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The role of selected social and psychological factors in violence against Myanmar migrant women in Thailand. 选定的社会和心理因素在泰国对缅甸移民妇女的暴力行为中的作用。
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100314
Kaung Zaw , Wirin Kittipichai , Kanittha Chamroonsawasdi , Arpaporn Powwattana

Introduction

Violence against women (VAW) is a serious human rights violation with significant implications for public health. VAW affects the well-being of women, children, and families. This cross-sectional study aimed to determine the structural relationship of a set of variables—attitude towards violence (ATT), self-esteem (SE), relationship with residential unit members (RES), social support (SS), and coping strategies (COP)- influencing VAW and to test the model using the empirical data.

Methods

The measurement was deployed to assess violence experienced by 295 Myanmar migrant women residing in Thailand. Data collection involved the use of a self-administered questionnaire consisting of six scales. These scales exhibit Cronbach's alpha coefficients ranging from 0.74 to 0.90. The construct validity was confirmed through confirmatory factor analysis. The structural equation modeling method was employed to test the validity of the model using Mplus Software.

Results

The model provided fitted well with the empirical data (χ2/df =1.74, CFI = 0.93; TLI = 0.91; RMSEA = 0.05; SRMR = 0.06). The VAW accounted for 33 percent of the variance through its set of variables. Among these, ATT, RES, and COP directly impacted VAW, while SS and SE had indirect effects. ATT exhibited the most significant overall influence on VAW, with RES and COP serving as mediators among other antecedents studied in relation to VAW.

Conclusion

The current findings suggest that violence against Myanmar migrant women residing in Thailand is associated with many factors. Understanding these factors can provide valuable insights for policymakers and stakeholders to develop and implement awareness and community-based intervention programs. These findings underscore the importance of targeted strategies to address this issue effectively.
暴力侵害妇女行为是一种严重的侵犯人权行为,对公共卫生具有重大影响。暴力侵害妇女行为影响妇女、儿童和家庭的福祉。本横断面研究旨在确定暴力态度(ATT)、自尊(SE)、家庭成员关系(RES)、社会支持(SS)和应对策略(COP)等变量对暴力行为影响的结构关系,并利用实证数据对模型进行检验。方法采用该方法对295名居住在泰国的缅甸移民妇女所遭受的暴力行为进行评估。数据收集涉及使用由六个量表组成的自我管理问卷。这些量表显示Cronbach的alpha系数在0.74到0.90之间。通过验证性因子分析对构念的效度进行验证。采用结构方程建模方法,利用Mplus软件对模型的有效性进行检验。结果所建立的模型与经验数据拟合良好(χ2/df =1.74, CFI = 0.93;Tli = 0.91;Rmsea = 0.05;SRMR = 0.06)。VAW通过它的一组变量占了33%的方差。其中,ATT、RES和COP直接影响VAW,而SS和SE具有间接影响。ATT对VAW的整体影响最为显著,RES和COP在其他与VAW相关的前因中起中介作用。结论目前的研究结果表明,对居住在泰国的缅甸移民妇女的暴力行为与许多因素有关。了解这些因素可以为决策者和利益相关者提供宝贵的见解,以制定和实施意识和基于社区的干预方案。这些发现强调了有效解决这一问题的有针对性战略的重要性。
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引用次数: 0
Oral health literacy and oral health status of a german adult population with migration background – findings from the MuMi Study 具有移民背景的德国成年人口的口腔健康素养和口腔健康状况——来自MuMi研究的结果
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100309
Berit Lieske , Christopher Kofahl , Katrin Borof , Kristin Spinler , Anna Poth , Demet Dingoyan , Thomas Beikler , Guido Heydecke , Ghazal Aarabi

Background

People with migration background in Germany demonstrate poorer oral health and different oral health behaviors compared to people without migration background. One crucial factor for achieving and maintaining good oral health is a person's oral health literacy. This article presents results on oral health and oral health literacy from the baseline data of the cluster-randomized controlled MuMi study (Promotion of oral health literacy and oral health of persons with migration background).

