non) encounters with Swedish sexual and reproductive health services and information: An explorative study","authors":"","doi":"10.1016/j.jmh.2024.100270","DOIUrl":"10.1016/j.jmh.2024.100270","url":null,"abstract":"<div><div>Although a growing body of literature has focused on the experience of young people with migration experience with Swedish sexual and reproductive health (SRH) services, there is a lack of deep qualitative exploration. The study aims to explore the encounters of young people with migration experience with SRH services and their understandings of factors that affect their use of these services. The findings of this study were drawn from 18 interviews conducted between October 2021 and May 2023 in Southern Sweden. A combination of convenient and snowball sampling strategies was used. Participants included in the study self-identified as Middle Eastern, migrated to Sweden, and were aged between 17 and 26. Data were analyzed using reflexive thematic analysis approach.</div><div>Three themes were generated during the analysis. The first <em>SRH services: dual perceptions and experiences</em> shows how participants had ambivalent perceptions of SRH services, mainly the youth clinic. Some perceived the youth clinic as a stigmatized place associated with shame and SRH concerns like unwanted pregnancy and sexually transmitted infections, while others viewed the youth clinic as a safe space. The negative perceptions along with the difficulties with accessing the youth clinic contributed to low service use. The second <em>Sexuality education: an eye-opener or a joke?</em> reflects participants’ both positive and negative experiences and attitudes when receiving sexuality education in schools. The third <em>SRH information: beyond formal services and education</em> captures participants’ ways of accessing SRH information that go beyond information provided at the traditional SRH services and sexuality education in schools. These sources include the family, friends, and the internet. The study points to the need for multicomponent strategies to improve the accessibility of SRH services and draws attention to the importance of challenging norms related to Swedishness in sexuality education to foster the engagement of youth with migration experience and ensure their sexual citizenship.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418453","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}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100261
Background
The rise of global forced migration urges healthcare systems to respond to the needs of forced migrants (FM) during pregnancy and childbirth. Yet, comprehensive data on the health outcomes of pregnant FM in destination countries remain scarce. This study aimed to describe the characteristics and maternal and perinatal outcomes of pregnancy in this specific migrant population on a national scale in the Netherlands and to explore differences from other populations.
Methods
The Dutch perinatal registry was linked to national migration data to analyze pregnancy outcomes in FM (2014–2019), using non-migrants (NM) and resident migrants (RM) as reference populations. We reported outcome rates (% [95 % CI]) for a range of primary and secondary pregnancy outcomes. Primary outcomes included perinatal mortality, small for gestational age infants (SGA), preterm birth, and emergency cesarean section (CS), for which we also calculated the crude relative risk (RR [95 % CI]) of FM compared to NM and RM. In addition, we conducted binary logistic regression analyses on primary outcomes to report adjusted odds ratios (aORs [95 % CIs]) while controlling for multiple births, maternal age and parity.
Findings
Compared to the NM group, the FM group had increased risks of perinatal mortality (RR 1.50 [95 % CI 1.20–1.88]), SGA (1.65 [1.59–1.71], and emergency CS (1.19 [1.13–1.25]). Compared to RM, FM still had elevated risks of SGA (1.17 [1.13–1.22]). In contrast, the risk of preterm birth was lower in FM than in NM (0.81 [0.76–0.86]) and RM (0.83 [0.77–0.88]). These differences were confirmed in the adjusted analysis. Differences in secondary outcomes included higher rates of late antenatal care in FM (29.4 % [28.5–30.3]) than in NM (6.7 % [6.6–6.9]) and RM (15.5 % [15.1–15.9]). Rates of planned CS were similarly elevated (14.3 % [95 % CI 13.7–14.8] versus 7.·8 % [7.7–7.8] and 9.6 % [9.5–9.7]), while FM had lower rates of postpartum hemorrhage (3.9 % [3.6–4.2]) versus 6.8 % [6.8–6.9] and 5.7 % [5.6–5.9]).
