Special Issue "The Health and Wellbeing of Migrant Populations"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Global Health".

Deadline for manuscript submissions: 20 September 2020.

Special Issue Editors

Dr. Helena Legido-Quigley
Website
Guest Editor
Saw Swee Hock School of Public Health, National University of Singapore, Singapore and London School of Hygiene and Tropical Medicine, Singapore 119077, Singapore
Interests: migrant health; patient’s experiences; health systems and policies
Dr. Montserrat Gea-Sánchez
Website1 Website2 Website3
Guest Editor
GESEC group, Faculty of Nursing and Physiotherapy, University of Lleida. GRECS group, Institute of Biomedial Research in Lleida (IRBLleida). GLOMHI: Global Migration and Health Initiative, University of Toronto
Interests: migrant health; social determinants of health; health systems and services

Special Issue Information

Dear Colleagues,

In 2018, there were an estimated 1 billion migrants in the world, of whom more than a quarter were international migrants. Furthermore, the number of forcibly displaced migrants worldwide has risen to 65 million, with nearly 26 million refugees and asylum seekers. Whilst international migrants need to access health services in thier migration journey and once they arrive to their new host country, very little is known about the health and health system needs of these populations.

This Special Issue aims to contribute to knowledge and policy design and implementation by providing much needed evidence on international migration. We welcome papers on international migration, including migrant workers in precarious work, refugees, and asylum seekers. We welcome research that focuses on migration movements in high-income countries as well as, and perhaps more importantly, on research focusing on the large migration flows from Global South countries. We encourage papers describing issues pertaining to migrants’ access to healthcare services (covering both infectious and non-communicable diseases); analyzing migrants’ social and health inequalities; exploring the ways in which international, national and local organizations are addressing migrant health; and the implications of such movements on public policy and population health. Papers should focus on research and interventions that focus on barriers to be overcome, including aspects related to migrants themselves such as cultural norms and gender roles, as well as focusing on the broader regulatory and legal frameworks. We also welcome research that describes positive inititives that are currently taking place to address the needs of migrants whilst also accounting for the differences in context.

This Special Issue seeks quantitative and qualitative studies as well as mixed-methods studies. High-quality systematic reviews will be also considered. We especially welcome research projects that adopt a multisectoral and multidisplinary approach.

Dr. Helena Legido-Quigley
Dr. Montserrat Gea-Sánchez
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Migrants
  • Refugees
  • Asylum seekers
  • Migrant health
  • Access to health care
  • Health inequalities
  • Health systems
  • Social determinants of health
  • Policy analysis
  • Multidisciplinary research
  • Systematic review
  • Qualitative research
  • Quantitative research
  • Mixed methods

Published Papers (16 papers)

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Research

Open AccessArticle
The Policy Information Gap and Resettlers’ Well-Being: Evidence from the Anti-Poverty Relocation and Resettlement Program in China
Int. J. Environ. Res. Public Health 2020, 17(8), 2957; https://doi.org/10.3390/ijerph17082957 - 24 Apr 2020
Abstract
The widespread dissemination of policy information is necessary for the success of the public policy, but the distribution of information among vulnerable groups has received little attention. We examined a public policy that focuses on the poorest people in China, the anti-poverty relocation [...] Read more.
The widespread dissemination of policy information is necessary for the success of the public policy, but the distribution of information among vulnerable groups has received little attention. We examined a public policy that focuses on the poorest people in China, the anti-poverty relocation and settlement program (ARSP). The infrastructure in the region where the policy is implemented is weak, and the information literacy of resettlers is low. This study analyses the impact of the policy information gap on the subjective well-being of resettlers. We found that the distribution of policy information among the poor is uneven, and the resettlers compare the policy information they obtain with a reference group (working-age people and less-educated people in the same village/community) to generate a policy information gap. The policy information gap indirectly affects subjective well-being by affecting the probability that people will be exposed to risks due to policy. As the policy information gap increases, the subjective well-being of resettlers changes in an inverted U-shape. This impact varies significantly among different groups, policy implementation stages, and resettlement methods. Attention should be paid to the information acquisition ability of the vulnerable groups and the welfare effects of social comparison, and to improve the method of publicizing policy information, which helps to improve the well-being of resettlers. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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Open AccessArticle
Contact Mixing Patterns and Population Movement among Migrant Workers in an Urban Setting in Thailand
Int. J. Environ. Res. Public Health 2020, 17(7), 2237; https://doi.org/10.3390/ijerph17072237 - 26 Mar 2020
Abstract
Data relating to contact mixing patterns among humans are essential for the accurate modeling of infectious disease transmission dynamics. Here, we describe contact mixing patterns among migrant workers in urban settings in Thailand, based on a survey of 369 migrant workers of three [...] Read more.