Methods

Comparative cross-sectional data on oral health and oral health literacy of patients with and without migration background were examined in 40 dental practices in Hamburg, Germany. Oral examination included a full dental status, the degree of caries restoration, and the approximal plaque index (API). To assess oral health literacy, the Oral Health Literacy Profile (OHLP) was used. Associations between migration status and oral health or oral health literacy were analyzed with linear mixed regression, adjusted for age, sex, education level. The relationship between oral health literacy and oral health was calculated using logistic regression.

Results

Participants with and without migration background differed significantly in oral health literacy and clinical parameters of oral health. The former showed significantly lower oral health literacy (lower OHLP-Scores) and poorer oral health (higher API values as well as a more problem-oriented dental service use). Furthermore, the degree of caries restoration is significantly lower among participants with migration background than those without. Lastly, the logistic regression analysis revealed a significant association between better oral health literacy and lower API values.

Discussion

Migration background appears to be a risk factor in its own right, as the differences in oral health literacy and oral health status remain even after statistically controlling for several confounders. In order to better reflect the diversity within the population with migration background, information on potential access barriers and migration-related factors must be included in further analyses.

Conclusion

Oral health literacy has been found to be a strong predictor for an individual's oral health outcome. Improving the oral health literacy of patients may help in the efforts to improve oral health behaviors and the overall treatment outcomes. Thus, future research should focus on tailored preventive measures for improving oral health literacy, thereby helping to strengthen equal opportunities in oral health in Germany.
德国有移民背景的人与没有移民背景的人相比,口腔健康状况更差,口腔健康行为也不同。实现和保持良好口腔健康的一个关键因素是一个人的口腔健康素养。本文介绍了来自集群随机对照MuMi研究(促进有移民背景的人的口腔健康素养和口腔健康)基线数据的口腔健康和口腔健康素养的结果。方法对德国汉堡40家牙科诊所中有和没有移民背景的患者的口腔健康和口腔健康素养进行比较。口腔检查包括全牙状态、龋修复程度和牙菌斑近似指数(API)。为了评估口腔健康素养,使用了口腔健康素养概况(OHLP)。采用线性混合回归分析移民身份与口腔健康或口腔健康素养之间的关系,并根据年龄、性别、教育水平进行调整。采用logistic回归计算口腔健康素养与口腔健康之间的关系。结果有移民背景和无移民背景的被试在口腔健康素养和口腔健康临床指标上存在显著差异。前者表现出较低的口腔健康素养(较低的ohlp分数)和较差的口腔健康(较高的API值以及更多的问题导向的牙科服务使用)。此外,有移民背景的受试者龋修复程度明显低于无移民背景的受试者。最后,逻辑回归分析显示良好的口腔健康素养与较低的API值之间存在显著关联。移民背景本身似乎是一个风险因素,因为即使在统计上控制了几个混杂因素后,口腔健康知识和口腔健康状况的差异仍然存在。为了更好地反映具有移徙背景的人口内部的多样性,必须在进一步的分析中列入关于可能的进入障碍和与移徙有关的因素的资料。结论口腔健康素养是预测个体口腔健康状况的重要指标。提高患者的口腔健康素养可能有助于改善口腔健康行为和整体治疗效果。因此,未来的研究应侧重于量身定制的预防措施,以提高口腔健康素养,从而有助于加强德国口腔健康的平等机会。
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引用次数: 0
Health in Transit: A case study on the migratory trajectories of Haitian populations in Chile and Mexico 过境保健:海地人口在智利和墨西哥的移徙轨迹个案研究
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100328
Loreto Watkins , Francesca McLaren , Lindsey Carte , Carla Olivari , Kenya Lazos , Teresita Rocha-Jiménez
Current migration journeys often involve crossing several borders, exposing migrants to numerous difficulties and dangers. This article qualitatively describes the migrant trajectories of twenty-five Haitian migrants who intended to travel from Chile to Mexico in an attempt to cross into the United States, delving into the dynamic physical and mental health outcomes at different phases of their journey. Our findings reveal that Haitian participants began their journeys in a context of instability, violence, insecurity, and precariousness from their country of origin, and factors such as stress, sadness, feelings of disappointment, and unfulfilled expectations followed them into their receiving societies. Participants in transit encountered severe health issues, including starvation, sickness, fatigue, exposure to contaminated water, violence, and sexual abuse—all without access to healthcare or medical assistance. Despite these adversities, migrants demonstrated a remarkable ability in surviving the hardships of their journey. The challenging physical and mental health situation faced by Haitian migrants on the move underscores the limitations of current health systems in effectively responding to this reality, and it should be recognized as a critical public health issue. This article focuses on the health challenges faced by Haitian migrants, who currently depend on the support of their community to ensure their well-being and emphasizes the need for policies that recognize the fluidity of migrant trajectories and foster collaboration to address health disparities throughout the migration journey.
目前的移民旅程往往涉及跨越几条边界,使移民面临许多困难和危险。本文定性地描述了25名海地移民的移民轨迹,他们打算从智利前往墨西哥,试图越境进入美国,深入研究了他们在旅途不同阶段的动态身心健康结果。我们的研究结果表明,海地参与者在不稳定、暴力、不安全和不稳定的背景下开始了他们的旅程,压力、悲伤、失望和未实现的期望等因素跟随他们进入了接收社会。过境的参与者遇到了严重的健康问题,包括饥饿、疾病、疲劳、接触受污染的水、暴力和性虐待——所有这些都无法获得保健或医疗援助。尽管有这些逆境,移民们在旅途的艰辛中表现出了非凡的生存能力。海地移民在流动中面临的具有挑战性的身心健康状况,突显了当前卫生系统在有效应对这一现实方面的局限性,应将其视为一个关键的公共卫生问题。本文重点关注海地移民面临的健康挑战,他们目前依靠社区的支持来确保自己的健康,并强调需要制定政策,承认移民轨迹的流动性,促进合作,以解决整个移民过程中的健康差异。
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引用次数: 0
The impact of healthcare provision on immigrant pregnancy behaviors: the case of Ramadan fasting in Germany 医疗保健提供对移民怀孕行为的影响:以德国斋月禁食为例
IF 2.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100349
Paul Witte , Fabienne Pradella , Reyn van Ewijk
Germany and other Western countries are home to a growing number of Muslims. This implies that health-related behaviors more common among Muslims are becoming increasingly important in routine healthcare. For example, Ramadan during pregnancy has been shown to be associated with adverse offspring health outcomes along the life course. At the same time, a high share of pregnant Muslims worldwide chooses to fast. In this study, we investigate the dynamics underlying Ramadan fasting during pregnancy in Germany, using survey data (N=326) of Muslims delivering after being pregnant during a Ramadan. In this sample, 36.5 % of women fasted during their recent pregnancy, for an average of 17 days. Respondents generally did not regard fasting during pregnancy as obligatory and women tended to make their own, independent decisions about whether to fast. Most women did not expect fasting to be associated with impaired offspring health, even though many women actively searched for information on Ramadan during pregnancy. They often did so on the internet or by talking to family and friends. Only about one-third of women consulted with their prenatal caregiver about fasting. These consultations were associated with a reduction in days fasted by about 11 days. A sensitization of healthcare providers to Ramadan during pregnancy, and routinely addressing the issue with Muslim families of reproductive age can have important public health benefits.
德国和其他西方国家是越来越多穆斯林的家园。这意味着与健康相关的行为在穆斯林中更为普遍,在日常医疗保健中变得越来越重要。例如,怀孕期间的斋月已被证明与一生中不利的后代健康结果有关。与此同时,全世界有很大一部分怀孕的穆斯林选择斋戒。在这项研究中,我们调查了德国怀孕期间斋月禁食的动态,使用调查数据(N=326)穆斯林在斋月怀孕后分娩。在这个样本中,36.5%的女性在最近怀孕期间禁食,平均为17天。受访者普遍不认为怀孕期间禁食是强制性的,妇女倾向于自己独立决定是否禁食。尽管许多妇女在怀孕期间积极搜索有关斋月的信息,但大多数妇女没想到斋戒与后代健康受损有关。他们经常在网上或通过与家人和朋友交谈来这样做。只有约三分之一的女性就禁食问题咨询了产前护理人员。这些咨询与禁食天数减少约11天有关。提高保健提供者在怀孕期间对斋月的认识,并定期与穆斯林育龄家庭讨论这一问题,可带来重要的公共卫生效益。
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引用次数: 0
Prevalence of peripheral neuropathy, diabetic foot and level of glycemic control in refugees and migrants residing in Greece 希腊难民和移民周围神经病变、糖尿病足和血糖控制水平的患病率
IF 2.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100345
Zisimangelos Solomos , Eftychia Pappa , Nikolaos Tentolouris

