Search Results (1,194)

(1) Background: Worldwide, refugees may have some difficulties in accessing healthcare services. However, little is known about the factors that may predict the level of accessibility to the public healthcare system in the host countries. (2) Aim: To examine the level of accessibility of Syrian refugees to the public healthcare system in Jordan and further to identify the prediction of socioeconomic factors and barriers to healthcare access. (3) Methods: A cross-sectional study was conducted with a convenient sample of 356 Syrian refugees residing outside camps (Irbid, Ajloun, and Jarash). Data were collected using the Access to Healthcare Services Scale instrument (adopted from the Canadian Community Health Survey), which is composed of 2 sections: the general access scale (8 items) and the difficulties scale (20 items). One-way ANOVA test and independent t-test were used to examine epidemiological correlations among variables, whereas a hierarchical linear regression model was used to examine the predictability of socioeconomic factors and barriers to overall access to the public healthcare system by exploring the incremental impact of additional predictors. (4) Results: the mean age of the 356 participants was 35.22 years old, 56.5% were female, 67.4% were married, most of them 46.1% have secondary education, and non-employed 69.9%. Significant associations were observed among participants with different marital status (p < 0.001), educational level (mean 11.85 vs. 19.85, p < 0.001), working status (15.47 vs. 17.93, p < 0.001), family household number (16.42 vs. 17.0, p < 0.001), and health insurance (none: 15.50 vs. governmental 24.50, p < 0.001). Multivariate analysis revealed that the most important factors that may predict the overall access to healthcare services were: family monthly income (beta −0.19, p < 0.001), household family number (beta 0.17, <0.001), health insurance (beta −0.09, p = 0.047), and barriers (beta −0.43, <0.001), even after adjusting for potential confounding effects: sex, age, educational level, and place of residence. (5) Conclusions: Our findings indicate that socioeconomic factors and barriers may considerably predict overall access to public healthcare in Jordan. It is crucially important, therefore, for the Jordanian government and international organizations to create and develop strategic plans and programs that enhance refugees’ access to health services, positively impacting their health and wellness. Full article

Background: Refugee children with disabilities are vulnerable to developing dysfunctional coping skills due to barriers in accessing health care services, including occupational therapy (OT). This study investigated the perceptions of refugee caregivers regarding the use of mindfulness-based interventions (MBIs) as a treatment for coping skills among their children with disabilities. Methods: A qualitative survey was used to analyse the coping mechanisms and access to services among refugee children with disabilities, as well as their caregivers’ perceptions regarding the use of MBIs. The caregivers were recruited using convenience sampling from a database of individuals at the Al-Baqa’a refugee camp in Jordan via their community-based rehabilitation (CBR) centre. A demographic survey was sent to 156 refugees using WhatsApp. Refugees above the age of 18 years identifying as the caregivers of children with disabilities were eligible. Twenty-eight individuals completed the survey, and twenty-six were eligible. Open-ended questions asked about their child’s struggles, supports, barriers to support, and perceptions of MBIs. The data were collected via Google Sheets. Three researchers coded the responses using a descriptive coding method and line-by-line analysis. Results: Five themes were derived from the responses: “Daily Challenges”, “Support and Strategies”, “barriers to accessing support”, “MBIs: Caregiver Perceptions”, and “MBIs: Barriers”. The participants identified the behavioural, emotional, and cognitive challenges impacting their child’s participation. Financial and environmental constraints, stigma, and timing were the reported barriers to services. The participants felt positive about the potential of MBIs to support their children. Conclusions: Overall, this study obtained foundational data to establish accessible mental health programmes for refugees with disabilities. Further research is needed to transcend the barriers and maintain MBI programmes in the community and the home settings. Full article

Despite their higher risk of mental health conditions, migrants often face barriers to accessing mental health care. This systematic review aims to synthesize the evidence on interventions to improve mental health care access for migrants (protocol CRD42024556575). PubMed, Embase, PsycINFO, and CINAHL were searched for experimental and observational studies on this topic. A narrative summary and a meta-analysis of the study findings are presented, along with a GRADE quality assessment. Eighteen reports, accounting for 3285 migrants, were included in the final selection. There were six randomized controlled trials, nine non-randomized clinical trials, and three observational studies. The interventions consisted of psychoeducation (27.8%), digital tools (22.2%), outreach programs, counseling, peer support (each 11.1%), and miscellaneous approaches (16.7%). There was marked heterogeneity in the intervention structure and outcome measure across the studies. Nevertheless, all studies reported a positive effect of the interventions on mental health care access. Still limited by few studies providing data suitable for the pooled estimate, the meta-analyses found a significant effect in reducing stigma and improving mental health literacy. Overall, this review identified promising interventions for improving migrant mental health care access. Future research is needed to validate interventions that can be applied sustainably across different contexts and migrant populations. Full article

