RESUMO
BACKGROUND: Phuket Province is a major tourist destination with a migrant workforce accounting for 10% of its population. Despite governmental efforts to adjust health insurance policies, migrants face healthcare access challenges. This study examines the current healthcare access situation and factors associated with unmet needs among migrants in Phuket Province. METHODS: We used a cross-sectional mixed-methods approach, recruiting participants through snowball sampling from the Migrant Health Volunteer Network. Quantitative data were gathered using self-administered questionnaires, with unmet need defined as desired outpatient or recommended inpatient services not received at government hospitals. Multivariable logistic regression identified unmet need predictors, and we assessed the mediating effect of health insurance status. Qualitative data from three focus groups on healthcare access provided context and enriched the quantitative findings. RESULTS: This study includes 296 migrants mainly from Myanmar. The overall unmet need prevalence was 14.86%, mainly attributed to having undocumented status (34.09%), affordability issues (20.45%), and language barriers (18.18%). Working in the fishery industry significantly increased unmet needs risk (aOR 2.68, 95% CI 1.08-6.62). Undocumented status contributed a marginal total effect of 4.86 (95% CI 1.62-14.54), with a natural indirect effect through uninsured status of only 1.16 (95% CI 0.88-1.52). Focus group participants used various medical resources, with insured individuals preferring hospital care, but faced obstacles due to undocumented status and language barriers. CONCLUSION: Valid legal documents, including work permits and visas, are crucial for healthcare access. Attention to fishery industry practices is needed. We recommend stakeholder discussions to streamline the process of obtaining and maintaining these documents for migrant workers. These improvements could enhance health insurance acquisition and ultimately improve healthcare affordability for this population. These insights could be applied to migrant workers in other urban and suburban area of Thailand regarding access to government healthcare facilities.
Assuntos
Acessibilidade aos Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Migrantes , Humanos , Estudos Transversais , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Feminino , Migrantes/estatística & dados numéricos , Tailândia , Masculino , Adulto , Necessidades e Demandas de Serviços de Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Inquéritos e Questionários , Grupos Focais , Seguro Saúde/estatística & dados numéricos , Cobertura do Seguro/estatística & dados numéricosRESUMO
BACKGROUND: The sustainability of diets consumed by African populations under socio-economic transition remains to be determined. This study developed and characterized a multi-dimensional Sustainable Diet Index (SDI) reflecting healthfulness, climate-friendliness, sociocultural benefits, and financial affordability using individual-level data of adults in rural and urban Ghana and Ghanaian migrants in Europe to identify the role of living environment in dietary sustainability. METHODS: We used cross-sectional data from the multi-centre Research on Obesity and Diabetes among African Migrants Study (N = 3169; age range: 25-70 years). For the SDI construct (0-16 score points), we used the Diet Quality Index-International, food-related greenhouse gas emission, the ratio of natural to processed foods, and the proportion of food expenditure from income. In linear regression analyses, we estimated the adjusted ß-coefficients and 95% confidence intervals (CIs) for the differences in mean SDI across study sites (using rural Ghana as a reference), accounting for sociodemographic and lifestyle factors. RESULTS: The overall mean SDI was 8.0 (95% CI: 7.9, 8.1). Participants in the highest SDI-quintile compared to lower quintiles were older, more often women, non-smokers, and alcohol abstainers. The highest mean SDI was seen in London (9.1; 95% CI: 8.9, 9.3), followed by rural Ghana (8.2; 95% CI: 8.0, 8.3), Amsterdam (7.9; 95% CI: 7.7, 8.1), Berlin (7.8; 95% CI: 7.6, 8.0), and urban Ghana (7.7; 95% CI: 7.5, 7.8). Compared to rural Ghana, the differences between study sites were attenuated after accounting for age, gender and energy intake. No further changes were observed after adjustment for lifestyle factors. CONCLUSION: The multi-dimensional SDI describes four dimensions of dietary sustainability in this Ghanaian population. Our findings suggest that living in Europe improved dietary sustainability, but the opposite seems true for urbanization in Ghana.