Introduction

Data regarding access to diabetic neuropathy (DN) and diabetic foot (DF) examination, as well as the prevalence of these conditions in refugees and migrants (R&M) with diabetes mellitus (DM) residing in European countries are currently lacking. The study’s primary objective was the estimation of DN and DF prevalence among diabetic R&M residing in Greece. Associations between DN diagnosis, demographic characteristics, glycemic control (HbA1c value), housing status and level of access to the National Healthcare System (ESY) were secondarily explored.

Materials and methods

R&M with DM were screened for DN/DF at the Doctors of the World’s central polyclinic in Athens. For DN diagnosis, calculation of the Neuropathy Disability and Neuropathy Symptoms scores for each patient was followed by examination with 10 g Semmes-Weinstein monofilament. Demographic characteristics were also collected. Logistic regression was used for DN correlation with various variables. For HbA1c value association with the variables “Social Security Number (AMKA) possession” (representing access to ESY) and "unstable housing", Shapiro-Wilk regularity and Mann-Whitney tests were used. P < 0.05 was selected as the cutoff for statistical significance.

Results

From 67 patients examined, 47.8 % (n = 32) and 7.5 % (n = 5) were diagnosed with DN and DF respectively, while none had been previously screened for DN in Greece. In the single-factor analysis, age, years of diabetes and AMKA were significantly associated with DN. In the multivariate analysis, only age remained statistically significant. A statistically significant decrease in HbA1c values was observed in AMKA holders. Lower HbA1c values were observed in those with stable housing, but the association was not statistically significant.