Data relating to contact mixing patterns among humans are essential for the accurate modeling of infectious disease transmission dynamics. Here, we describe contact mixing patterns among migrant workers in urban settings in Thailand, based on a survey of 369 migrant workers of three nationalities. Respondents recorded their demographic data, including age, sex, nationality, workplace, income, and education. Each respondent chose a single day to record their contacts; this resulted in a total of more than 8300 contacts. The characteristics of contacts were recorded, including their age, sex, nationality, location of contact, and occurrence of physical contact. More than 75% of all contacts occurred among migrants aged 15 to 39 years. The contacts were highly clustered in this age group among migrant workers of all three nationalities. There were far fewer contacts between migrant workers with younger and older age groups. The pattern varied slightly among different nationalities, which was mostly dependent upon the types of jobs taken. Half of migrant workers always returned to their home country at most once a year and on a seasonal basis. The present study has helped us gain a better understanding of contact mixing patterns among migrant workers in urban settings. This information is useful both when simulating disease epidemics and for guiding optimal disease control strategies among this vulnerable section of the population. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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Open AccessArticle
The Impact of Spousal Migration on the Mental Health of Nepali Women: A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2020, 17(4), 1292; https://doi.org/10.3390/ijerph17041292 - 17 Feb 2020
Abstract
Spousal separation, lack of companionship, and increased household responsibilities may trigger mental health problems in left-behind female spouses of migrant workers. This study aimed to examine mental ill-health risk in the left-behind female spouses of international migrant workers in Nepal. A cross-sectional survey [...] Read more.
Spousal separation, lack of companionship, and increased household responsibilities may trigger mental health problems in left-behind female spouses of migrant workers. This study aimed to examine mental ill-health risk in the left-behind female spouses of international migrant workers in Nepal. A cross-sectional survey was carried out in the Nawalparasi district. Study areas were purposively chosen; however, participants were randomly selected. Nepali versions of the 12-item General Health Questionnaire (GHQ), Beck Depression Inventory (BDI), and Connor–Davidson Resilience Scale (CD-RISC) were used. Mental ill-health risk was prevalent in 3.1% of the participants as determined by GHQ. BDI identified mild or moderate depression in 6.5% of the participants with no one having severe depression. In bivariate analysis, a high frequency of communication with the husband was associated with lower mental ill-health risk and depression, as well as increasing resilience. Reduced return intervals of husbands and a high frequency of remittance were also associated with a low GHQ score. In a multiple regression model, adjusting for potential confounding variables, participants who communicated with their husbands at least once a day had a greater mean CD-RISC score (i.e., high resilience against mental ill-health risk) compared to those who did so at least once a week; a mean difference of 3.6 (95% CI 0.4 to 6.9), P = 0.03. To conclude, a low mental ill-health risk was found in the female spouses of migrants. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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Open AccessArticle
The Role of Emotional Intelligence and Sociocultural Adjustment on Migrants’ Self-reported Mental Well-Being in Spain: A 14 Month Follow-Up Study
Int. J. Environ. Res. Public Health 2020, 17(4), 1206; https://doi.org/10.3390/ijerph17041206 - 13 Feb 2020
Abstract
The analysis of mental and psychological health is a relevant public issue in modern societies. Migration is a process that may have a lasting impact on a person’s mental well-being. In this study, perceived health, emotional intelligence, sociocultural adjustment and the participants’ perceived [...] Read more.