Assuntos
População Rural , Humanos , Gana , Feminino , Pessoa de Meia-Idade , Masculino , Adulto , Estudos Transversais , Idoso , População Rural/estatística & dados numéricos , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos , Dieta Saudável/estatística & dados numéricos , Dieta Saudável/métodos , Dieta/métodos , Dieta/estatística & dados numéricos , Migrantes/estatística & dados numéricos , Estilo de VidaRESUMO
Background: As China has undergone the processes of urbanization and economic development, a large migrant population has emerged, creating new family migration trends. Family migration brings about changes in urban integration costs and benefits, affecting health investment. Objective: The primary objective of this research is to investigate the influence of urban integration of migrant workers' families on their mental wellbeing, with the aim of offering policy recommendations conducive to the realization of a comprehensive public health strategy in China. Methods: This paper uses multi-dimensional indexes to measure family urban integration, covering economic, social and psychological dimensions, which may consider the complexity of integration. Utilizing a machine learning clustering algorithm, the research endeavors to assess the level of urban integration experienced by migrant workers and their respective families. The analysis discerns three distinct clusters denoting varying degrees of urban integration within these familial units, namely high-level, medium-level, and low-level urban integration. We applied binary logit regression models to analyze the influence of family urban integration on the mental health among migrant workers. Then we conducted a series of robustness tests. Results: The results show that family urban integration decreases the probability of depressive symptoms by 14.6 percentage points. Further mechanism tests show that family economic integration enhances the psychological wellbeing of migrant workers by elevating their income status. Family social integration decreases depressive symptoms by increasing social status. Family psychological integration increases the psychological health of migrant workers by making them more satisfied with their lives. The heterogeneity test shows that family urban integration and its different dimensions have a strong impact on the depressive symptoms of women, first-generation, and less-educated groups. Conclusions: This study finds that family urban integration and its economic, social, and psychological dimensions significantly reduced the depressive symptoms of migrant workers. The results of this study lead the authors to recommend formulating a family-centered policy for migrant workers to reside in urban areas, optimizing the allocation of medical resources and public services, and improving family urban integration among migrant workers in order to avoid mental health problems in the process of urban integration.
Assuntos
Saúde Mental , Migrantes , Humanos , China , Migrantes/psicologia , Migrantes/estatística & dados numéricos , Feminino , Masculino , Adulto , Família/psicologia , População Urbana/estatística & dados numéricos , Urbanização , Depressão/psicologia , Depressão/epidemiologia , Integração Social , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Previous research has highlighted inequalities in access to Swedish youth clinics (YCs). These inequalities exist not only between non-migrant and young migrant populations but also within various migrant groups. OBJECTIVES: To assess awareness and utilization of Swedish YCs among migrants enrolled in Swedish language programmes and explore associated factors. METHODS: This cross-sectional study involved 1,112 migrants aged 15-65. The analytical sample included 642 (57%) participants who answered the main outcome question about awareness of YCs. Descriptive statistics, bivariate, and multivariate log-binomial regression analyses using a Bayesian approach were applied to summarize the data and identify factors associated with awareness and utilization of YCs among migrants. RESULTS: The results revealed that 30% of all participants and 40% of the participants aged 15-25 years had heard of YCs. Additionally, 23% of the target group (15-25 years) had ever visited one. During descriptive and bivariate analyses, socio-demographic variations were evident in YCs' awareness and utilization. However, in multivariate analyses, only the associations between awareness and year of arrival, and YCs' utilization and year of arrival and type of residence permit, remained statistically significant. CONCLUSION: This study highlights the level of awareness of YCs among migrants attending Swedish language programmes and their utilization by those aged 15-25 years, potentially impacting their access to crucial services and resources. Targeted interventions and sustainable strategies beyond one-time interventions are essential to address the specific needs of different socio-demographic groups and ensure equitable access to YCs' information and services.
Main findings: This study highlights the level of awareness and utilization of youth clinics among migrants attending Swedish language programmes, revealing socio-demographic disparities across different groups.Added knowledge: Migrant men and unaccompanied minors are more likely to be aware of and use youth clinics than migrant women and those with legal guardians, while recent migrants and those with temporary residence permits are at an increased risk of being unaware of or not utilizing these services.Global health impact for policy and action: Targeted interventions and sustainable strategies, beyond one-time efforts, are essential to address the specific needs of different migrant subgroups and ensure equitable and universal access to crucial information and services related to sexual and reproductive health and rights.