Conclusion

A significant percentage of our study participants were diagnosed with DN and DF. Significantly lower HbA1c values were observed in patients with AMKA, thus underlining the importance of improving access to healthcare services for marginalized populations in Greece.
目前缺乏关于糖尿病神经病变(DN)和糖尿病足(DF)检查的数据,以及居住在欧洲国家的患有糖尿病(DM)的难民和移民(R&;M)中这些疾病的患病率。该研究的主要目的是估计居住在希腊的糖尿病R&;M中DN和DF的患病率。其次探讨DN诊断、人口统计学特征、血糖控制(HbA1c值)、住房状况和国家医疗保健系统(ESY)可及程度之间的关系。材料和方法在雅典世界医生中心综合诊所对DM患者进行DN/DF筛查。对于DN的诊断,计算每位患者的神经病变残疾和神经病变症状评分,然后用10 g Semmes-Weinstein单丝检查。还收集了人口统计学特征。采用Logistic回归对DN与各变量的相关性进行分析。对于HbA1c值与“社会安全号码(AMKA)持有”(代表获得ESY)和“不稳定住房”变量的关联,采用Shapiro-Wilk规则和Mann-Whitney检验。P & lt;统计学意义以0.05为截止值。结果在67例患者中,分别有47.8% (n = 32)和7.5% (n = 5)被诊断为DN和DF,而此前在希腊没有人接受过DN筛查。在单因素分析中,年龄、糖尿病年数和AMKA与DN显著相关。在多变量分析中,只有年龄仍然具有统计学意义。在AMKA持有者中观察到HbA1c值有统计学意义上的显著下降。稳定住房组的HbA1c值较低,但相关性无统计学意义。结论我们的研究参与者中有相当比例的人被诊断为DN和DF。在AMKA患者中观察到明显较低的HbA1c值,从而强调了改善希腊边缘化人群获得医疗服务的重要性。
{"title":"Prevalence of peripheral neuropathy, diabetic foot and level of glycemic control in refugees and migrants residing in Greece","authors":"Zisimangelos Solomos ,&nbsp;Eftychia Pappa ,&nbsp;Nikolaos Tentolouris","doi":"10.1016/j.jmh.2025.100345","DOIUrl":"10.1016/j.jmh.2025.100345","url":null,"abstract":"<div><h3>Introduction</h3><div>Data regarding access to diabetic neuropathy (DN) and diabetic foot (DF) examination, as well as the prevalence of these conditions in refugees and migrants (R&amp;M) with diabetes mellitus (DM) residing in European countries are currently lacking. The study’s primary objective was the estimation of DN and DF prevalence among diabetic R&amp;M residing in Greece. Associations between DN diagnosis, demographic characteristics, glycemic control (HbA1c value), housing status and level of access to the National Healthcare System (ESY) were secondarily explored.</div></div><div><h3>Materials and methods</h3><div>R&amp;M with DM were screened for DN/DF at the Doctors of the World’s central polyclinic in Athens. For DN diagnosis, calculation of the Neuropathy Disability and Neuropathy Symptoms scores for each patient was followed by examination with 10 g Semmes-Weinstein monofilament. Demographic characteristics were also collected. Logistic regression was used for DN correlation with various variables. For HbA1c value association with the variables “Social Security Number (AMKA) possession” (representing access to ESY) and \"unstable housing\", Shapiro-Wilk regularity and Mann-Whitney tests were used. <em>P</em> &lt; 0.05 was selected as the cutoff for statistical significance.</div></div><div><h3>Results</h3><div>From 67 patients examined, 47.8 % (<em>n</em> = 32) and 7.5 % (<em>n</em> = 5) were diagnosed with DN and DF respectively, while none had been previously screened for DN in Greece. In the single-factor analysis, age, years of diabetes and AMKA were significantly associated with DN. In the multivariate analysis, only age remained statistically significant. A statistically significant decrease in HbA1c values was observed in AMKA holders. Lower HbA1c values were observed in those with stable housing, but the association was not statistically significant.</div></div><div><h3>Conclusion</h3><div>A significant percentage of our study participants were diagnosed with DN and DF. Significantly lower HbA1c values were observed in patients with AMKA, thus underlining the importance of improving access to healthcare services for marginalized populations in Greece.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"12 ","pages":"Article 100345"},"PeriodicalIF":2.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738663","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}
引用次数: 0