The analysis of mental and psychological health is a relevant public issue in modern societies. Migration is a process that may have a lasting impact on a person’s mental well-being. In this study, perceived health, emotional intelligence, sociocultural adjustment and the participants’ perceived general situation, not only economical, were analyzed to attest their impact on psychological distress as a measure of mental well-being. Sixty-three migrants from Romania and Ecuador were contacted twice during a 14 month period in a middle-sized Spanish city. Attrition analyses show no significant differences in perceived psychological distress between those who participated only one time or who participated in both waves. Less psychological distress is related to less attention to one’s feelings and higher mood repair in both data waves. Stronger behavioral adjustment is also linked to less distress. Less distress in time 1 led to better perceived health, sociocultural adjustment and a perception of a better general situation in Spain in comparison to their home country in time 2. In general, more attention to negative feelings triggered more perceived psychological distress, whereas mood repair elicited less psychological distress, in time 2. The relevance of understanding the impact of emotional intelligence to health promotion programs with migrants is discussed. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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Open AccessArticle
School-Class Co-Ethnic and Immigrant Density and Current Smoking among Immigrant Adolescents
Int. J. Environ. Res. Public Health 2020, 17(2), 598; https://doi.org/10.3390/ijerph17020598 - 17 Jan 2020
Abstract
Although the school-class is known to be an important setting for adolescent risk behavior, little is known about how the ethnic composition of a school-class impacts substance use among pupils with a migration background. Moreover, the few existing studies do not distinguish between [...] Read more.
Although the school-class is known to be an important setting for adolescent risk behavior, little is known about how the ethnic composition of a school-class impacts substance use among pupils with a migration background. Moreover, the few existing studies do not distinguish between co-ethnic density (i.e., the share of immigrants belonging to one’s own ethnic group) and immigrant density (the share of all immigrants). This is all the more surprising since a high co-ethnic density can be expected to protect against substance use by increasing levels of social support and decreasing acculturative stress, whereas a high immigrant density can be expected to do the opposite by facilitating inter-ethnic conflict and identity threat. This study analyses how co-ethnic density and immigrant density are correlated with smoking among pupils of Portuguese origin in Luxembourg. A multi-level analysis is used to analyze data from the Luxembourg Health Behavior in School-Aged Children study (N = 4268 pupils from 283 classes). High levels of co-ethnic density reduced current smoking. In contrast, high levels of immigrant density increased it. Thus, in research on the health of migrants, the distinction between co-ethnic density and immigrant density should be taken into account, as both may have opposite effects. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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Open AccessArticle
HIV Care Outcomes among Hispanics/Latinos with Diagnosed HIV in the United States by Place of Birth-2015–2018, Medical Monitoring Project
Int. J. Environ. Res. Public Health 2020, 17(1), 171; https://doi.org/10.3390/ijerph17010171 - 25 Dec 2019
Abstract
Relocation from one’s birthplace may affect human immunodeficiency virus (HIV) outcomes, but national estimates of HIV outcomes among Hispanics/Latinos by place of birth are limited. We analyzed Medical Monitoring Project data collected in 2015–2018 from 2564 HIV-positive Hispanic/Latino adults and compared clinical outcomes [...] Read more.
Relocation from one’s birthplace may affect human immunodeficiency virus (HIV) outcomes, but national estimates of HIV outcomes among Hispanics/Latinos by place of birth are limited. We analyzed Medical Monitoring Project data collected in 2015–2018 from 2564 HIV-positive Hispanic/Latino adults and compared clinical outcomes between mainland US-born (referent group), Puerto Rican (PR-born), and those born outside the United States (non-US-born). We reported weighted percentages of characteristics and used logistic regression with predicted marginal means to examine differences between groups (p < 0.05). PR-born Hispanics/Latinos were more likely to be prescribed antiretroviral therapy (ART) (94%) and retained in care (94%) than mainland-US-born (79% and 77%, respectively) and non-US-born (91% and 87%, respectively) Hispanics/Latinos. PR-born Hispanics/Latinos were more likely to have sustained viral suppression (75%) than mainland-US-born Hispanics/Latinos (57%). Non-US-born Hispanics/Latinos were more likely to be prescribed ART (91% vs. 79%), retained in care (87% vs. 77%), and have sustained viral suppression (74% vs. 57%) than mainland-US-born Hispanics/Latinos. Greater Ryan White HIV/AIDS-funded facility usage among PR-born, better mental health among non-US-born, and less drug use among PR-born and non-US-born Hispanics/Latinos may have contributed to better HIV outcomes. Expanding programs with comprehensive HIV/AIDS services, including for mental health and substance use, may reduce HIV outcome disparities among Hispanics/Latinos. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
Open AccessArticle
Living a Healthy Life in Australia: Exploring Influences on Health for Refugees from Myanmar
Int. J. Environ. Res. Public Health 2020, 17(1), 121; https://doi.org/10.3390/ijerph17010121 - 23 Dec 2019
Abstract
Background: Humanitarian migrants from Myanmar represent a significant refugee group in Australia; however, knowledge of their health needs and priorities is limited. This study aims to explore the meaning and influencers of health from the perspectives of refugees from Myanmar. Method: Using a [...] Read more.