Assuntos
Acessibilidade aos Serviços de Saúde , Migrantes , Humanos , Adolescente , Estudos Transversais , Suécia , Feminino , Masculino , Adulto Jovem , Adulto , Migrantes/estatística & dados numéricos , Migrantes/psicologia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Pessoa de Meia-Idade , Idioma , Idoso , Conhecimentos, Atitudes e Prática em Saúde , Fatores Socioeconômicos , Instituições de Assistência Ambulatorial/estatística & dados numéricosRESUMO
BACKGROUND: The impact of migration on HIV risk among non-migrating household members is poorly understood. We measured HIV incidence among non-migrants living in households with and without migrants in Uganda. METHODS: We used four survey rounds of data collected from July 2011 to May 2018 from non-migrant participants aged 15-49 years in the Rakai Community Cohort Study. Non-migrants were individuals with no-migration between surveys or at the prior survey. Household migration was defined as ≥1 household member migrating into or out of the house from another community between surveys (â¼18 months). Incident HIV was defined as testing HIV seropositive following a negative result. Incidence rate ratios (IRRs) were estimated using Poisson regression with generalized estimating equations. Analyses were stratified by gender, migration into or out of the household and the relationship between non-migrants and migrants (e.g. spouse, child). RESULTS: About 11 318 non-migrants (5674 women) were followed for 37 320 person-years. Twenty-eight percent (6059/21 370) of non-migrant person-visits had recent migration into or out of the household, and 240 HIV incident cases were identified. Overall, non-migrants in migrant households were not at greater risk of acquiring HIV than non-migrants in households without any migration. However, men were significantly more likely to acquire HIV if their spouse had recently migrated in [adjusted IRR: 2.12; 95% confidence interval (CI): 1.05-4.27] or out (adjusted IRR: 4.01; 95% CI, 2.16-7.44) compared with men with no spousal migration. CONCLUSIONS: HIV incidence is higher among non-migrant men with migrant spouses. Targeted HIV testing and prevention interventions like pre-exposure prophylaxis could be considered for men with migrant spouses.
Assuntos
Características da Família , Infecções por HIV , Migrantes , Humanos , Uganda/epidemiologia , Masculino , Feminino , Incidência , Adulto , Infecções por HIV/epidemiologia , Adolescente , Pessoa de Meia-Idade , Adulto Jovem , Migrantes/estatística & dados numéricos , Estudos de Coortes , Fatores de RiscoRESUMO
The article is devoted to presenting the topic of migration of Ukrainian nationals to Poland. The work makes use of a survey under a project carried out in Polish rural areas and small towns. Seven hundred interviews were held in total. We conducted a quantitative analysis of its results here. The employed methods involve variable frequency distribution. The independence of the features was tested with the non-parametric chi-square test of independence. The association of the investigated variables was determined with Cramér's V. The research shows that the most numerous foreign nationals in the Polish labour market in 2021 were Ukrainians. The positive trend started in 2017. The respondents perceived the migration of Ukrainian nationals to Poland mostly positively, especially regarding seasonal work. They also emphasized that the Ukrainians performed work at variance with their qualifications. Only every fifth participant agreed that migrants took away jobs from Poles. Most of the respondents pointed out that small business owners benefited from employing Ukrainians. The overwhelming majority of the respondents noted an increase in migration from Ukraine after the full-scale invasion and that entire families of Ukrainians were coming to Poland. Nearly half of them agreed that the support system for Ukrainian migrants was a burden on municipal budgets.
Assuntos
População Rural , Migrantes , Ucrânia , Polônia , Humanos , Migrantes/estatística & dados numéricos , Migrantes/psicologia , Feminino , Masculino , Adulto , Emprego/estatística & dados numéricos , Inquéritos e Questionários , Pessoa de Meia-Idade , Adulto Jovem , Emigração e ImigraçãoRESUMO
OBJECTIVE: In recent years, several international studies have been published, that describe a relationship between country of origin and the occurrence of work-related injury. Since we regularly treat migrant workers in our hospital after work-related injury, we wanted to gain more insight into the characteristics of this group. DESIGN: Descriptive retrospective cohort study. METHOD: Patients were identified from the Dutch Nationwide Trauma Registration (LTR). Patients that were included in the study were admitted and treated in our hospital after a work-related injury from 2017 to 2021. Additional information regarding patient characteristics and outcomes were retrieved from our electronic hospital information system. RESULTS: 14,9% of the 397 patients were found to have an injury with an Injury Severity Score (ISS) of 16 or higher. The most common mechanism of injury was a fall from height (ISS≤15: 26.0%, ISS≥16: 57.6%). In the study population, 15,4% had a non-Dutch origin. The majority consisted of employees with an Eastern European nationality (70,5%), mainly from Poland. Within this group relatively more often patients were encountered that had no valid insurance (14% of patients with an Eastern European origin) or were intoxicated (19% of patients with Eastern European origin). CONCLUSION: A relatively large part of our patient population consisted of migrant workers. We did not observe large differences in mechanism of injury, severity of injury and outcome between native patients and migrant workers. We did observe a relatively high frequency of insurance problems and intoxications among migrant workers.