Conclusion
This first Dutch registry-based study demonstrated increased risks of multiple, though not all, adverse pregnancy outcomes in forced migrants. Our results emphasize the imperative to further unravel and address migration-related disparities, dismantle structural barriers to health among forced migrants, and improve the inclusivity of data systems. Collaborative policy, clinical practice, and research efforts are essential to ensure equitable care for every individual, regardless of migration status.
{"title":"Pregnancy outcomes of forced migrants in the Netherlands: A national registry-based study","authors":"","doi":"10.1016/j.jmh.2024.100261","DOIUrl":"10.1016/j.jmh.2024.100261","url":null,"abstract":"<div><h3>Background</h3><p>The rise of global forced migration urges healthcare systems to respond to the needs of forced migrants (FM) during pregnancy and childbirth. Yet, comprehensive data on the health outcomes of pregnant FM in destination countries remain scarce. This study aimed to describe the characteristics and maternal and perinatal outcomes of pregnancy in this specific migrant population on a national scale in the Netherlands and to explore differences from other populations.</p></div><div><h3>Methods</h3><p>The Dutch perinatal registry was linked to national migration data to analyze pregnancy outcomes in FM (2014–2019), using non-migrants (NM) and resident migrants (RM) as reference populations. We reported outcome rates (% [95 % CI]) for a range of primary and secondary pregnancy outcomes. Primary outcomes included perinatal mortality, small for gestational age infants (SGA), preterm birth, and emergency cesarean section (CS), for which we also calculated the crude relative risk (RR [95 % CI]) of FM compared to NM and RM. In addition, we conducted binary logistic regression analyses on primary outcomes to report adjusted odds ratios (aORs [95 % CIs]) while controlling for multiple births, maternal age and parity.</p></div><div><h3>Findings</h3><p>Compared to the NM group, the FM group had increased risks of perinatal mortality (RR 1.50 [95 % CI 1.20–1.88]), SGA (1.65 [1.59–1.71], and emergency CS (1.19 [1.13–1.25]). Compared to RM, FM still had elevated risks of SGA (1.17 [1.13–1.22]). In contrast, the risk of preterm birth was lower in FM than in NM (0.81 [0.76–0.86]) and RM (0.83 [0.77–0.88]). These differences were confirmed in the adjusted analysis. Differences in secondary outcomes included higher rates of late antenatal care in FM (29.4 % [28.5–30.3]) than in NM (6.7 % [6.6–6.9]) and RM (15.5 % [15.1–15.9]). Rates of planned CS were similarly elevated (14.3 % [95 % CI 13.7–14.8] versus 7.·8 % [7.7–7.8] and 9.6 % [9.5–9.7]), while FM had lower rates of postpartum hemorrhage (3.9 % [3.6–4.2]) versus 6.8 % [6.8–6.9] and 5.7 % [5.6–5.9]).</p></div><div><h3>Conclusion</h3><p>This first Dutch registry-based study demonstrated increased risks of multiple, though not all, adverse pregnancy outcomes in forced migrants. Our results emphasize the imperative to further unravel and address migration-related disparities, dismantle structural barriers to health among forced migrants, and improve the inclusivity of data systems. Collaborative policy, clinical practice, and research efforts are essential to ensure equitable care for every individual, regardless of migration status.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000503/pdfft?md5=55b03b494b2619d5166bd63fa9a94278&pid=1-s2.0-S2666623524000503-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172745","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}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100266
Background
The healthcare policies for migrant workers in Singapore had a traditional focus on improving occupational health and preventing workplace injuries. The COVID-19 pandemic led to a rapid paradigm shift in the provision of healthcare for migrant workers, with an urgent focus on improving the accessibility and affordability of primary and preventive health services and strengthening public health surveillance. The purpose of this study is to identify areas for improvement, so that policy makers can improve the implementation effectiveness of healthcare policies for migrant workers. This is achieved by establishing a baseline understanding of (a) the health-seeking behaviours of migrant workers in Singapore, (b) how they consume primary and preventive health services, and (c) systemic gaps in the delivery of services.
