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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
Emigration and tobacco smoking among those staying behind 移民和吸烟是留守者的主要原因
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100305
Artjoms Ivlevs , Roswitha M. King
High or growing rates of smoking tobacco and high rates of emigration are salient features of many low- and middle-income countries, yet the links between migration and smoking remain underexplored. We study the effects of household member emigration on the likelihood of smoking among those staying behind in the countries of former Yugoslavia. Using instrumental variable analysis, we find that the emigration of household members reduces the likelihood of smoking, especially among women and older respondents. These findings support the ‘social remittances’ hypothesis that migration contributes to the transfer of smoking-related norms from destination to source countries. Migration may thus contribute to socioeconomic development of source countries by reducing one of the world's biggest health epidemics: smoking.
高吸烟率或不断增长的吸烟率和高移徙率是许多低收入和中等收入国家的显著特点,但移徙与吸烟之间的联系仍未得到充分探讨。我们研究了家庭成员移民对留在前南斯拉夫国家的人吸烟可能性的影响。使用工具变量分析,我们发现家庭成员的移民减少了吸烟的可能性,特别是在女性和老年受访者中。这些发现支持了“社会汇款”假说,即移民有助于将与吸烟有关的规范从目的地国转移到来源国。因此,移徙可以减少世界上最大的健康流行病之一:吸烟,从而促进来源国的社会经济发展。
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引用次数: 0
Improving nutrition for migrant children in Europe through policy: A scoping review 通过政策改善欧洲移民儿童的营养:范围审查
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2024.100290
Rebecca Lawes, Professor Debbi Marais, Professor Mariza Louw, Ms Beatrice Bennett
Nutrition research concerning migrant populations is abundant, with a surplus of prevalence data related to diverse aspects of malnutrition. However, there is a lack of studies on European country interventions. This gap is more pronounced when examining interventions specific to children. The challenges are clear, but the policy impetus for solving them is not. Examining European interventions on nutrition in refugee and asylum-seeking (RAS) children and families allows for an assessment of the unmet needs in the United Kingdom regarding migration, nutrition, child support, and food security.
This scoping review followed the guidelines in the PRISMA Extension for Scoping Reviews, and 20 documents which covered a mixture of policy interventions were eligible. Meaningful comparisons can be made by assessing the interventions made in migrant nutrition from various European countries with varying political approaches to immigration. This creates a fuller picture of the policy landscape for paediatric migrant nutrition, and in due course, policy decisions can be taken.
This scoping review found a lack of diversity in RAS nutrition policies across Europe and a lack of transparency in those in place, likely rooted in the challenging political landscape of increasing RAS populations in Europe. Improving nutrition interventions requires separating food and health from politics. No interventions focusing on the double burden of malnutrition were found. However, policies addressing the double burden in RAS children should be considered as they may be more politically palatable and financially beneficial to implement.
关于流动人口的营养研究是丰富的,与营养不良的各个方面有关的流行数据过剩。然而,缺乏对欧洲国家干预措施的研究。在审查针对儿童的干预措施时,这种差距更为明显。挑战是明确的,但解决这些挑战的政策动力并不明确。考察欧洲在难民和寻求庇护儿童和家庭营养方面的干预措施,可以评估联合王国在移民、营养、儿童支助和粮食安全方面未满足的需求。本次范围审查遵循了PRISMA扩大范围审查的指导方针,20份涵盖混合政策干预措施的文件符合条件。通过评估欧洲各国对移民采取不同政治方法的移民营养干预措施,可以进行有意义的比较。这为儿科流动人口的营养提供了更全面的政策图景,并可在适当时候作出政策决定。这项范围审查发现,整个欧洲的RAS营养政策缺乏多样性,并且这些政策缺乏透明度,这可能源于欧洲RAS人口不断增加的政治环境的挑战。改善营养干预措施需要将粮食和健康与政治分开。没有发现针对营养不良双重负担的干预措施。然而,应该考虑解决RAS儿童双重负担的政策,因为这些政策在政治上更容易接受,在财政上也更有利于实施。
{"title":"Improving nutrition for migrant children in Europe through policy: A scoping review","authors":"Rebecca Lawes,&nbsp;Professor Debbi Marais,&nbsp;Professor Mariza Louw,&nbsp;Ms Beatrice Bennett","doi":"10.1016/j.jmh.2024.100290","DOIUrl":"10.1016/j.jmh.2024.100290","url":null,"abstract":"<div><div>Nutrition research concerning migrant populations is abundant, with a surplus of prevalence data related to diverse aspects of malnutrition. However, there is a lack of studies on European country interventions. This gap is more pronounced when examining interventions specific to children. The challenges are clear, but the policy impetus for solving them is not. Examining European interventions on nutrition in refugee and asylum-seeking (RAS) children and families allows for an assessment of the unmet needs in the United Kingdom regarding migration, nutrition, child support, and food security.</div><div>This scoping review followed the guidelines in the PRISMA Extension for Scoping Reviews, and 20 documents which covered a mixture of policy interventions were eligible. Meaningful comparisons can be made by assessing the interventions made in migrant nutrition from various European countries with varying political approaches to immigration. This creates a fuller picture of the policy landscape for paediatric migrant nutrition, and in due course, policy decisions can be taken.</div><div>This scoping review found a lack of diversity in RAS nutrition policies across Europe and a lack of transparency in those in place, likely rooted in the challenging political landscape of increasing RAS populations in Europe. Improving nutrition interventions requires separating food and health from politics. No interventions focusing on the double burden of malnutrition were found. However, policies addressing the double burden in RAS children should be considered as they may be more politically palatable and financially beneficial to implement.</div></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"11 ","pages":"Article 100290"},"PeriodicalIF":3.9,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143101959","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}
引用次数: 0
Assessing the impact of paternal emigration on children ‘left-behind’—A cohort analysis 评估父亲移民对儿童“留守”的影响——队列分析
IF 3.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100308
Natalia Norori , Lucy Barrass , Maria Theresa Redaniel , Nanette R. Lee , Laura D. Howe , Duleeka Knipe

