Search Results (42)

Gestational weight gain (GWG) is a critical determinant of maternal and neonatal health, yet its patterns and consequences in displaced populations remain understudied. This study examined the association between GWG and birth outcomes among Forcibly Displaced Rohingya (FDR) women in Cox’s Bazar, Bangladesh. We conducted a longitudinal cohort study from October 2022 to October 2024, enrolling 2888 pregnant women at different stages of pregnancy. Among them, 301 were recruited in the first trimester and followed through the third trimester, with 231 neonatal outcomes recorded within 72 hours of delivery. Overall, 66.8% of women experienced inadequate GWG. Despite the high prevalence of inadequate GWG, mean birth weight (2.79 kg) and mean gestational age at delivery (38.6 weeks) were within favorable ranges. Inadequate GWG was more common in mothers aged 30–39 years (p = 0.061) but significantly less common in underweight mothers (p = 0.012). GWG was positively associated with neonatal birth weight, length, and weight–length ratio (WLR) Z score, but not with gestational age. After adjusting for confounding factors, inadequate GWG showed a significant independent association with lower birth length (p = 0.016). These findings highlight the need for targeted interventions in displaced populations. Full article

The UNHCR reported that over 123.2 million people were forcibly displaced worldwide by the end of 2024, with the mental health of refugees emerging as a critical issue. In the UK, asylum seekers and refugees make up around 13% of immigrants and the number is increasing year on year. The Immigration and Asylum Act 1999 aimed to ensure that most cases of asylum seekers would be decided fairly, and within six months. However, it has been argued that long wait times and systemic inequalities and inequities within the asylum system have contributed to heightened mental health problems among refugees even once they gain refugee status. The present study aimed to examine the factors that refugees perceive as limiting their ability and willingness to access mental health services in the UK. A systematic review of 15 relevant articles followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Results highlight intersecting perceived limitations to accessing mental health services, such as language difficulties, cultural disconnection regarding mental health including stigma and prejudice, mistrust of services as well as structural barriers including general service limitations and the involuntary transient nature of many refugees’ lives. Policy recommendations emphasize integrating ethnic minority organizations into services, developing culturally adapted services that take into consideration the views of refugees, and ensuring holistic approaches to address socio-economic determinants. Full article

Background: Migrant populations are commonly under-immunised relative to general populations in host countries. The evidence base on routine vaccination among migrant children suggests that higher priority is given to infants and younger children compared to adolescents. Though migrants are often classified as a homogenous group, different sub-populations of migrants exist, including voluntary migrants who choose to move and involuntary migrants forcibly displaced by humanitarian crises. The human papillomavirus (HPV) vaccine, a relatively recent addition to global routine immunisation schedules for adolescents, is a useful proxy for understanding vaccine equity for this under-prioritised group. This qualitative systematic review explores health system determinants of delivery and uptake of HPV vaccination services among involuntary migrants. Methods: A literature search was conducted across ten electronic databases. An analytical framework tailored to the migrant context aided in capturing the complexity and magnitude of systemic factors that determine vaccine delivery and uptake among involuntary migrants. Of the 676 records retrieved, 27 studies were included in this review. Results: Key determinants of vaccine delivery include adaptation of immunisation policies for migrant inclusiveness, implementation of migrant-targeted interventions, health provider recommendations, electronic health records, and free vaccines. Uptake determinants include access dependent on legal status, awareness-related determinants akin to culturally appropriate health messaging, and acceptance-related determinants associated with sociocultural beliefs, misinformation, and distrust. Conclusions: Prioritising vaccination programmes linked with non-outbreak-related diseases is challenging in the disruptive context of humanitarian crises given fragile health systems, limited resources, loss of health infrastructure and deployment of health personnel to emergency care. We strongly advocate for global actors at all health systems levels to actively reform national HPV vaccination programmes to enhance inclusivity of adolescent girls in crises settings or resettled in host countries. Full article