Methods
A cross-sectional study was conducted at five migrant worker dormitories and two community spaces in Singapore, between August and November 2022. 1101 male migrant workers participated in a survey and 1089 valid responses were analysed. Multivariable logistic regression was used to identify sociodemographic factors associated with health service utilisation and awareness of the new healthcare financing plan introduced for migrant workers, called the Primary Care Plan (PCP).
Results
The mean age of participants was 34 years. Most of them were of Indian or Bangladeshi nationality. At least 82 % of participants reported that they could access varying health services in Singapore and 73 % were satisfied with the costs of healthcare. However, a lower percentage of the participants (54 %) had seen a doctor, mostly for respiratory, fever or musculoskeletal conditions, and only 7 % saw a dentist at least once in a year. This was attributable to their low perceived need to see a doctor (91 %) or dentist (71 %). While the prevalence of chronic diseases (4 %) was low among the participants, about one-third of participants smoked (26 %), consumed alcohol (32 %), or resorted to self-treatment or medication (39 %).
Conclusion
This study corroborated with previous observational studies where migrant workers in Singapore only sought care during an acute episode of illness. While participants perceived healthcare in Singapore to be accessible and affordable, there was limited evidence to suggest that preventive health care was prioritised. This indicates possible gaps in current outreach programmes and further development of new targeted programmes to increase the health literacy and awareness of primary and preventive health services among migrant workers in Singapore.
{"title":"Building a healthy migrant workforce in Singapore – A cross-sectional study to understand health-seeking behaviours of male migrant workers","authors":"","doi":"10.1016/j.jmh.2024.100266","DOIUrl":"10.1016/j.jmh.2024.100266","url":null,"abstract":"<div><h3>Background</h3><div>The healthcare policies for migrant workers in Singapore had a traditional focus on improving occupational health and preventing workplace injuries. The COVID-19 pandemic led to a rapid paradigm shift in the provision of healthcare for migrant workers, with an urgent focus on improving the accessibility and affordability of primary and preventive health services and strengthening public health surveillance. The purpose of this study is to identify areas for improvement, so that policy makers can improve the implementation effectiveness of healthcare policies for migrant workers. This is achieved by establishing a baseline understanding of (a) the health-seeking behaviours of migrant workers in Singapore, (b) how they consume primary and preventive health services, and (c) systemic gaps in the delivery of services.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted at five migrant worker dormitories and two community spaces in Singapore, between August and November 2022. 1101 male migrant workers participated in a survey and 1089 valid responses were analysed. Multivariable logistic regression was used to identify sociodemographic factors associated with health service utilisation and awareness of the new healthcare financing plan introduced for migrant workers, called the Primary Care Plan (PCP).</div></div><div><h3>Results</h3><div>The mean age of participants was 34 years. Most of them were of Indian or Bangladeshi nationality. At least 82 % of participants reported that they could access varying health services in Singapore and 73 % were satisfied with the costs of healthcare. However, a lower percentage of the participants (54 %) had seen a doctor, mostly for respiratory, fever or musculoskeletal conditions, and only 7 % saw a dentist at least once in a year. This was attributable to their low perceived need to see a doctor (91 %) or dentist (71 %). While the prevalence of chronic diseases (4 %) was low among the participants, about one-third of participants smoked (26 %), consumed alcohol (32 %), or resorted to self-treatment or medication (39 %).</div></div><div><h3>Conclusion</h3><div>This study corroborated with previous observational studies where migrant workers in Singapore only sought care during an acute episode of illness. While participants perceived healthcare in Singapore to be accessible and affordable, there was limited evidence to suggest that preventive health care was prioritised. This indicates possible gaps in current outreach programmes and further development of new targeted programmes to increase the health literacy and awareness of primary and preventive health services among migrant workers in Singapore.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418452","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}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100267
Background
Travel restrictions implemented to mitigate the spread of SARS-CoV-2 decreased mobility and reduced physical contact during 2020–2021 for many in the general population. This analysis explored changes to network contacts among people who inject drugs (PWID) in the San Diego Border Region (SDBR) by cross-border mobility before and during the COVID-19 era.