Corrigendum to “The association of migration-related stress with poor mental health among recently resettled Afghan refugees” [Journal of Migration and Health Volume 10, 2024, 100282] “最近重新安置的阿富汗难民中与移徙有关的压力与心理健康状况不佳的关系”的勘误[移徙与健康杂志第10卷,2024年,100282]
IF 2.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100372
Munjireen Sifat , Sarah Kenney , Venera Bekteshi , Shawn C. Chiang , Motolani Ogunsanya , Laili K. Boozary , Adam C. Alexander , Darla E. Kendzor
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引用次数: 0
Meaning and value attributed to non-therapeutic circumcision of boys among Danish parents of Jewish Origin: The formation of parents and families 犹太血统丹麦父母对男孩进行非治疗性包皮环切的意义和价值:父母和家庭的形成
IF 2.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100366
Tania Aase Dræbel, Jane Brandt Sørensen, Dan Wolf Meyrowitsch
Non-therapeutic circumcision of boys (NTCB) has been the subject of a heated public debate in Denmark from around 2010 to 2022. In this debate, the parents' perspective has largely been missing. Until now, very little is known about the meaning with and attribution of value to NTCB by Danish-Jewish parents. In the present study, we have examined social and discursive practices of NTCB among Danish-Jewish parents. The analysis is based on 20 semi-structured interviews with parents about their views and experiences with either choosing or opting out of NTCB. The concepts used in the analysis are Sense of Coherence proposed by medical sociologist Aaron Antonovsky, and Davies and Harré positioning theory of Subjectivation, Becoming, Belonging and Positioning. Using these concepts, the analysis indicates that NTCB may be understood as a cultural act and related to the interviewees' process of becoming parents and a family, actualizing questions of gender, ethnic-cultural identity, origin, family biography, and affiliation to Judaism as well as questions of identity and belonging. Parents viewed NTCB as a valuable and meaningful continuation of culture and tradition. The analysis shows how NTCB is currently articulated and how parents make sense of the practice based on their cultural, social and religious identity and within the current context of Denmark where debates about NTCB are raised. This article makes an important contribution to the understanding of the perspective of Danish-Jewish parents. Knowledge on the cultural and religious reasons for NTCB is critical to inform the debate and decision about a ban on non-therapeutic circumcision of boys in Denmark. Taking the views of Danish-Jewish parents into account will allow us to understand the complexity of the practice as well as reveal new and different ways of making sense of non-therapeutic circumcision of boys.
从2010年到2022年,男孩的非治疗性包皮环切术(NTCB)一直是丹麦公众激烈辩论的主题。在这场辩论中,父母的观点在很大程度上被忽视了。到目前为止,对于丹麦裔犹太人父母对NTCB的意义和价值归属知之甚少。在本研究中,我们研究了在丹麦-犹太父母中NTCB的社会和话语实践。该分析基于对20名家长的半结构化访谈,了解他们对选择或退出NTCB的看法和经历。分析中使用的概念是医学社会学家Aaron Antonovsky提出的“连贯性”(Sense of Coherence),以及Davies和harr主体化、成为、归属和定位的定位理论。利用这些概念,分析表明,NTCB可以被理解为一种文化行为,与受访者成为父母和家庭的过程有关,实现了性别、种族文化认同、血统、家族史、对犹太教的隶属关系以及身份和归属问题。家长认为NTCB是文化和传统的宝贵和有意义的延续。分析显示了目前NTCB是如何表达的,以及父母如何根据他们的文化、社会和宗教身份以及在丹麦提出关于NTCB的辩论的当前背景下理解这种做法。本文对理解丹麦裔犹太父母的视角做出了重要贡献。了解非结核性包皮环切的文化和宗教原因,对于告知丹麦关于禁止对男孩进行非治疗性包皮环切的辩论和决定至关重要。考虑到丹麦犹太父母的观点将使我们能够理解这种做法的复杂性,并揭示新的和不同的方式来理解男孩的非治疗性割礼。
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引用次数: 0
Determinants of institutional delivery service utilization among internally displaced vulnerable populations in Benadir region, Somalia: A community based cross-sectional study 索马里贝纳迪尔地区境内流离失所的弱势群体利用机构提供服务的决定因素:基于社区的横断面研究
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100319
Hassan Abdullahi Dahie, Mohamed Abdullahi Osman, Yusuf Ali Jimale, Falis Ibrahim Mohamud, Hamdi Ahmed Hussein, Mohamed Osman Alasow, Abukar Abdi Osman, Abdirahman Mohamed Abdullahi, Mohamed Maalin Dakane, Dek Abdi Hussein