Assuntos
Migrantes , Humanos , Migrantes/estatística & dados numéricos , Países Baixos/epidemiologia , Estudos Retrospectivos , Feminino , Masculino , Adulto , Local de Trabalho/estatística & dados numéricos , Traumatismos Ocupacionais/epidemiologia , Escala de Gravidade do Ferimento , Estudos de Coortes , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Women who have migrated often encounter difficulties in accessing healthcare and experience inequitable sexual and reproductive health outcomes in destination countries. These health inequities include contraceptive access and use. To better understand what influences contraceptive access and use, this scoping review set out to synthesize the evidence on contraceptive access and use and on associated interventions among women with migratory experience in high-income countries (HICs) in Europe, North America and Australasia. METHODS: The scientific databases PubMed, Web of Science and CINAHL were searched for peer-reviewed quantitative, qualitative and mixed method articles published between January 2000 and June 2023. Articles were included if they reported on studies exploring contraceptive use to prevent pregnancies among women of reproductive age with migratory experience living in HICs. Two researchers independently screened and extracted data from the articles. Findings were categorized by patient and health system level factors according to Levesque et al.'s framework of access to health care. RESULTS: A total of 68 articles were included, about half (n = 32) from North America. The articles focused on the individual level rather than the health system level, including aspects such as women's contraceptive knowledge, the influence of culture and religion on accessing and using contraception, partner involvement, and differing health insurance coverage. On the health system level, the articles highlighted lack of information on contraceptive services, cultural (in)adequacy of services and communication aspects, contraceptives' side effects, as well as geographic availability and cost of services. The review further identified three articles reporting on interventions related to contraceptive counselling. CONCLUSIONS: There is a lack of knowledge regarding how health systems impose obstacles to contraceptive services for women with migratory experience on an organizational level, as research has focused heavily on the individual level. This review's findings may serve as a foundation for further research and advances in policy and practice, specifically recommending early provision of health system related information and contraceptive education, engagement of male partners in contraceptive discourses, cultural competency training for healthcare professionals, and strengthening of interpretation services for contraceptive counselling.
Assuntos
Comportamento Contraceptivo , Países Desenvolvidos , Acessibilidade aos Serviços de Saúde , Humanos , Feminino , Comportamento Contraceptivo/estatística & dados numéricos , Comportamento Contraceptivo/psicologia , Migrantes/psicologia , Migrantes/estatística & dados numéricos , Anticoncepção/estatística & dados numéricos , Anticoncepção/psicologia , Europa (Continente) , América do Norte , AustralásiaRESUMO
BACKGROUND: Numerous studies have explored the impact of pre- and post-migration factors on the overall health of migrant populations. The objective of this study is to enhance our understanding of additional determinants affecting migrants' health by examining the impact of the migration phase and related journeys in the European context. METHODS: We conducted a systematic review of studies published in the MEDLINE, Embase, and Scopus databases from 2003 up to January 5, 2024. We included observational studies reporting information on the health status of migrant populations recorded upon arrival in a country situated in Europe, and on the transit phase, including specific risk factors experienced during the journey or its characteristics. Title and abstract screening were performed using active learning techniques provided by ASReview software. The results of the included studies were presented qualitatively, with a focus on publications that formally assessed the association between the journey and the investigated health outcomes. The systematic review was registered on PROSPERO, CRD42024513421. RESULTS: Out of 11,370 records screened, we ultimately included 25 studies, all conducted since 2017. Most adopted a cross-sectional design and a quantitative approach, with relatively small sample sizes. The majority of the studies were conducted in Serbia and Italy. Only 14 of them formally assessed the association between different exposures in the transit phase and health outcomes, including mental health, well-being and quality of life, infectious and non-communicable diseases. CONCLUSION: Epidemiological research focusing on the transit phase in Europe remains limited, with few available studies facing challenges related to data collection, study design and analysis, thereby limiting the interpretability and generalisability of their results. These findings underscore the need for action, prompting the development of adequate and feasible strategies to conduct additional studies focusing on migrant populations during migration journeys.