Methods
Baseline data collected between October 2020–2021, from a cohort study of PWID in the SDBR were used to retrospectively describe differences in baseline characteristics across cross-border PWID groups (cross-border PWID [CB-PWID]: n = 206; San Diego PWID [SD-PWID]: n = 203; Tijuana PWID [TJ-PWID]: n = 202). Chi-square and Fisher's exact tests evaluated sociodemographic, injecting risk behaviors, harm reduction service history, incarceration history, non-fatal overdose, HCV, HIV. Median differences in sex, drug/alcohol, and close partners before and during the pandemic among all PWID and by cross-border PWID status were evaluated using Kruskal-Wallis tests. Pairwise associations across cross-border PWID groups were assessed using the Dwass, Steel, Critchlow-Fligner multiple comparison test.
Results
Among 611 PWID, the number of sex, drug/alcohol-related partners and close contacts before and during the pandemic remained relatively stable (psex=0.71;pdrug/alcohol=0.15;pclose=0.09). PWID in San Diego experienced the greatest difference in drug/alcohol-related partners (median[IQR]:-1[-6,0]), while cross-border PWID reported the smallest change in close contacts versus pre-pandemic (median[IQR]:0[0,1]). PWID in Tijuana had the greatest proportion (87%) of close contacts who injected drugs of all three groups.
Conclusions
Compared to pre-pandemic, the median number of sex partners, drug/alcohol-related partners, and close contacts remained stable among PWID in the SDBR. Future research should explore how these network contacts evolve over time.
{"title":"Differences in characteristics and interactions with close contacts among PWID in the San Diego Border Region before and during the COVID-19 pandemic","authors":"","doi":"10.1016/j.jmh.2024.100267","DOIUrl":"10.1016/j.jmh.2024.100267","url":null,"abstract":"<div><h3>Background</h3><div>Travel restrictions implemented to mitigate the spread of SARS-CoV-2 decreased mobility and reduced physical contact during 2020–2021 for many in the general population. This analysis explored changes to network contacts among people who inject drugs (PWID) in the San Diego Border Region (SDBR) by cross-border mobility before and during the COVID-19 era.</div></div><div><h3>Methods</h3><div>Baseline data collected between October 2020–2021, from a cohort study of PWID in the SDBR were used to retrospectively describe differences in baseline characteristics across cross-border PWID groups (cross-border PWID [CB-PWID]: <em>n</em> = 206; San Diego PWID [SD-PWID]: <em>n</em> = 203; Tijuana PWID [TJ-PWID]: <em>n</em> = 202). Chi-square and Fisher's exact tests evaluated sociodemographic, injecting risk behaviors, harm reduction service history, incarceration history, non-fatal overdose, HCV, HIV. Median differences in sex, drug/alcohol, and close partners before and during the pandemic among all PWID and by cross-border PWID status were evaluated using Kruskal-Wallis tests. Pairwise associations across cross-border PWID groups were assessed using the Dwass, Steel, Critchlow-Fligner multiple comparison test.</div></div><div><h3>Results</h3><div>Among 611 PWID, the number of sex, drug/alcohol-related partners and close contacts before and during the pandemic remained relatively stable (p<sub>sex</sub>=0.71;p<sub>drug/alcohol</sub>=0.15;p<sub>close</sub>=0.09). PWID in San Diego experienced the greatest difference in drug/alcohol-related partners (median[IQR]:-1[-6,0]), while cross-border PWID reported the smallest change in close contacts versus pre-pandemic (median[IQR]:0[0,1]). PWID in Tijuana had the greatest proportion (87%) of close contacts who injected drugs of all three groups.</div></div><div><h3>Conclusions</h3><div>Compared to pre-pandemic, the median number of sex partners, drug/alcohol-related partners, and close contacts remained stable among PWID in the SDBR. Future research should explore how these network contacts evolve over time.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357027","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}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100229
Benjamin Schmid , Carla Njeim , Lavanya Vijayasingham , Leah Anku Sanga , Rima Kighsro Naimi , Fouad M. Fouad , Chaza Akik , Carla Zmeter , Sigiriya Aebischer Perone , Lars Bruun Larsen , Jytte Roswall , Éimhín Ansbro , Pablo Perel
In line with the peer reviewers comments, the authors have added highlights in stead of an abstract. It was felt that it was better able to capture the findings and is more in line with the paper's target audience.