Background

Previous work has shown that children ‘left-behind’ as a consequence of parental migration experience worse outcomes, although the majority of this evidence focuses on short- rather than long-term effects.

Methods

Using data from the Cebu Longitudinal Health and Nutrition Survey cohort (n = 1651), we assessed the association of paternal emigration (identified based on evidence of remittances sent back by mother's spouse) during childhood with the mental health and educational attainment at age 18 of Filipino children, adjusted for sex, socioeconomic position and paternal education. We explored whether timing of emigration, and household composition modified associations observed.

Findings

Children who had migrant fathers were found to be 1.24 times more likely to have high educational attainment at age 18 than children who did not have migrant fathers, although the association was imprecise (95 % confidence intervals: 0.83-1.85). We found no statistical evidence of a difference between children who experienced paternal migration compared to those who did not in terms of depressive symptoms or suicidal ideation at age 18. There was evidence that experiencing paternal migration in older childhood (≥10 years) was associated with better mental health. We found evidence that household composition modified associations for depressive symptoms.

Interpretation

This study does not suggest a detrimental long-term impact of paternal emigration on children ‘left-behind, either for educational attainment or mental health. This may reflect beneficial effects of paternal migration and/or pre-existing socioeconomic and health differences amongst families who do and do not experience paternal migration.
之前的研究表明,由于父母迁移而“留守”的儿童经历了更糟糕的结果,尽管大多数证据都集中在短期而不是长期的影响上。方法使用宿务纵向健康和营养调查队列(n = 1651)的数据,我们评估了童年时期父亲移民(根据母亲配偶寄回的汇款证据确定)与菲律宾儿童18岁时的心理健康和受教育程度的关系,并根据性别、社会经济地位和父亲的教育程度进行了调整。我们探讨了移民的时间和家庭组成是否改变了观察到的关联。研究发现,有流动父亲的孩子在18岁时获得高教育程度的可能性是没有流动父亲的孩子的1.24倍,尽管这种关联并不精确(95%置信区间:0.83-1.85)。我们没有发现统计证据表明,在18岁时,经历过父亲迁移的儿童与没有经历过父亲迁移的儿童在抑郁症状或自杀意念方面存在差异。有证据表明,在儿童期较大(≥10岁)经历父亲迁移与较好的心理健康相关。我们发现有证据表明家庭构成改变了抑郁症状的关联。本研究并未显示父亲移民对留守儿童的教育成就或心理健康有不利的长期影响。这可能反映了父亲移徙和(或)有父亲移徙和没有父亲移徙的家庭之间先前存在的社会经济和健康差异的有益影响。
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引用次数: 0
Prevalence and factors associated with psychosocial distress and trauma among Rohingya refugees living in Cox’s Bazar and Bhasan Char in Bangladesh 生活在孟加拉国考克斯巴扎尔和巴哈桑查尔的罗兴亚难民的患病率及其与心理社会困扰和创伤相关的因素
IF 2.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100371
Nuruzzaman Khan , Md Badsha Alam , Gemma Tarpey-Brown , M Mofizul Islam , Karen Block

Aim

This study assessed and compared psychosocial distress among Rohingya refugees in Bhasan Char and Cox’s Bazar.

Methods

We conducted a secondary analysis of cross-sectional survey microdata collected by UNHCR in 2023 and 2024, comprising 9087 individuals, including 8274 from the Cox’s Bazar refugee camps and 813 from the Bhasan Char refugee camps. The outcome variable examined was psychosocial distress and/or trauma (yes/no), while the primary explanatory variable was the individual’s location (Cox’s Bazar or Bhasan Char). Multivariable logistic regressions were conducted to examine the association between the outcome variable and explanatory variables, adjusted for potential confounders.

Findings

Psychosocial distress and/or trauma were significantly higher in Bhasan Char (60.8 %) than in Cox’s Bazar (38.4 %). Refugees in Bhasan Char had nearly three times higher odds of distress (aOR: 2.86, 95 % CI: 2.44–3.34, p < 0.01) compared to those in Cox’s Bazar. Significant predictors included perceived lack of safety—those feeling "very unsafe" (aOR: 1.40, 95 % CI: 1.21–1.62, p < 0.01) and those who never walked alone (aOR: 1.29, 95 % CI: 1.04–1.60, p = 0.02)—as well as moderate (aOR: 1.31, 95 % CI: 1.16–1.47) and severe disabilities (aOR: 1.72, 95 % CI: 1.42–2.09), both p < 0.01. Larger household size (5–7 members: aOR: 1.24, 95 % CI: 1.12–1.37 and ≥8 members: aOR: 1.22, 95 % CI: 1.08–1.38, both p < 0.01) and unmet healthcare needs (aOR: 1.24, 95 % CI: 1.13–1.36, p < 0.01) also increased the odds of distress.