Background

Every day, nearly 830 women succumb to preventable pregnancy and childbirth-related complications, with 99 % of maternal deaths occurring in developing nations. Maternal mortality is disproportionately higher among women in rural areas and impoverished communities, especially in Sub-Saharan Africa, where approximately 85 % of cases are concentrated. In Somalia, a country grappling with prolonged conflicts and a healthcare system in disarray, maternal mortality remains alarmingly high at 692 per 100,000 live births. Delivery institutions in the IDP camps are mainly operated by humanitarian agencies and offer their services free of charge. We aim to investigate the prevalence of institutional delivery and factors associated with it among internally displaced mothers in Benadir region.

Methods

Community-based survey was conducted in ten Internally Displaced Persons (IDP) camps in the Benadir region of Somalia from September to October 2023. Questionnaires were administered to 410 women who had given birth in the last 6 months. Subsequent to data collection, a logistic regression analysis was performed to reveal associations between covariates of interest and the outcome variable.

Results

The study observed a 25 % prevalence of institutional delivery, with key associations identified. Women who were married during the data collection period had more than twice the odds of opting for healthcare facility deliveries (AOR 2.283, CI: 1.272–4.097), while employed women demonstrated nearly double the odds (AOR 1.916, CI: 1.109–3.312). Those who experienced their first pregnancy before the age of 20 had 1.7 times higher odds of delivering at a health facility (AOR 1.741, CI: 1.088–2.785). ANC attendees displayed over thirteen times the odds of choosing health facilities for delivery (AOR 13.299, CI: 6.752–26.196), and women knowledgeable about danger signs exhibited four times higher odds (AOR: 4.483, CI: 2.381–8.438). On the other hand, home deliveries are driven by various factors such as financial constraints, distant facility locations, urgent labor situations, lack of transportation, facility closures, a preference for the comfort of home, and fear of surgical procedures at health facilities.