Background: Humanitarian migrants from Myanmar represent a significant refugee group in Australia; however, knowledge of their health needs and priorities is limited. This study aims to explore the meaning and influencers of health from the perspectives of refugees from Myanmar. Method: Using a community-based participatory research (CBPR) design, a partnership was formed between the researchers, Myanmar community leaders and other service providers to inform study design. A total of 27 participants were recruited from a government-funded English language program. Data were collected using a short demographic survey and four focus groups, and were analysed using descriptive statistics and thematic analysis methods. Results: Key themes identified included: (1) health according to the perspectives of Australian settled refugees from Myanmar, (2) social connections and what it means to be part of community, (3) work as a key influence on health, and (4) education and its links with work and health. Conclusions: This study outlined the inter-relationships between health, social connections, work and education from the perspectives of refugees from Myanmar. It also outlined how people from Myanmar who are of a refugee background possess strengths that can be used to manage the various health challenges they face in their new environment. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
Open AccessArticle
Nothing Like Living with a Family: A Qualitative Study of Subjective Well-Being and its Determinants among Migrant and Local Elderly in Dongguan, China
Int. J. Environ. Res. Public Health 2019, 16(23), 4874; https://doi.org/10.3390/ijerph16234874 - 03 Dec 2019
Abstract
Chinese economic development has led to a significant rise in internal migration over the last 20 years, including large numbers of elderly. When elderly Chinese people migrate, they still register their residency to their place of origin and often do not register with [...] Read more.
Chinese economic development has led to a significant rise in internal migration over the last 20 years, including large numbers of elderly. When elderly Chinese people migrate, they still register their residency to their place of origin and often do not register with the new administrative office at the destination due to the household registration (hukou) system in China. Thus, most of these migrant elderly do not receive full social services, possibly leading to poor subjective well-being. This study aims to qualitatively examine the level of subjective well-being and its determinants among migrants and local elderly in Dongguan City of Guangdong province, one of the most rapid economically developing areas in China. We also present the results of in-depth interviews among 27 elderly, 15 elderly migrants and 12 local elderly living in Dongguan. The results reveal that the overall subjective well-being of the two groups were good. Most migrants believed their well-being had remained stable or even improved over time due to family reunion and a better physical environment. Elderly’s most valuable needs and the main reason of migration is family reunion; however, inadequacy of social support, including community support and government support (e.g., gift during holiday season, free health examination, healthcare expenditure reimbursement), cannot be neglected for maintaining a good level of well-being. The well-being of migrant elderly can be further enhanced by promoting social services and welfare, recreational activities, and enhancing healthcare reimbursement in their new home. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
Open AccessArticle
Professional and Volunteer Refugee Aid Workers–Depressive Symptoms and Their Predictors, Experienced Traumatic Events, PTSD, Burdens, Engagement Motivators and Support Needs
Int. J. Environ. Res. Public Health 2019, 16(22), 4542; https://doi.org/10.3390/ijerph16224542 - 17 Nov 2019
Cited by 3
Abstract
In 2016, the Department of Psychosomatic Medicine and Psychotherapy of the University Hospital of Erlangen started conducting training for professional and voluntary aid workers. In total, 149 aid workers took part in the training courses, of which 135 completed the corresponding questionnaires. Engagement [...] Read more.