Assuntos
Nível de Saúde , Migrantes , Humanos , Migrantes/psicologia , Migrantes/estatística & dados numéricos , Europa (Continente)/epidemiologiaRESUMO
BACKGROUND: Malaria is a major disease burden in Ethiopia. Migration can influence malaria transmission dynamics, with individuals relocating from malaria-free highland regions to malarious lowlands potentially facing elevated risks of contracting malaria. Migrants may find it difficult to protect themselves against malaria and have limited access to diagnosis or treatment. Settlers in gold mining sites are one type of migrant and are often neglected in malaria research yet may have particularly high malaria risk. This study was a malaria prevalence survey among settlers in a new gold mining settlement in the highly malarious Gambella Region, Ethiopia. METHODS: n = 590 people were surveyed for demographic information and their knowledge and practices of malaria. Participants were tested for malaria using rapid diagnostic tests and microscopy. Using logistic regressions, the influence of demographic characteristics on malaria infections and bed net access were analysed. A sub-sample of participants was interviewed to comprehend settlement living conditions and healthcare accessibility. RESULTS: The overall prevalence of Plasmodium falciparum was 37.5% (CI 32.4-42.3%). Young children were most likely to have malaria, with individuals aged 15-24 having 67% lower odds (aOR: 0.33; CI 0.13-0.86) of infection compared to those aged 1-4 years old. Meanwhile, those age 25-plus had 75% decreased odds of malaria infection (aOR 0.25; CI 0.10-0.65). Individuals with bed nets had ~ 50% decreased odds of testing positive for falciparum malaria than those reporting having no bed net (aOR: 0.47; CI 0.22-0.97). Individuals who relocated from low elevation with high malaria test positivity rate areas were more prone to testing positive for malaria, as were those residing in densely populated households with multiple malaria cases. Conversely, individuals from higher elevations with low malaria test positivity rates, and those living in households with 5-10 occupants and < 2 malaria infections, were more likely to possess bed nets. CONCLUSIONS: This gold mining settlement provides an example of an oft-neglected atypical community where malaria is a significant, but under-addressed, health problem. Within this community, future interventions focused on distributing bed nets, particularly to larger households and those with children, have great potential to alleviate the malaria burden. Efforts should also be made to provide affordable, and accessible, early diagnosis and treatment.
Assuntos
Ouro , Malária Falciparum , Mineração , Migrantes , Humanos , Etiópia/epidemiologia , Estudos Transversais , Adulto , Adolescente , Feminino , Masculino , Prevalência , Adulto Jovem , Migrantes/estatística & dados numéricos , Pessoa de Meia-Idade , Pré-Escolar , Criança , Lactente , Malária Falciparum/epidemiologia , Idoso , Plasmodium falciparumRESUMO
OBJECTIVE: Coronavirus disease 2019 (COVID-19) has caused psychological distress among health-care professionals (HCP) worldwide, suggesting that morale could also be affected. This warrants further investigation as HCPs' morale directly impacts delivery of quality care and work productivity. This study aims to explore the experiences of HCPs who served migrant workers in a local COVID-19 hotspot in Singapore and the impact on their morale. METHODS: Eleven volunteer HCPs from a regional hospital in Singapore who served migrant workers in a local COVID-19 hotspot were recruited. Semi-structured face-to-face interviews were conducted, and recordings were transcribed verbatim. Transcripts were analyzed using thematic analysis. Morale of HCPs was evaluated based on responses. RESULTS: Four main themes emerged: motivators, challenges, support, and leadership. Motivators or factors that drove HCPs to serve include varying personal reasons and a sense of duty to do good. Challenges faced by HCPs include a language barrier, keeping up with rapidly changing workflows, fear of contagion, and coping with emotions. Support and leadership were revealed to have boosted HCPs' morale. CONCLUSIONS: Peer and social support and effective leadership have potential protective effects on HCPs' morale against negative experiences faced during the COVID-19 pandemic.
Assuntos
COVID-19 , Pessoal de Saúde , Moral , Migrantes , Humanos , Singapura , COVID-19/psicologia , COVID-19/epidemiologia , Pessoal de Saúde/psicologia , Pessoal de Saúde/estatística & dados numéricos , Migrantes/psicologia , Migrantes/estatística & dados numéricos , Masculino , Feminino , Adulto , Pesquisa Qualitativa , Pandemias , Pessoa de Meia-Idade , SARS-CoV-2 , Motivação , Entrevistas como Assunto/métodosRESUMO
BACKGROUND: This study focused on Ukrainian refugees and migrants, a population that, with an ongoing war, is expected to grow in Germany. Over 1 million Ukrainians with exceptional legal status and access to public insurance in Germany significantly burden governmental services, especially German healthcare. It is thus essential to facilitate their integration into the healthcare system and ensure its proper usage. Identifying the obstacles Ukrainian refugees and migrants encounter while accessing healthcare services is crucial to ease their integration. METHODS: A qualitative study was conducted from February 2023 to April 2023. Thirty semi-structured interviews were performed with Ukrainian migrants and refugees. The interviews were transcribed verbatim, organized, and categorized. Thematic analysis was performed to identify barriers related to the use of German healthcare services. To assess possible differences in the experiences of Ukrainian refugees and migrants, the responses of these two groups for each topic were analysed separately. RESULTS: Ukrainian migrants and refugees experience similar barriers while accessing German healthcare services. Predominantly, language barriers and a lack of understanding of the German healthcare system posed the main barriers in both groups. Additionally, structural challenges, such as differences in referral processes, appointment scheduling, and consultation duration, presented further challenges. CONCLUSION: This research study emphasizes the importance of addressing cultural and structural barriers to improve healthcare accessibility and utilization for Ukrainian refugees and migrants in Germany to better facilitate their integration into the healthcare system.