In response to the growing number of forcibly displaced persons caused by natural disasters and conflicts, this study investigates the use of paper-based materials in the design and construction of temporary emergency shelters. The research presents an iterative development of five full-scale prototypes of the TECH (Transportable Emergency Cardboard House) project. The study combines material testing, thermal simulations, and prototyping to evaluate the structural, thermal, and environmental performance of mass-produced paper elements—such as corrugated cardboard, honeycomb panels, and paper tubes—applied in various architectural and climatic contexts. Each TECH prototype was assessed for durability, thermal resistance, and assembly feasibility. Findings confirm that paper-based materials can meet the basic requirements of emergency architecture while maintaining low environmental impact, ease of transport, and low production costs. The results support the feasibility of using cellulose-based components as sustainable alternatives to conventional relief shelters. The study concludes with design guidelines for further development of long-lasting, low-impact housing units adaptable to diverse climate zones and emergency scenarios. Full article

In response to contemporary challenges such as the COVID-19 pandemic, climate change, armed conflicts, and economic instability, healthcare systems worldwide are increasingly confronted with multifaceted and overlapping crises—collectively referred to as polycrisis. These interconnected threats amplify one another, placing unprecedented strain on healthcare infrastructure, governance, and equity. The COVID-19 pandemic alone led to an estimated 16.3 million missed hospitalizations in 2020 and 14.7 million in 2021, revealing systemic vulnerabilities and deepening social inequalities. Armed conflicts, such as in Syria and Gaza, have devastated healthcare access. In Gaza, by mid-2024, 85% of the population had been forcibly displaced, with only 17 of 36 hospitals partially functioning and over 885 healthcare workers killed. Climate change further exacerbates health burdens, with over 86% of urban residents globally exposed to harmful air pollution, contributing to 1.8 million deaths annually. This study introduces a novel perspective by applying social epidemiology to the analysis of polycrisis. While the existing literature often emphasizes political or economic dimensions, our approach highlights how overlapping crises affect population health, social vulnerability, and systemic resilience. By integrating sociodemographic and environmental data, social epidemiology supports crisis-resilient care models, targeted interventions, and equitable health policies. We argue for a stronger mandate to invest in data infrastructure, enhance surveillance, and embed social determinants into health system responses. Full article

Background: Since the outbreak of war in Ukraine, countless forcibly displaced individuals facing not only material loss, but also deep psychological distress, have sought refuge across Europe. For those traumatized by war, the absence of a shared language in therapy can hinder healing and exacerbate suffering. While cultural diversity in psychotherapy has gained recognition, the role of native-language communication—especially from a person-centered perspective—remains underexplored. Methods: This narrative review with a thematic analysis examines whether and how psychotherapy in the mother tongue facilitates access to therapy and enhances therapeutic efficacy. Four inter-related clusters emerged: (1) the psychosocial context of trauma and displacement; (2) language as a structural gatekeeper to care (RQ1); (3) native-language therapy as a mechanism of change (RQ2); (4) potential risks such as over-identification or therapeutic mismatch (RQ2). Results: The findings suggest that native-language therapy can support the symbolic integration of trauma and foster the core conditions for healing. The implications for multilingual therapy formats, training in interpreter-mediated settings, and future research designs—including longitudinal, transnational studies—are discussed. Conclusions: In light of the current crises, language is not just a tool for access to therapy, but a pathway to psychological healing. Full article

Objectives: Scarce data are available regarding preventive medicine in forcibly displaced populations especially regarding non-communicable diseases like neoplasia, while even more limited data are available on Ukrainian refugees in Romania. To address this research gap, the present analysis was performed to investigate Ukrainian refugee women’s beliefs, attitudes, and opinions towards the Romanian and Ukrainian healthcare system in a comparison model while focusing on the HPV immunization rates and factors influencing the uptake for themselves and their children. Methods: Participants were recruited using the snowball sampling method through their General Practitioner (GP) and a health mediator. Results: In total, 105 women completed the online or physical survey. The mean age was 50 years. In total, 40% of women had not been to a gynecological check-up in 3 or more years, and more than 56% had never been screened. Only four were vaccinated against HPV, and none remembered which type of vaccine was dispensed or how many doses were utilized. The primary hindrances to accessing health services or immunization programs were language barriers, financial burdens, and a lack of information. Respondents’ general distrust of health systems and healthcare workforces were recurrent themes. Relationship status, living arrangements, and previous engagement in screening practices influenced immunization rates. Perceiving the healthcare officials as proactive concerning optional vaccination programs such as HPV immunization and actively receiving recommendations drove respondents to pursue vaccination. Conclusions: This analysis offers a foundational insight into the specific needs of refugee women. It can guide the development of effective public health interventions to improve health outcomes and vaccination rates among Ukrainian refugees in Romania. Tailored preventive campaigns with adequate native language information and prompts from medical experts in designated centers should be deployed to ensure inclusive tactics for vulnerable populations. Full article