Conclusion

Psychosocial distress is significantly higher among Rohingya refugees in Bhasan Char than in Cox’s Bazar, highlighting the need for targeted mental health support in isolated settings.
目的本研究评估并比较了巴桑查尔和考克斯巴扎尔罗兴亚难民的社会心理困扰。方法我们对联合国难民署在2023年和2024年收集的横断面调查微观数据进行了二次分析,其中包括9087人,其中8274人来自Cox 's Bazar难民营,813人来自Bhasan Char难民营。检查的结果变量是心理社会困扰和/或创伤(是/否),而主要解释变量是个体的位置(Cox 's Bazar或Bhasan Char)。进行多变量逻辑回归来检验结果变量和解释变量之间的关联,并对潜在的混杂因素进行调整。Bhasan Char地区的社会心理困扰和/或创伤发生率(60.8%)明显高于Cox 's Bazar地区(38.4%)。与考克斯巴扎尔的难民相比,巴桑查尔的难民遭受痛苦的几率几乎高出三倍(aOR: 2.86, 95% CI: 2.44-3.34, p < 0.01)。重要的预测因素包括感知到缺乏安全——感觉“非常不安全”的人(aOR: 1.40, 95% CI: 1.21-1.62, p < 0.01)和从不独自行走的人(aOR: 1.29, 95% CI: 1.04-1.60, p = 0.02),以及中度残疾(aOR: 1.31, 95% CI: 1.16-1.47)和重度残疾(aOR: 1.72, 95% CI: 1.42-2.09), p < 0.01。较大的家庭规模(5-7人:aOR: 1.24, 95% CI: 1.12-1.37,≥8人:aOR: 1.22, 95% CI: 1.08-1.38, p < 0.01)和未满足的医疗保健需求(aOR: 1.24, 95% CI: 1.13-1.36, p < 0.01)也增加了痛苦的几率。结论巴桑查尔的罗兴亚难民的心理社会困扰明显高于考克斯巴扎尔,这突出了在孤立环境中有针对性的心理健康支持的必要性。
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引用次数: 0
Climate-induced migration and climate immobility in Ghana: A socio-ecological mixed method study 加纳气候引起的移民和气候不流动:一项社会生态混合方法研究
IF 2.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100364
Seth Christopher Yaw Appiah
<div><h3>Background</h3><div>Several communities face the cyclical challenge of living with situations where climate change events and triggers push members to migrate at their own planned and prepared timelines or against their own prepared timelines often termed voluntary and involuntary climate-induced migration. There are others who express no desire to migrate despite the exposure to climate change stressors in addition to those who desire to migrate and or are unable to migrate and may feel trapped due to their exposure to climate change stressors (flood, extreme heat, windstorm and drought). The combined occurrence of these climate change outcomes (Climate change induced migration and Climate immobility) emerges as two polar end complicated socio-environmental challenge with varying socio-economic impacts on livelihoods. This study examines the drivers of climate-induced migration and climate immobility among rural and peri‑urban Ghanaian residents in the northern and upper-east regions of Ghana.</div></div><div><h3>Method</h3><div>The study was anchored on an embedded concurrent mixed method design, with 2125 persons surveyed and 21 interviews conducted across 12 communities in the Talensi and Savelugu district in Upper East and Northern region of Ghana. Multistage cluster sampling and purposive sampling were used to select participants for both quantitative and qualitative component of the study. The dependent variables were