Assuntos
Barreiras de Comunicação , Acessibilidade aos Serviços de Saúde , Pesquisa Qualitativa , Refugiados , Migrantes , Humanos , Refugiados/estatística & dados numéricos , Refugiados/psicologia , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Ucrânia , Alemanha , Feminino , Masculino , Migrantes/estatística & dados numéricos , Migrantes/psicologia , Adulto , Pessoa de Meia-Idade , Entrevistas como AssuntoRESUMO
Objective: Ensuring the sustainability of the migrant workforce requires a comprehensive understanding of the psychological challenges faced by this sub-population due to concerns about the wellbeing and financial situation of family members in their home countries. Therefore, this study investigates the factors associated with psychological distress among sub-Saharan Africa (SSA) migrant workers across Australia and Canada during the COVID-19 pandemic. Method: Data were collected from 378 first-generation migrant workers with SSA ancestry residing in Australia and Canada using the Depression Anxiety and Stress Scale 21 (DASS-21). Multivariate logistic regression analysis was used to determine socio-demographic factors associated with depression, anxiety, and stress among SSA migrants' populations. Results: Across both countries, migrants with lower levels of education were more prone to reporting feelings of depression, anxiety, and stress during the pandemic. Female participants in Australia were more likely to report feeling of depression. Participants in Australia and Canada who were separated/divorced/widowed were less likely to report stress and depression, respectively. Participants in Australia who had lived in Australia between 11 and 20 years and those between 36 and 50 years old were more likely to report feelings of depression. Participants residing in Australia whose SSA ancestry was Southern Africa/Central Africa were more likely to report anxiety. Participants in Australia who worked as part-time permanent workers and those who worked as fixed-term workers/short-term/casual workers were less likely to report anxiety. Finally, participants in Canada who reported two or more people living with them had higher odds of reporting anxiety. Conclusions: The findings from this study highlight key factors associated with SSA migrant workers' psychological distress during the pandemic. The results can inform policies and provide insight to the development of mental health intervention strategies for migrant workers to minimize similar distress during pandemics.
Assuntos
COVID-19 , Angústia Psicológica , Migrantes , Humanos , COVID-19/psicologia , COVID-19/epidemiologia , Feminino , Adulto , Masculino , Estudos Transversais , Pessoa de Meia-Idade , Austrália/epidemiologia , Canadá/epidemiologia , Migrantes/psicologia , Migrantes/estatística & dados numéricos , África Subsaariana/etnologia , África Subsaariana/epidemiologia , Adulto Jovem , Depressão/epidemiologia , Depressão/psicologia , Estresse Psicológico/epidemiologia , Estresse Psicológico/psicologia , Ansiedade/epidemiologia , Ansiedade/psicologia , Adolescente , SARS-CoV-2RESUMO
(1) Background: To evaluate a model based on the right-to-health approach, considering the impact of associated factors on the future utilization of primary healthcare services among international migrants in Chile. (2) Methods: A cross-sectional design was employed to survey 499 South American migrants residing in Chile. Ad-hoc questionnaires were used to assess their experiences related to the right to health, perceived discrimination, income, education, length of residence, age, marital status, gender, migration status, among others. Correlation analyses were conducted, followed by path analysis with significant variables to assess the fit of two models. (3) Results: Ten variables were identified as significant for path analysis. Among the two evaluated models, the final model identified six variables with significant direct and indirect effects. Among them, the availability, accessibility, acceptability, and quality of healthcare services were positively associated with the future intention to use them. Additionally, perceived racial and ethnic discrimination also had a positive effect on the intention to use healthcare services, suggesting a possible adaptive response to adversity, exhibiting acceptable goodness-of-fit indices (χ2 =241,492; p < 0.001; CFI = 0.913; TLI = 0.82; RMSEA = 0.062; SRMR = 0.05). (4) Conclusions: While the initial model provides valuable insights, it is essential to broaden the analysis to include other factors influencing the specific context of international migrants.