In 2016, the Department of Psychosomatic Medicine and Psychotherapy of the University Hospital of Erlangen started conducting training for professional and voluntary aid workers. In total, 149 aid workers took part in the training courses, of which 135 completed the corresponding questionnaires. Engagement motivators, perceived distress in refugee work and training needs were examined. Moreover, depressive symptoms, the prevalence of traumatic experiences and symptoms of posttraumatic stress disorder were explored. Participants named helping others as the highest motivating factor for their work with refugees and communication problems as the main burden. Thirteen aid workers (10.1%) showed clinically relevant depressive symptoms. In total, 91.4% of refugee aid workers had experienced at least one traumatic event personally or as a witness but only three (3.6%) fulfilled the psychometric requirements of a PTSD diagnosis. These three participants all belonged to the professional aid workers (6.3%). More severe symptoms of depression were significantly associated with female gender (β = 0.315, p = 0.001), higher perceived burdens of refugee work (β = 0.294, p = 0.002), and a larger number of experienced traumatic events (β = 0.357, p < 0.001). According to our results, we recommend psychological trainings and regular screenings for psychological stress in order to counteract possible mental illnesses. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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Open AccessArticle
Exploring the Experiences of West African Immigrants Living with Type 2 Diabetes in the UK
Int. J. Environ. Res. Public Health 2019, 16(19), 3516; https://doi.org/10.3390/ijerph16193516 - 20 Sep 2019
Abstract
The increasing prevalence and poorer management of Type 2 diabetes among West African immigrants in the UK is a public health concern. This research explored the experiences of West African immigrants in the management of Type 2 diabetes in the UK using a [...] Read more.
The increasing prevalence and poorer management of Type 2 diabetes among West African immigrants in the UK is a public health concern. This research explored the experiences of West African immigrants in the management of Type 2 diabetes in the UK using a constructivist grounded theory approach. In-depth individual interviews were conducted with thirty-four West African immigrants living with Type 2 diabetes in the London area. Fifteen male and nineteen female adult West African immigrants with age range from 33–82 years participated in the study. Participants were recruited from five diabetes support groups and community settings. Initial, focused and theoretical coding, constant comparison and memos were used to analyse collected data. Three concepts emerged: Changing dietary habits composed of participants’ experiences in meeting dietary recommendations, improving physical activity concerned with the experience of reduced physical activity since moving to the UK and striving to adapt which focus on the impact of migration changes in living with Type 2 diabetes in the UK. These address challenges that West African immigrants experience in the management of Type 2 diabetes in the UK. The findings of this research provide a better understanding of the influencing factors and can be used to improve the support provided for West Africans living with Type 2 diabetes in the UK, presenting a deeper understanding of socio-cultural factors that contribute to supporting individuals from this population. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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Open AccessArticle
Generalized Violence as a Threat to Health and Well-Being: A Qualitative Study of Youth Living in Urban Settings in Central America’s “Northern Triangle”
Int. J. Environ. Res. Public Health 2019, 16(18), 3465; https://doi.org/10.3390/ijerph16183465 - 18 Sep 2019
Abstract
El Salvador, Guatemala, and Honduras rank among the top 10 countries experiencing violence in the world, despite not being at war. Although there is abundant literature on generalized violence in this “northern triangle” of Central America as a driver of out-migration to the [...] Read more.