climate migration and climate immobility. The independent variables include socio demographic characteristics and participants experience with climate induced displacement. Using a multilevel regression analysis, the determinants of climate migration and climate immobility are analyzed with variables considered significant at <em>p</em> < 0.05. A comparative thematic approach guided the qualitative analysis.</div></div><div><h3>Results</h3><div>The experience of climate-induced migration was reported by 462(21.7%) individuals. Nearly half, 1060(49.9%) respondents were climate change immobile reflected in their show of no intentions of relocating from their present location notwithstanding climate change conditions. The age of residents with persons 36–45 years and above 55 years showed an increased likelihood of being climate immobile. Moreover, income levels were positively associated with climate immobility as individuals with low income (aOR= 1.607;95% CI= 1.247,2.071) had higher odds of being climate immobile. For climate-induced migration, individuals who self-rated their present health condition as poorer than a year ago had a greater likelihood of migrating (aOR=2.690;95%CI=1.744–4.148) compared to those with better health status. The qualitative narratives present the predictability of climate displacement experiences of an annual minimum of 3 to 14 times occurrences heralded by flooding from Bagre Dam spillage.</div></div><div><h3>Conclusion</h3><div>The central and local government authorities must stren
一些社区面临着周期性的挑战,即气候变化事件和触发因素迫使成员按照自己计划和准备的时间表或违背自己准备的时间表(通常称为自愿和非自愿气候引起的移民)迁移。还有一些人尽管面临气候变化的压力,但仍表示没有迁移的意愿,此外还有一些人希望迁移或无法迁移,并可能因面临气候变化的压力(洪水、极端高温、风暴和干旱)而感到被困住。这些气候变化结果(气候变化引起的移民和气候不流动)的综合发生成为两极复杂的社会环境挑战,对生计产生不同的社会经济影响。本研究考察了加纳北部和上东部地区农村和城郊居民中气候引起的移民和气候不流动的驱动因素。该研究采用嵌入式并行混合方法设计,在加纳上东部和北部地区的Talensi和Savelugu地区的12个社区进行了2125人的调查和21次访谈。采用多阶段整群抽样和目的抽样来选择定量和定性研究的参与者。因变量为气候迁移和气候不动。自变量包括社会人口特征和参与者对气候导致的流离失所的经历。使用多水平回归分析,对气候迁移和气候不动的决定因素进行了分析,变量在p <; 0.05水平上被认为是显著的。比较专题方法指导了定性分析。结果共有462人(21.7%)报告了气候迁移经历。近一半(1060人)(49.9%)的受访者认为气候变化不会改变,这反映在他们表示尽管气候变化,但他们无意从目前的位置搬迁。年龄在36-45岁和55岁以上的居民表现出气候不迁移的可能性增加。此外,收入水平与气候不动正相关,低收入个体(aOR= 1.607;95% CI= 1.247,2.071)具有更高的气候不动几率。对于气候导致的移民,自认为目前健康状况比一年前差的个体与健康状况较好的个体相比,迁移的可能性更大(aOR=2.690;95%CI= 1.744-4.148)。定性叙述提出了气候迁移经历的可预测性,每年至少发生3至14次,预示着巴格雷大坝溢流引发的洪水。结论中央和地方政府必须加强气候变化导致的脆弱人群的现有适应能力。
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引用次数: 0
Systematic meta-review on migrant healthcare access: Language barriers and the role of translation 移民医疗保健获取的系统元综述:语言障碍和翻译的作用
IF 2.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100358
Mar Díaz-Millón , María Dolores Olvera-Lobo