Assuntos
Intenção , Atenção Primária à Saúde , Migrantes , Humanos , Atenção Primária à Saúde/estatística & dados numéricos , Feminino , Masculino , Adulto , Chile , Estudos Transversais , Migrantes/estatística & dados numéricos , Migrantes/psicologia , Pessoa de Meia-Idade , Adulto Jovem , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Inquéritos e Questionários , Adolescente , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricosRESUMO
This case study, anchored in the Social Ecological Model (SEM), delves into the dietary behaviors of a 67-year-old first-generation Tongan woman in Utah. It uncovers pivotal themes through narrative and thematic analysis: cultural identity, economic constraints, environmental adaptation, and health perceptions. The study underscores the importance of cultural preservation, economic stability, and the centrality of traditional Tongan foods, revealing a complex interplay between cultural adaptation and health awareness. Community support and engagement emerged as crucial in sustaining healthy dietary practices amid cultural changes. The study advocates for an SEM-based framework to guide future research and develop culturally sensitive interventions to improve dietary behaviors among first-generation Tongan immigrants and similar groups and offers valuable insights. The limited generalizability of this study due to its single-case design necessitates future investigations to incorporate broader and more diverse samples to validate the findings and tailor more precise interventions.
Assuntos
Migrantes , Humanos , Feminino , Idoso , Utah , Tonga , Migrantes/estatística & dados numéricos , Migrantes/psicologia , Dieta/métodos , Dieta/estatística & dados numéricos , Comportamento Alimentar/psicologia , Emigrantes e Imigrantes/estatística & dados numéricos , Emigrantes e Imigrantes/psicologia , Estados UnidosRESUMO
The increasing presence of overseas Filipino workers (OFWs) in Taiwan, particularly in the electronics and technology (E&T) industry, has raised concerns about their health and health-seeking behaviours. Our study draws on a theoretical framework combining Brandenberger et al.'s 3C model, which considers challenges in communication, continuity of care, and confidence regarding healthcare delivery for migrant workers, with Scott's sociology of nothing. This framework enables us to interpret the decisions of OFWs on seeking care, not seeking care, or not making any decision. Although the National Health Insurance covers migrant workers and the New South Bound Policy commits to promoting migrant health, narrative accounts of individual workers, migrant rights advocates, and shelter organisers inform us of OFWs' ambivalence towards utilising the healthcare resources available. The decisions made by OFWs in the E&T industry may include seeking assistance, not seeking assistance, or not addressing health concerns due to legal, financial, or cultural reasons. The contextual nuances behind their decisions led us to look beyond the challenges they face and argue for interventions such as peer education on legal rights awareness and health literacy to enable OFWs to make informed decisions about their well-being.
Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Humanos , Taiwan , Filipinas/etnologia , Feminino , Masculino , Adulto , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Migrantes/psicologia , Migrantes/estatística & dados numéricos , Tomada de Decisões , Acessibilidade aos Serviços de Saúde , Pesquisa QualitativaRESUMO
BACKGROUND: The MENA region has experienced extraordinary events in recent years, resulting in an influx of refugees and displaced people who are vulnerable to mental disorders. Several previous studies have examined their prevalence, but none have focused on this region. This systematic review provided an estimate of the prevalence of mental illness and associated risk factors in the MENA region, and overcame the methodological limitations of individual studies. METHODS: Thorough searches of the relevant databases were carried out to locate relevant published articles. Furthermore, cross-sectional studies were conducted to assess mental disorders in refugees, asylum seekers, migrants, or internally displaced people residing in the MENA region. Only studies meeting the aforementioned criteria were considered. For this purpose, RStudio software version 2023.12.0 + 369 with netmeta package was used for measurement and data analysis. JBI used to assess study quality. RESULTS: The results, including 32 cross-sectional studies with a total of 21659 participants were obtained and discussed. The overall prevalence was 42% (95% CI; 30%, 54%) for depression, 43% (95% CI; 31%, 57%) for anxiety, 22% (95% CI; 11%, 39%) for stress, and 45% (95% CI; 36%, 53%) for PTSD. As a result, it was noted that being female was associated with depression, and being female and unemployed was associated with PTSD, however being married was protective against this later. CONCLUSION: Compared to the rest of the globe, MENA has a greater rate of mental illness among refugees. Nevertheless, much effort should be devoted on listing causes associated, as well as their management and prevention.