Emergency displacement has become an increasingly salient global phenomenon, precipitated by the intensification of climate crises and persistent geopolitical conflicts. These events forcibly displace millions each year and generate complex social, political, and institutional challenges. While the literature on displacement is expanding, much of it centers on individual and household experiences, often overlooking the collective dimensions of displacement. This article addresses this gap by critically examining the concept of the displaced community, a term used to describe collectivities formed in host societies comprising individuals who have been forcibly uprooted. The article undertakes a conceptual investigation of displaced communities, seeking to define their constitutive features while accounting for their internal heterogeneity and contextual variability. To sharpen analytical clarity, the study contrasts displaced communities with healthy communities, thereby situating two polar ends of a continuum. Based on these two types of community, the question arises, “can displaced communities be healthy communities?” The article advances a conceptual model of a healthy displaced community, positing that such a construct extends conventional understandings of resilience by foregrounding the processual dynamics of recovery and adaptation. Specifically, it is argued that community health in contexts of forced displacement must be understood as the outcome of iterative processes intentionally involving community-based intervention, empowerment, and long-term sustainability. Drawing on published case studies and empirical accounts of work with displaced populations, the article demonstrates how these three pillars—community intervention, empowerment, and sustainability—are implemented in practice. It concludes with policy and practice recommendations designed to prevent further deterioration and promote the development of health and well-being within displaced communities. Full article

The COVID-19 pandemic may have disproportionately affected forcibly displaced people due to parallel uncertainties such as visa insecurity and family separation. This study explicitly examined whether different sources of uncertainty contributed in specific ways to increased psychological symptoms for refugees during the pandemic. A large cohort of 733 refugees and asylum seekers settled in Australia completed a mental health survey in June 2020 (T1) and 12 months later in June 2021 (T2). Using cross-lagged panel modelling, we tested changes in post-traumatic stress (PTS), depression and anxiety symptoms, visa status, family separation and COVID-19 uncertainty stress, and the contribution of intolerance of uncertainty (trait prospective and inhibitory), controlling for age, sex, trauma exposure, language, and time in Australia. Visa status and family separation stress at T1 predicted increased depression (bidirectional pathways) and PTS symptoms at T2 (unidirectional pathways), respectively. Visa status uncertainty at T1 was also associated with increases in COVID-19 and family separation stress at T2. Intolerance of uncertainty showed limited associations with symptoms and stressors. Findings demonstrate that different forms of refugee uncertainty had specific impacts on psychopathology during the first year of the COVID-19 pandemic. Refugees facing diverse kinds of stress may benefit from individual, community, and policy level support targeted to their specific circumstances and mental health needs during future crises. Full article

Scholarship addressing research ethics with forcibly displaced communities has gained heightened attention in the recent past. While critical, this scholarship has remained largely theoretical and has not included the voices of those who face forced displacement. This manuscript contributes to a more comprehensive discussion on ethical research with refugees and forcibly displaced populations by providing recommendations from refugees in the Kakuma Refugee Camp in Kenya. Based on focus group discussions in the Kakuma Refugee Camp, this article offers practical refugee-inspired research recommendations when working in the contexts of forced displacement. The paper categorizes these recommendations into three categories: (a) pre-research, (b) data-collection, and (c) post-research. By framing the analysis in and advocating for a decolonising research ethics prism, we illustrate the broad implications for maintaining the holistic well-being of research participants in forcibly displaced contexts. Full article

Forcibly displaced people in Scotland face multiple barriers in accessing health, social care, and policing services. This paper explores how social connections shape engagement with these services, particularly the role of police in community safety and wellbeing. Drawing on qualitative interviews and social connections mapping workshops, this study examines how third-sector organisations act as key intermediaries, shaping how people access statutory services. The findings show that while community policing and partnerships with trusted organisations can improve accessibility, concerns about racial discrimination, the underreporting of hate crime, and the lack of language support continue to undermine confidence in policing. Additionally, the growing reliance on police officers to respond to mental health crises reflects wider gaps in specialist service provision. This paper argues for a shift towards a cross-sector approach that strengthens community-led safety strategies, reduces police involvement in non-criminal matters, and improves language and cultural competency within public services. Strengthening institutional accessibility and trust-building initiatives is key to improving engagement with policing and health and social care services for forcibly displaced communities. Full article

