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Health System Responses to the Health Needs of Refugees and Asylum-seekers in Malaysia: A Qualitative Study

1
Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2 #10-01, Tahir Foundation Building, Singapore 117549, Singapore
2
United Nations High Commissioner for Refugees Malaysia, 570, Jalan Bukit Petaling, Bukit Petaling, Wilayah Persekutuan Kuala Lumpur, Kuala Lumpur 50460, Malaysia
3
Department of Nutrition and Dietetics, Universiti Putra Malaysia, Jalan Upm, Serdang 43400, Selangor, Malaysia
4
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London WC1H 9SH, UK
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(9), 1584; https://doi.org/10.3390/ijerph16091584
Received: 19 March 2019 / Revised: 25 April 2019 / Accepted: 27 April 2019 / Published: 6 May 2019
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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Abstract

Background: This study was conducted to examine the responses and challenges in addressing the health needs of refugees and asylum-seekers in Malaysia from a health systems and policy perspective. Methods: Twenty semi-structured in-depth interviews were conducted with key informants comprising experts, healthcare professionals and program personnel with professional experience in refugee health issues. Deductive and inductive analyses were conducted to identify themes. Results: Our study identified a broad range of actors involved in the response to refugee health locally, of which a greater alignment of interests, collaboration and sharing of responsibility is needed. From a health systems and policy perspective, financial constraints are among the key challenges in addressing the health needs of the refugee and asylum-seeker population in Malaysia. While participants reported high quality healthcare being present in Malaysia, this was not affordable to refugees and asylum seekers. Cultural and language discordance are also key challenges faced by healthcare workers in the delivery of services; accentuating the need for greater cultural competence and language support. Improved access to medication is needed for those with chronic illnesses in order to effectively address the comprehensive health needs of the refugee and asylum-seeker population. Conclusions: Suggested ways forward include adopting a comprehensive health advocacy strategy grounded in the right to healthcare for all; adopting a multi-sectoral approach; tackling the social determinants of health; seeking diversified funding at the global and national level; and improving coordination and collaboration between the various actors. View Full-Text
Keywords: Malaysia; refugees; asylum-seekers; urban refugees; health needs; health systems; health policy; forced migration Malaysia; refugees; asylum-seekers; urban refugees; health needs; health systems; health policy; forced migration
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Chuah, F.L.H.; Tan, S.T.; Yeo, J.; Legido-Quigley, H. Health System Responses to the Health Needs of Refugees and Asylum-seekers in Malaysia: A Qualitative Study. Int. J. Environ. Res. Public Health 2019, 16, 1584.

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