Conclusion & recommendation

The study highlights a troublingly low prevalence of institutional delivery compared with the national target, underscoring challenges in promoting healthcare facility utilization for childbirth. To improve rates, interventions should address socio-economic factors, emphasize healthcare benefits, and enhance community awareness of danger signs and antenatal care importance. Tackling access barriers, including financial constraints and facility distance, is pivotal in reducing the preference for home deliveries.
每天,近830名妇女死于可预防的妊娠和分娩相关并发症,其中99%的孕产妇死亡发生在发展中国家。农村地区和贫困社区妇女的孕产妇死亡率高得不成比例,特别是在撒哈拉以南非洲,大约85%的病例集中在那里。在索马里,一个长期冲突和医疗系统混乱的国家,孕产妇死亡率仍然高得惊人,为每10万活产692人。国内流离失所者营地内的运送机构主要由人道主义机构经营,并免费提供服务。我们的目标是调查机构分娩在贝纳迪尔地区国内流离失所母亲中的流行程度及其相关因素。方法于2023年9 - 10月在索马里贝纳迪尔地区的10个国内流离失所者(IDP)营地进行社区调查。对410名在过去6个月内分娩的妇女进行了问卷调查。在数据收集之后,进行逻辑回归分析,以揭示感兴趣的协变量与结果变量之间的关联。结果该研究观察到25%的机构交付率,并确定了关键关联。在数据收集期间,已婚妇女选择在医疗机构分娩的几率是已婚妇女的两倍多(AOR 2.283, CI: 1.272-4.097),而在职妇女的几率几乎是已婚妇女的两倍(AOR 1.916, CI: 1.109-3.312)。那些在20岁之前第一次怀孕的人在医疗机构分娩的几率高出1.7倍(AOR 1.741, CI: 1.088-2.785)。非国大参会者选择卫生设施分娩的几率是参会者的13倍多(AOR: 13.299, CI: 6.752-26.196),了解危险信号的妇女选择分娩的几率是参会者的4倍多(AOR: 4.483, CI: 2.381-8.438)。另一方面,家庭分娩受到各种因素的影响,如财政限制、设施位置遥远、临产情况紧急、缺乏交通工具、设施关闭、偏爱舒适的家庭环境以及害怕在卫生设施进行外科手术。结论,该研究强调,与国家目标相比,机构分娩的流行率低得令人不安,这突显了在促进医疗机构对分娩的利用方面面临的挑战。为了提高比率,干预措施应解决社会经济因素,强调保健福利,并提高社区对危险迹象和产前保健重要性的认识。解决准入障碍,包括财政限制和设施距离,对于减少对在家分娩的偏好至关重要。
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引用次数: 0
Research priorities for cardiometabolic syndrome in humanitarian settings: A global consensus-based agenda 人道主义环境中心脏代谢综合征的研究重点:基于全球共识的议程
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100321
Chaza Akik , Lilian Kiapi , Abla M. Sibai , Stella Njagi , Nancy Zaitouny , Fouad Fouad , Mouna Mayoufi , Mesfin Teklu Tessema
Non-communicable diseases (NCDs) are a leading cause of global morbidity and mortality. The burden of NCDs largely falls on low- and middle- income countries, where the majority of humanitarian crises fall. Already fragile health care systems in acute and protracted crisis settings struggle to meet the increasing needs of people living with NCDs. Cardio-Metabolic Syndrome (CMS), in particular, is of growing concern, with little evidence on effectively managing cardiovascular disease care in emergency settings. A strategy that begins with identifying clear research priorities to inform a collective and integrated CMS care in humanitarian preparedness and response is needed. This study aimed to generate consensus-based research priorities for the humanitarian sector targeting CMS care. This was done by adopting an adapted approach of the Child Health and Nutrition Research Initiative (CHNRI). Our findings highlight the need to prioritize models of care, including processes and outcomes, for people living with CMS and NCDs in humanitarian settings. They also highlight the importance of adopting integrated, multidisciplinary approaches that address research, interventions, and policies involving local and international stakeholders. Sustainable approaches that facilitate continuity of care and ensure integration within existing health care systems are needed to adequately address the growing global burden of CMS and NCDs. The ranked priority questions from this research priority setting exercise serve as guidance for advocacy and the deployment of funds for future research, interventions, and policies.
非传染性疾病是全球发病率和死亡率的一个主要原因。非传染性疾病的负担主要落在低收入和中等收入国家身上,而大多数人道主义危机发生在这些国家。在急性和长期危机环境中,本已脆弱的卫生保健系统难以满足非传染性疾病患者日益增长的需求。特别是心血管代谢综合征(CMS)越来越受到关注,在急诊环境中有效管理心血管疾病护理的证据很少。需要制定一项战略,首先确定明确的研究重点,为人道主义准备和应对中的集体和综合CMS护理提供信息。本研究旨在为针对CMS护理的人道主义部门产生基于共识的研究重点。这是通过采用儿童健康和营养研究倡议(CHNRI)的一种变通办法实现的。我们的研究结果强调,需要优先考虑人道主义环境下CMS和非传染性疾病患者的护理模式,包括过程和结果。它们还强调了采用综合多学科方法处理涉及地方和国际利益攸关方的研究、干预和政策的重要性。为充分解决日益增长的全球CMS和非传染性疾病负担,需要采取可持续的方法,促进护理的连续性并确保与现有卫生保健系统相结合。从这项研究确定优先事项的工作中选出的优先问题可作为未来研究、干预和政策的宣传和资金部署的指导。
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引用次数: 0
Emptying villages, overflowing glasses: Out-migration and drinking patterns in Rural China 村庄空了,杯子满了:中国农村的外迁和饮酒模式
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100311
Yaxin LAN , Lei JIN