Non-communicable diseases, previously thought of as a problem of high-income countries, now coexist in low- and middle-income countries, including the countries of origin for many refugees traveling to Europe. We aimed to describe the prevalence of risk factors for non-communicable diseases among refugees, asylum seekers, and subsidiary protection beneficiaries resettled or relocated in Portugal between 2015 and 2020 and compare these to the prevalence of risk factors in the 12 months before they left their country of origin. A cross-sectional study was conducted between 2019 and 2020 of all refugees, asylum seekers, and subsidiary protection beneficiaries attending a Lisbon, Portugal refugee center. Behavioral and biological risk factors were assessed using the WHO STEPwise modified questionnaire. A descriptive statistical analysis was conducted, which included 80 respondents, mainly men, with an average age of of 30.3 ± 9.8 years. The prevalence of several behavioral risk factors for non-communicable diseases among refugees, asylum seekers, and subsidiary protection beneficiaries was higher at the time of the study than in the 12 months before leaving the country of origin. Differences between men and women were noted in tobacco (49.1% vs. 25.9%) and alcohol use (43.4% vs. 18.5%) in the receiving country. Overweight and obesity also showed differences by gender (7.5% vs. 11.1% and 39.6% vs. 48.1%). The prevalence of suicidal ideation and suicidalplanning was high, and varied from 6.3% and 20% in the country of origin to 16.3% and 38.5% respectively in the receiving country, however the prevalence of suicide attempts was lower in the receiving country (66.7%) compared to the country of origin (100.0%). Information on health and social determinants is critical to identify priorities and increase access to access to gender-specific health and community level interventions, including mental health, to reduce risk factors associated with refugee relocation and resettlement. Full article

Although multilingualism is a major issue in educational policies, especially in states hosting a high number of newcomer immigrant students, there is limited research exploring the experiences of a multilingual group of newcomer students and how they use language in schools. This article draws on 112 interviews with students from an immigrant background across four high schools in Arizona and New York. We illuminate the role of language in shaping identity and inclusion. Through conceptualizing power and language ideology, we find that language ideologies and practices shape the perception of students’ social interactions in school settings. Our findings also indicate that teachers’ practices and school policies surrounding language(s) have the potential to affect how students view language in relation to their own identity and via social interactions. We contribute to an understanding of how language policies and ideologies shape the experiences and power dynamics of diverse, multilingual, immigrant-origin students. Full article

Tuberculosis has had a long-standing prevalence in Greece over the last century, going hand in hand with the country’s overall socioeconomic situation. The current study explores aspects of tuberculosis in Greece since the interwar period and up to the present. Apparently, ignorance of the nature of the disease coupled with false medical perceptions sealed the fate of patients while unwittingly influencing public opinion and making societies hostile toward patients. Such paradigms are of great and timeless value for the cohesion and functioning of societies, not excluding modern ones. Although the present-day situation in Greece is utterly different from that in the previous century, considering the limited number of cases and minimal impact of the disease, new challenges have emerged, such as the under-reporting of cases, the emergence of multidrug-resistant tuberculosis, latent tuberculosis or the management of large refugee flows in the Eastern Mediterranean involving citizens from countries with a high prevalence of the disease. On the other hand, the study of tuberculosis is nowadays more urgent than ever, given the global concerns regarding the future of the disease in the midst of the COVID-19 pandemic, which has put enormous pressure on national health systems. Full article

The background and motivation of the research presented in this article is the obligation of Public Theology to do justice to young Muslim refugees as a minority group in German society regarding the role of religiosity in the way they are coping with life. In the research process, the authors became increasingly aware that most instruments to measure religiosity have a Western and/or Protestant bias in that they are more interested in religious attitude than in religious practice and/or religious lifestyle, which is very important for Muslim religiosity. Therefore, this article focuses on the distinction between halal and haram as indicators of religious practice according to Muslim benchmarks. Both the concept and the operationalization of a two-dimensional instrument of living a halal life are described. The instrument distinguishes between the individual importance of halal goods (food, medicine, cosmetics) and services (doctors) and their availability in the local environment. Each of the two dimensions comprises four items. Construct validity is shown by confirmatory factor analysis (CFI_robust = 0.934, TLI_robust = 0.902, RMSEA_robust = 0.114 [0.073; 0.156]) of a sample of N = 155 Muslim adolescents who have fled to Germany from Syria, Iraq and Afghanistan. External validity is tested by analyzing the correlation of the measurement instrument developed by the authors with the Centrality of Religiosity Scale. The presented halal instrument offers an approach to Muslim lifestyle that meets the orthopractic character of this religion. At the same time, it addresses the consequential dimension of religion within quantitative research. Full article