A key challenge migrants face is communication, particularly when they move to countries whose local language they do not speak. Language barriers create significant obstacles in accessing essential services, especially healthcare. These barriers hinder communication between migrants and healthcare providers, resulting in unmet medical needs and adverse health outcomes. In this context, the role of translation and cultural mediation as tools to bridge communication gaps becomes critical. This study conducts a meta-review of existing literature to examine the barriers migrants face in accessing healthcare and explore the role of translation in these circumstances. A sample of 38 literature reviews were selected for analysis. The methodology followed PRISMA guidelines, and qualitative data analysis was performed using NVivo software. Four key themes were identified: access to healthcare, translation, impact on migrant health, and challenges for migrant women. The findings reveal that language, cultural, and economic barriers create difficulties for migrants. Language barriers prevent migrants from understanding medical instructions, navigating healthcare systems, and building trust with providers. Although translation services have demonstrated their potential to mitigate these issues, they remain underutilized. The study concludes by emphasizing the urgent need for systemic measures to promote equitable access to healthcare for migrants. Recommendations include integrating professional translation services into healthcare systems, training providers in cultural competency, and addressing the economic barriers that prevent many migrants from seeking care. By prioritizing these strategies, healthcare systems can better meet the needs of diverse migrant populations and foster more inclusive, equitable care.
移民面临的一个关键挑战是沟通,特别是当他们移居到他们不会说当地语言的国家时。语言障碍对获得基本服务,特别是保健服务造成重大障碍。这些障碍阻碍了移徙者与保健提供者之间的沟通,导致医疗需求得不到满足和不良健康后果。在这种背景下,翻译和文化调解作为弥合沟通差距的工具的作用变得至关重要。本研究对现有文献进行了荟萃回顾,以研究移民在获得医疗保健方面面临的障碍,并探讨翻译在这些情况下的作用。选取38篇文献综述作为样本进行分析。方法遵循PRISMA指南,使用NVivo软件进行定性数据分析。确定了四个关键主题:获得保健、翻译、对移徙者健康的影响以及移徙妇女面临的挑战。调查结果显示,语言、文化和经济障碍给移民带来了困难。语言障碍阻碍了移民理解医疗说明,导航医疗系统,并与提供者建立信任。虽然翻译服务已经证明了它们缓解这些问题的潜力,但它们仍然没有得到充分利用。该研究最后强调,迫切需要采取系统措施,促进移民公平获得医疗保健。建议包括将专业翻译服务纳入卫生保健系统,培训提供者的文化能力,以及解决阻碍许多移徙者求医的经济障碍。通过优先考虑这些战略,卫生保健系统可以更好地满足不同流动人口的需求,并促进更包容、更公平的护理。
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引用次数: 0
Multifaceted determinants of depressive symptoms in children migrating back from urban to rural areas: An ecological systems theory approach 从城市回到农村地区的儿童抑郁症状的多方面决定因素:生态系统理论方法
IF 2.9 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-01-01 DOI: 10.1016/j.jmh.2025.100347
Jiaxue Lou , Shuting Kong , Wenkang Zhou , Yawen Xuan , Menmen Wang , Xudong Zhou , Jingjing Lu , Hui Zhu