El Salvador, Guatemala, and Honduras rank among the top 10 countries experiencing violence in the world, despite not being at war. Although there is abundant literature on generalized violence in this “northern triangle” of Central America as a driver of out-migration to the United States, very little is known about the perspectives and experiences of youth who do not migrate. This study aimed to elicit the emic perspectives of youth residing in the region on how the day-to-day generalized violence produces a pervasive threat to the overall health and human security of youth as well as the key protective factors and resiliencies at work. We conducted two separate waves of qualitative research in 2015 and 2018 over a 6-month period, which included 60 in-depth interviews and six focus groups among Salvadoran, Guatemalan and Honduran youth living in urban areas. Qualitative thematic analysis revealed two meta-themes: (1) ‘Lack of health,’ defined as not experiencing peace within the family, the community, and the country’ and (2) ‘Resilience.’ Thematic clusters that reflect the first meta-theme are: (1) violence as a common occurrence; (2) living in fear and insecurity; (3) victimization; and (4) lack of state protection and services. Thematic clusters for the second meta-theme are: (1) a positive future outlook and a commitment to education; (2) transnational and local family network support; and (3) engagement in community-based youth groups. To interpret the findings, we adopt the Latin American Social Medicine and Collective Health (LASM-CH) approach that prioritizes perspectives from the region. Generalized violence is conceptualized as a systemic phenomenon that is generated and reproduced through the complex interactions of structural inequities and unequal power relations. The findings of this study provide new insights into the implementation of a different approach to address the generalized violence, insights that may guide multi-sectoral health policies and interventions both in the region and transnationally. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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Open AccessArticle
Factors Associated with Access of Marital Migrants and Migrant Workers to Healthcare in Taiwan: A Questionnaire Survey with Quantitative Analysis
Int. J. Environ. Res. Public Health 2019, 16(16), 2830; https://doi.org/10.3390/ijerph16162830 - 08 Aug 2019
Cited by 1
Abstract
In Taiwan, migrants come mostly for marriage and work. Several researchers have conducted health-related studies of marital migrants and migrant workers, but the access of the two groups to healthcare has not been studied. Therefore, our study investigated the factors associated with migrants’ [...] Read more.
In Taiwan, migrants come mostly for marriage and work. Several researchers have conducted health-related studies of marital migrants and migrant workers, but the access of the two groups to healthcare has not been studied. Therefore, our study investigated the factors associated with migrants’ access to healthcare, with the main foci being marital migrants and migrant workers in Taiwan. A structured and cross-sectional questionnaire was anonymously self-administered by migrants recruited to participate in this survey on a voluntary basis from 11 medical centers and 11 migrant-helping associations in Taiwan between May 1st and September 21st, 2018. A total of 753 questionnaires were analyzed. The majority of marital migrants (n = 243) and migrant workers (n = 449) surveyed were enrolled in Taiwan’s National Health Insurance system (92.7 vs. 93.5%, p = 0.68). More of the migrant workers (n = 205) than the marital migrants (n = 42) encountered language barriers while seeking medical services (48.0 vs. 17.1%, p < 0.001). A professional interpreter at the point of care was considered important by more of the migrant workers (n = 316) than the marital migrants (n = 89) (70.2 vs. 39.6%, p < 0.001). Although more than 90% of the surveyed migrants were enrolled in the health insurance system in Taiwan, many, especially among the migrant workers, still faced language barriers while seeking medical services. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
Open AccessArticle
Evaluating the Provision of Health Services and Barriers to Treatment for Chronic Diseases among Syrian Refugees in Turkey: A Review of Literature and Stakeholder Interviews
Int. J. Environ. Res. Public Health 2019, 16(15), 2660; https://doi.org/10.3390/ijerph16152660 - 25 Jul 2019
Cited by 3
Abstract
Background: While Turkey hosts the largest number of Syrian refugees, the provision of health services for chronic disease among Syrian refugees in Turkey has been inadequate and understudied. This paper explores Turkish healthcare policies surrounding Syrian refugees’ access to health services for chronic [...] Read more.
Background: While Turkey hosts the largest number of Syrian refugees, the provision of health services for chronic disease among Syrian refugees in Turkey has been inadequate and understudied. This paper explores Turkish healthcare policies surrounding Syrian refugees’ access to health services for chronic diseases. Methods: We conducted a literature review and supplementary stakeholder interviews to evaluate the provision of chronic health services and the most common barriers to healthcare access among Syrian refugees in Turkey. Results: Though access to treatment for displaced Syrians has improved throughout the past five years, five primary barriers persist: registration procedure regulations, navigation of a new health system, language barriers, fear of adverse treatment, and cost. Conclusions: To drive improvements in healthcare for chronic diseases among Syrian refugees in Turkey, we recommend making registration procedures more accessible, developing more healthcare options in patients’ native language, increasing human resources, and advocating for more research surrounding chronic health conditions among refugees. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
Open AccessArticle
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(9), 1584; https://doi.org/10.3390/ijerph16091584 - 06 May 2019
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, [...] Read more.