(1) Background: Migrant and refugee youth’s (MRY’s) sexual and reproductive health and rights (SRHRs) are a global health issue. MRY encounter adverse SRH experiences due to limited access to and knowledge of SRHRs services. Using a socioecological framework, this study examined the barriers affecting MRY’s SRHRs. (2) Methods: A cross-sectional study utilising a participatory action research design was used. A total of 87 MRY (ages 16–26, from 20 cultural groups within Greater Western Sydney, Australia) completed seventeen focus group discussions on their SRHRs experiences. The focus groups were co-facilitated by youth project liaisons to ensure their authenticity and validity. The data were analysed thematically and interpreted using socioecological theory. (3) Results: The findings identified socioecological barriers, a lack of awareness about and access to services, and sociocultural dissonance as leading to the under-implementation of SRHRs services. These barriers included cultural disconnects, language barriers, remote service locations, intergenerational cultural conflicts, and ineffective SRHRs services. The key themes identified included traditional and institutional stigma, lack of SRH education, reliance on social media for SRH information, and privacy concerns. (4) Conclusions: There is a limited consideration of MRY’s SRHRs and the impact of intergenerational discordance and stigma on MRY’s rights. The findings suggest the necessity for a collaborative SRHRs strategy and policy design that empowers MRY’s agency across multicultural contexts. Full article

Many gender differences in mental and physical health, along with accompanying social needs have been reported by those suffering with schizophrenia. The goal of this review is to explore the literature on migrant and culturally diverse women suffering with schizophrenia to develop and implement effective strategies in specialized clinics. In general, we found higher rates of mental health symptoms among migrant and refugee women when compared to men. Several factors contribute to this vulnerability, suggesting that women may experience more pre- and post-migration-related trauma. In clinical populations, migrant status, region of origin, age at the time of migration, migration with family or alone, and migration to join family determine the risk of schizophrenia and the clinical course of the illness. Refugee migrant women have a higher risk of schizophrenia than non-refugee migrants and native-born populations. Migration is associated with poor access to mental health services; low social support, lack of awareness of services, and language barriers may mediate this association. These findings call for specific assessments on migrant women, interventions (e.g., focus groups), and improvement in current programs. In our clinics, we have recently incorporated assessment and intervention strategies that may be effective in our programming. Full article

In this original research manuscript, we examined how gender, race, and ethnic heritage shape the science, technology, engineering, and mathematics (STEM)-related and higher education aspirations of different communities of refugee youth and families participating in university–community organization partnerships. Families from various ethnic-based community organizations in Arizona (serving Bhutanese, Burundian, Congolese, Somali, and Syrian people) participated in this study. Using social cognitive career theory as our conceptual framework and a qualitative research approach, we conducted interviews and focus groups with 27 families over two years to better understand their experiences. We found that the youth and families in our study experienced the following: (1) a recognition of the value of STEM education; (2) the value of consistent support from parents and community members; and (3) appreciation for the practical interventions provided by the university–community partnership. Additionally, families communicated conflicting perceptions of the salience of race and gender. We concluded by discussing the implications of the study findings for higher education scholarship and practice. Full article

Arabic diglossia, whereby Standard Arabic (SA) exists alongside numerous vernaculars, often leads to diglossic style-shifting, based on context or topic changes and marked in the vernacular by shifting to standard linguistic features. While this phenomenon has been widely studied in the speech of educated adults, research on diglossic style-shifting by children and adolescents has been rather limited. This paper investigates how it operates amongst 3–17-year-olds from a Bedouin speech community of Palestinian refugees in Syria. It examines context effects on realizations of the variables (θ) and (ð), which overlap with local realizations and (q), which has a standard realization ([q]) that is independent of dialectal variation in the community. Participants were recorded during sociolinguistic interviews and a picture-naming task, the latter being expected to evoke a school setting and prompt the use of more standard realizations, signaling diglossic style-shifting in their speech. Style-shifting was influenced by age, context, and the linguistic variables under examination. While picture-naming prompted greater use of standard realizations of all variables, shifting to [q] also appeared during the interview in lexical borrowings from SA, revealing topic effects on diglossic style-shifting. Children aged 6–14 exhibited more style-shifting in picture-naming, likely reflecting the central role of school in their lives, while the speech of 15–17-year-olds contained more lexical borrowing with [q]. This likely reflects their larger linguistic repertoires and longer exposure to SA than their younger peers. These findings indicate that SA plays a key role in participants’ linguistic practices and reflect their awareness of how to employ it appropriately in their speech. Full article