Background

While many studies have examined mental health and influencing factors of rural Chinese children who migrated back from urban areas, holistic exploration of multifaceted determinants of their depressive symptoms is lacking; this study, drawing on Bronfenbrenner’s ecological systems theory and the process-person-context-time (PPCT) model, investigated multilevel factors’ impact on such symptoms and gender differences.

Methods

A cross-sectional survey was conducted in 2022 in Nanling County (Anhui Province) in China. A sample of 859 school students in grades 5–9 completed assessments measuring their depressive symptoms (using the Children's Depression Inventory, CDI) and different blocks of variables (CONTEXT, PERSON, and PROCESS). The association was examined using hierarchical logistic regression, entering blocks sequentially. Furthermore, we have explored the gender differences.

Results

Among 859 participants included in the current study, depressive symptoms were found in 258 (30.03%) of them, and females suffered more. A more favorable family social context and better personal characteristics of the children were associated with lower odds of depressive symptoms. Better mother-child communication and school belongings significantly related to a lower risk of depressive symptoms, while father-child communication only played a role for males.

Conclusions

Good parent-child communication and a sense of school belonging can protect the mental health of rural children migrating back from urban areas. These research findings highlight the importance of families and schools working together to tackle this challenge of urban-rural migration, moreover, children from disadvantaged families may need extra assistance.
背景:虽然许多研究调查了中国农村儿童从城市回归的心理健康及其影响因素,但缺乏对其抑郁症状的多方面决定因素的整体探索;本研究利用Bronfenbrenner的生态系统理论和过程-人-情境-时间(process-person-上下文-time, PPCT)模型,探讨了多重因素对此类症状和性别差异的影响。方法于2022年在中国安徽省南陵县进行横断面调查。859名5-9年级的学生完成了对他们抑郁症状的评估(使用儿童抑郁量表,CDI)和不同的变量块(CONTEXT, PERSON, and PROCESS)。使用分层逻辑回归,按顺序进入块来检查关联。此外,我们还探讨了性别差异。结果在859名被试中,有258人(30.03%)出现抑郁症状,其中女性多见。更有利的家庭社会环境和更好的儿童个人特征与抑郁症状的几率较低有关。良好的母子沟通和学校物品与较低的抑郁症状风险显著相关,而父子沟通仅对男性起作用。结论良好的亲子沟通和学校归属感能保障农村返乡儿童的心理健康。这些研究结果强调了家庭和学校共同努力解决城乡人口迁移挑战的重要性,此外,来自弱势家庭的儿童可能需要额外的帮助。
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引用次数: 0
期刊
Journal of Migration and Health
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