Background

Rural-urban migration is a significant phenomenon in China, resulting in family separation and the emergence of left-behind populations in rural communities. Previous research suggests that migration can influence health behaviors through various pathways. However, limited empirical studies have examined the effects of migration on the drinking behavior of adults left behind. Moreover, the impact of migration at the household and community levels remains unclear.

Methods

This study analyzes the relationship between migration and drinking behavior in rural China with data from the China Health and Nutrition Survey (CHNS 1997–2015) (N = 20,264). Multilevel mixed-effects models are employed to test how household and community levels migration status affects rural residents' weekly alcohol intake.

Results

Weekly alcohol intake would increase by 7.51 g (SE = 2.976, p = 0.012) for men and 0.98 g (SE = 0.419, p = 0.019) for women in families whose members have moved out, while the influence of household migration was no longer significant after controlling for community-level effects. One percentage change in community migration rates would increase men's alcohol intake by 0.6319 g (SE = 26.494, p = 0.017) and women's by 0.0823 g (SE = 2.394, p = 0.001).

Conclusions

Our study emphasizes the importance of considering migration at different levels of analysis. The findings indicate that out-migration is associated with increased alcohol consumption among left-behind adults in rural China. Intervention policies should also consider the unique neighborhood relations in rural China, potentially leveraging social ties within rural communities to spread health awareness and reduce alcohol consumption.
农村向城市迁移是中国的一个重要现象,它导致了家庭分离和农村社区留守人口的出现。先前的研究表明,移民可以通过各种途径影响健康行为。然而,有限的实证研究调查了移民对留守成年人饮酒行为的影响。此外,移徙对家庭和社区的影响仍不清楚。方法利用中国健康与营养调查(CHNS 1997-2015) (N = 20,264)的数据,分析中国农村人口迁移与饮酒行为的关系。采用多水平混合效应模型检验家庭和社区水平移民身份对农村居民每周酒精摄入量的影响。结果迁出家庭中男性每周酒精摄入量增加7.51 g (SE = 2.976, p = 0.012),女性每周酒精摄入量增加0.98 g (SE = 0.419, p = 0.019),在控制了社区水平的影响后,家庭迁出的影响不再显著。社区迁移率每变化一个百分点,男性酒精摄入量将增加0.6319 g (SE = 26.494, p = 0.017),女性酒精摄入量将增加0.0823 g (SE = 2.394, p = 0.001)。结论我们的研究强调了在不同层次分析中考虑迁移的重要性。研究结果表明,外迁与中国农村留守成年人饮酒增加有关。干预政策还应考虑中国农村独特的邻里关系,潜在地利用农村社区内的社会关系来传播健康意识和减少酒精消费。
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引用次数: 0
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Journal of Migration and Health
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