Oral cholera vaccination (OCV) campaigns are increasingly used to prevent cholera outbreaks; however, little is known about their cost-effectiveness in refugee camps. We conducted a cost-effectiveness analysis of a pre-emptive OCV campaign in the Maela refugee camp in Thailand, where outbreaks occurred with an annual incidence rate (IR) of up to 10.7 cases per 1000. Data were collected via health sector records and interviews and household interviews. In the base-case scenario comparing the OCV campaign with no campaign, we estimated the campaign effect on the cholera IR and case fatality rate (CFR: 0.09%) from a static cohort model and calculated incremental cost-effectiveness ratios for the outcomes of death, disability-adjusted life-years (DALYs), and cases averted. In sensitivity analyses, we varied the CFR and IR. The household economic cost of illness was USD 21, and the health sector economic cost of illness was USD 51 per case. The OCV campaign economic cost was USD 289,561, 42% attributable to vaccine costs and 58% to service delivery costs. In our base case, the incremental cost was USD 1.9 million per death averted, USD 1745 per case averted, and USD 69,892 per DALY averted. Sensitivity analyses that increased the CFR to 0.35% or the IR to 10.4 cases per 1000 resulted in a cost per DALY of USD 15,666. The low multi-year average CFR and incidence of the cholera outbreaks in the Maela camp were key factors associated with the high cost per DALY averted. However, the sensitivity analyses indicated higher cost-effectiveness in a setting with a higher CFR or cholera incidence, indicating when to consider campaign use to reduce the outbreak risk. Full article

Our study aimed to explore the lived experiences of Venezuelan refugee/migrant women and girls with disabilities to guide humanitarian assistance. The data analysed was part of a larger cross-sectional study whereby refugees and migrants in Ecuador, Peru, and Brazil were asked to share the migration experiences of a Venezuelan woman or girl. The sample for this analysis was drawn from one of the survey questions that asked participants whether the woman/girl in the narrative identified as a person with a disability. Thematic analysis using inductive coding was performed. A total of 126 narratives were included in the final analysis, of which four major themes were identified. Venezuelan refugees and migrants with disabilities described experiences of discrimination, violence, and physical challenges, such as exacerbation of symptoms while in transit. In host countries, refugees and migrants experienced a lack of disability-related accommodations in the workplace and long wait times when trying to obtain healthcare. Since discrimination is a cross-cutting issue, human rights awareness highlighting the dignity of persons with disabilities is imperative. Resources and support for Venezuelan refugee and migrant women and girls with disabilities should aim to create accessible employment opportunities, safe and timely access to medical care, and prioritise violence prevention. Full article

A high proportion of refugees coming into the U.S. are under the age of 18, and many continue to struggle to attain basic educational qualifications which may lead to viable economic opportunity. Recently, the Office of Refugee Resettlement (ORR) began issuing youth mentoring (YM) grants to support the integration of refugee youth. This paper explores the decision-making processes of resettlement organizations in a vertically complex network of organizations which implemented the YM programs for refugee youth in one large city of Texas. Through a series of semi-structured interviews with program implementers, findings suggest that resettlement agencies remain powerless in making key programmatic decisions, including implementation of the programs and designing accountability and effectiveness measures, which can truly evaluate the program quality. Other findings suggest that across the network of organizations involved in implementation of the YM programs, compliance with federal regulation is prioritized over accountability. The lack of program effectiveness and accountability measures have implications for one of the most vulnerable population, refugee youth. The main recommendation for policy and practice argues for the lead public agency’s increased involvement in defining key outcomes for the program recipients in a vertically complex network. Full article

This study enhances the understanding of resilience in forced migration through a psychological lens, highlighting the importance of identifying resilience determinants and evidence-based interventions. By fostering resilience, policymakers and practitioners can support the well-being and adaptive capacities of forcibly displaced Ukrainians, promoting psychological recovery, social integration, and positive long-term outcomes for affected individuals and communities. To determine the key resilience indicators, survey data were collected in 2023 from n = 502 Ukrainian refugees living in the U.S. (M age = 27 years). Individuals reported various psychological factors and cultural experiences, revealing high resilience and low-stress tolerance among forced Ukrainian migrants in the U.S., along with a strong correlation between their adopted acculturation strategies and their resilience and levels of traumatization. Full article