{"title":"Implementing (and evaluating) peer support with people living with noncommunicable diseases in humanitarian settings","authors":"Benjamin Schmid , Carla Njeim , Lavanya Vijayasingham , Leah Anku Sanga , Rima Kighsro Naimi , Fouad M. Fouad , Chaza Akik , Carla Zmeter , Sigiriya Aebischer Perone , Lars Bruun Larsen , Jytte Roswall , Éimhín Ansbro , Pablo Perel","doi":"10.1016/j.jmh.2024.100229","DOIUrl":"https://doi.org/10.1016/j.jmh.2024.100229","url":null,"abstract":"<div><p>In line with the peer reviewers comments, the authors have added highlights in stead of an abstract. It was felt that it was better able to capture the findings and is more in line with the paper's target audience.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000199/pdfft?md5=494e5283ea7da21efd72eebfbd7d2d2c&pid=1-s2.0-S2666623524000199-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140549466","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}
Pub Date : 2024-01-01DOI: 10.1016/j.jmh.2024.100277
Purpose
We explored differences in primary and secondary health care usage across migrants from different regions in Australia.
Design/methodology/approach
Data comes from the Household Income and Labour Dynamics of Australia survey from waves 9, 13, and 17 (2009, 2013, and 2017). Zero inflated Poisson regressions and non-linear decompositions were estimated.
Findings
Younger women from South Asia, Latin America and Eastern and Southern Europe and younger men from Eastern and Southern Europe had lower rates of GP visits compared to the host population. Older African men have higher rates of nights in hospital and younger Eastern and Southern European women, older women from the Rest of Asia, and younger African men and women have lower rates of nights in hospital compared to the host population
Originality
This is the first paper to investigate differences in primary and service usage amongst immigrants across the life course. Our results have important implications for planning of health service resources.
Practical implications
Migrants are a heterogenous group and health policy needs to consider these differences to ensure the effectiveness and efficiency of service provision.
{"title":"Comparing health service usage of migrant groups in Australia: Evidence from the household income and labour dynamics survey of Australia","authors":"","doi":"10.1016/j.jmh.2024.100277","DOIUrl":"10.1016/j.jmh.2024.100277","url":null,"abstract":"<div><h3>Purpose</h3><div>We explored differences in primary and secondary health care usage across migrants from different regions in Australia.</div></div><div><h3>Design/methodology/approach</h3><div>Data comes from the Household Income and Labour Dynamics of Australia survey from waves 9, 13, and 17 (2009, 2013, and 2017). Zero inflated Poisson regressions and non-linear decompositions were estimated.</div></div><div><h3>Findings</h3><div>Younger women from South Asia, Latin America and Eastern and Southern Europe and younger men from Eastern and Southern Europe had lower rates of GP visits compared to the host population. Older African men have higher rates of nights in hospital and younger Eastern and Southern European women, older women from the Rest of Asia, and younger African men and women have lower rates of nights in hospital compared to the host population</div></div><div><h3>Originality</h3><div>This is the first paper to investigate differences in primary and service usage amongst immigrants across the life course. Our results have important implications for planning of health service resources.</div></div><div><h3>Practical implications</h3><div>Migrants are a heterogenous group and health policy needs to consider these differences to ensure the effectiveness and efficiency of service provision.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432073","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}
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