Background/Objectives: Children that are forcibly displaced are more likely to experience mental health and behavioural challenges than non-displaced populations, including increased risk of anxiety, depression and post-traumatic stress disorder. Building appropriate parenting skills to strengthen the relationships between caregivers and their children in times of war is key to building resilience in children. There is a lack of research on the role of family skill interventions in internally displaced people (IDP). The aim of this study was to assess the potential change in parenting skills, child mental health, and resilience capacity in families living in IDP camps in Kachin State, Myanmar, after taking part in a brief family skill intervention, Strong Families. Methods: An open, multi-site pilot feasibility and acceptability trial was conducted with 100 families. Outcome data were collected prospectively, assessing changes in parenting skills and family adjustment in caregivers, children’s behaviour, and children’s resilience capacities. Families were assessed using three scales, Parenting and Family Adjustment Scales (PAFAS), the Strengths and Difficulties Questionnaire (SDQ), and the Child and Youth Resilience Measure (CYRM-R). Results: Despite being a light intervention, Strong Families produced improvements in the child mental health, parenting practices, and parent and family adjustment skills scales. Improvements were observed in scores particularly for caregivers and children with greater challenges at baseline. Conclusions: The results positively value the importance and feasibility of family skill interventions being integrated into the routine care of IDP families. This advocates for the prioritisation of using such tools for supporting better family functioning and mental health in humanitarian contexts. Full article

Considering refugees’ employment challenges in their host countries, they often need to create jobs by starting ventures and embracing self-employment. However, this requires financing. This study seeks to assess the roles of formal and informal financing in self-employment while also looking at the drivers of financing decisions and self-employment among refugees in an urban setting. Using the extension of the Blinder–Oaxaca decomposition pioneered by Fairlie, this study found informal financing to be significantly associated with an individual’s decision to be self-employed, while formal financing is not. Male refugees who access informal financing have a higher probability of embracing self-employment than refugee women and Kenyan nationals; this calls for actions that encourage forming community-based organizations that promote affirmative action and steer the use of informal finance. Full article

This study aims to investigate the suitability of earthen housing for refugees and establish a more efficient system for selecting and adjusting materials by quantitatively analyzing the influence of various factors affecting the mechanical performance of earthen housing. This paper examined the impact of dry unit weight, particle size distribution of soil solidification, clay minerals, and pH on the mechanical performance of soil solidification through compressive strength testing. Additionally, the tensile strength resulting from capillary forces between particles was estimated using a prediction equation, and the effects of capillary forces and cohesive forces due to clay minerals were quantitatively assessed by comparing them with the results of the compressive strength experiments. In an alkaline environment, conflicting results were obtained regarding the effect of the dispersion of particles on compressive strength, depending on the presence or absence of clay minerals in the soil. Based on these results, the implementation of earthen houses constructed in the target refugee camp was evaluated, and strategies for building houses more efficiently under given conditions were discussed. Full article

Background: Food security and access to healthcare are crucial determinants of health, but their impact on chronic disease risk among forcibly displaced populations is understudied. This study delves into the relationship between food security, accessibility to healthcare services, and chronic disease risk among Rohingya refugees in Bangladesh. Methods: Drawing from a nationally representative cross-sectional survey, this research investigates how the availability of food, accessibility to healthcare facilities, and utilization of services impact the likelihood of chronic diseases within this marginalized population. Using a cross-sectional survey collated from the UNHCR 2020 Joint Multi-Sector Needs Assessment survey, we deployed a series of multivariate logistic regression models to examine the relationship between food security, healthcare proximity, chronic disease, and sociodemographic characteristics. Results: Food security significantly decreased the risk of chronic diseases (OR = 0.65, 95% CI: 0.43, 0.98). Living far from healthcare facilities increased the risk (OR = 1.63, 95% CI: 1.03, 2.54). Conclusion: This study’s findings underscore the urgent need for targeted interventions aimed at enhancing food security and improving healthcare accessibility to alleviate the burden of chronic diseases among Rohingya refugees. By identifying key social determinants and barriers to healthcare access, this research equips policymakers with evidence-based strategies to design targeted interventions that improve nutrition, healthcare delivery, and chronic disease management for displaced populations. Full article