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. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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Open AccessArticle
Why I Can’t, Won’t or Don’t Test for HIV: Insights from Australian Migrants Born in Sub-Saharan Africa, Southeast Asia and Northeast Asia
Int. J. Environ. Res. Public Health 2019, 16(6), 1034; https://doi.org/10.3390/ijerph16061034 - 21 Mar 2019
Cited by 3
Abstract
People born in sub-Saharan Africa and Southeast Asia are overrepresented in HIV notifications in Australia. Just under half of all notifications among people from sub-Saharan Africa and Southeast Asia are diagnosed late. Increased HIV testing among these communities is necessary to ensure early [...] Read more.
People born in sub-Saharan Africa and Southeast Asia are overrepresented in HIV notifications in Australia. Just under half of all notifications among people from sub-Saharan Africa and Southeast Asia are diagnosed late. Increased HIV testing among these communities is necessary to ensure early diagnosis, better care and reduce likelihood of HIV onward transmission. Recently, Australia has made new HIV testing methods available: rapid HIV testing and self-testing kits. We conducted 11 focus groups with 77 participants with people from sub-Saharan Africa, Southeast Asia and Northeast Asia in four jurisdictions in Australia. Focus groups discussed barriers to HIV testing and the acceptability of new testing methods. Barriers to HIV testing included: cost and eligibility of health services, low visibility of HIV in Australia, HIV-related stigma, and missed opportunities by general practitioners (GPs) for early diagnosis of HIV and linkage into care. Participants had low levels of knowledge on where to test for HIV and the different methods available. Diverse opportunities for testing were considered important. Interventions to increase HIV testing rates among sub-Saharan African, Southeast Asia and Northeast Asian migrants in Australia need to be multi-strategic and aimed at individual, community and policy levels. New methods of HIV testing, including rapid HIV testing and self-testing, present an opportunity to engage with migrants outside of traditional health care settings. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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Open AccessArticle
The Devil Is in the Detail—Understanding Divergence between Intention and Implementation of Health Policy for Undocumented Migrants in Thailand
Int. J. Environ. Res. Public Health 2019, 16(6), 1016; https://doi.org/10.3390/ijerph16061016 - 20 Mar 2019
Cited by 5
Abstract
Migrants’ access to healthcare has attracted attention from policy makers in Thailand for many years. The most relevant policies have been (i) the Health Insurance Card Scheme (HICS) and (ii) the One Stop Service (OSS) registration measure, targeting undocumented migrants from neighbouring countries. [...] Read more.
Migrants’ access to healthcare has attracted attention from policy makers in Thailand for many years. The most relevant policies have been (i) the Health Insurance Card Scheme (HICS) and (ii) the One Stop Service (OSS) registration measure, targeting undocumented migrants from neighbouring countries. This study sought to examine gaps and dissonance between de jure policy intention and de facto implementation through qualitative methods. In-depth interviews with policy makers and local implementers and document reviews of migrant-related laws and regulations were undertaken. Framework analysis with inductive and deductive coding was undertaken. Ranong province was chosen as the study area as it had the largest proportion of migrants. Though the government required undocumented migrants to buy the insurance card and undertake nationality verification (NV) through the OSS, in reality a large number of migrants were left uninsured and the NV made limited progress. Unclear policy messages, bureaucratic hurdles, and inadequate inter-ministerial coordination were key challenges. Some frontline implementers adapted the policies to cope with their routine problems resulting in divergence from the initial policy objectives. The study highlighted that though Thailand has been recognized for its success in expanding insurance coverage to undocumented migrants, there were still unsolved operational challenges. To tackle these, in the short term the government should resolve policy ambiguities and promote inter-ministerial coordination. In the long-term the government should explore the feasibility of facilitating lawful cross-border travel and streamlining health system functions between Thailand and its neighbours. Full article
(This article belongs to the Special Issue The Health and Wellbeing of Migrant Populations)
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