Assuntos
Transtornos Mentais , Refugiados , Migrantes , Humanos , Prevalência , Fatores de Risco , Transtornos Mentais/epidemiologia , Migrantes/psicologia , Migrantes/estatística & dados numéricos , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Estudos Transversais , FemininoRESUMO
OBJECTIVES: This study aimed to explore farmworkers' experiences of social vulnerability during the peak period of the COVID-19 pandemic. METHODS: Telephone surveys of 63 migrant and seasonal farmworkers across three major agricultural areas in Florida were conducted. The survey, designed and disseminated with critical support from a statewide farmworker membership and advocacy organization, included items related to social and occupational precarity and a suite of demographic conditions, including specific employment-based indicators and categories. Data were analyzed with SPSS using a series of statistical significance tests including Pearson's Chi-Square, Fisher's Exact, T-tests, and Mann-Whitney U. An open-ended question regarding employment precarity was also analyzed for frequencies of responses pertaining to a set of descriptive categories. RESULTS: Survey findings demonstrated a high degree of social vulnerability among the farmworker sample, with notable variation in the type and severity of vulnerability and risk exposure across employment-based indicators and occupational categories. For example, a cross-industry comparison between vegetable field workers and greenhouse nursery workers revealed a disparity in COVID-exposure risk through commuting characteristics, as 43% of vegetable field workers used shared, employer-provided transport, while 68% of nursery workers used personal vehicles. CONCLUSION: While previous research has broadly established the extreme precarity of migrant and seasonal farmworkers during the peak COVID-19 period, the variability of experience, exposure to risk, and social vulnerability between farmworkers representing distinct employment-based indicators and occupational categories demonstrated in this study contributes to widening awareness of the importance of assessing farmworker experiences at a more granular level. In addition to delineating social vulnerability across key demographic categories, cross-industry comparisons between farmworkers revealed significant discrepancies in risk and vulnerability to COVID-19. Future research that further explores this variability may reveal opportunities to improve disaster-relief planning and mitigate social vulnerability in future disaster scenarios. The importance of surveying the vulnerability of worker populations, aside from geographic communities, is highlighted.
Assuntos
COVID-19 , Emprego , Fazendeiros , Migrantes , Humanos , COVID-19/epidemiologia , Migrantes/estatística & dados numéricos , Migrantes/psicologia , Fazendeiros/estatística & dados numéricos , Fazendeiros/psicologia , Masculino , Adulto , Feminino , Florida/epidemiologia , Emprego/estatística & dados numéricos , Vulnerabilidade Social , Pessoa de Meia-Idade , Inquéritos e Questionários , SARS-CoV-2 , Agricultura , Adulto Jovem , PandemiasRESUMO
PURPOSE: More than a quarter of the German population has a migration background (MB). As various studies in the healthcare sector have already shown, ethnic background and migration status can have an influence on individual patient care. The aim of our study was to evaluate whether there are differences in utilization of out of pocket health-care services and the consultation situation in the context of prenatal care, taking into account migration status, acculturation and socio-demographic aspects. METHODS: In the period from 01.03.21-01.03.22, a total of 511 women in childbed at the University Women's Hospital Ulm were interviewed in a retrospective survey using a standardized questionnaire translated into 9 languages and asked about their prenatal care. Due to the COVID pandemic, the study had to be terminated after one year. RESULTS: Women with MB-particularly 1st generation migrant women-used significantly fewer out of pocket prenatal care services (p < 0.001) and felt less informed and counselled regarding costs and benefits of possible prenatal care examinations (p < 0.001) compared to women without MB. Consistent with these results, there were associations between the assimilation index (AI) of patients with MB and both utilization and perception of individual healthcare services. CONCLUSION: Our study indicates that even today there are still differences in the treatment and perception of various health services in the context of prenatal care between women with and those without MB.
Assuntos
Aculturação , Cuidado Pré-Natal , Humanos , Feminino , Gravidez , Alemanha , Adulto , Cuidado Pré-Natal/estatística & dados numéricos , Estudos Retrospectivos , COVID-19/etnologia , COVID-19/epidemiologia , Aceitação pelo Paciente de Cuidados de Saúde/etnologia , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Inquéritos e Questionários , Migrantes/estatística & dados numéricos , Adulto Jovem , Emigrantes e Imigrantes/estatística & dados numéricosRESUMO
OBJECTIVE: The number of forced migrants has been rising for years. Many forced migrants suffer from post-traumatic stress disorder (PTSD), depression, and/or anxiety and need treatment. Here, we evaluate the effectiveness of psychological interventions (CBT, EMDR, expressive/art, mindfulness, mixed elements, NET and psychoeducation) in reducing symptoms of PTSD, depression, and anxiety in forced migrants. DESIGN AND DATA SOURCES: Systematic searches in PubMed and Web of Science and searches of preprint servers and grey literature were performed (final search date: 1 September 2023). Random-effects frequentist and Bayesian meta-analyses were used for data synthesis. RESULTS: We included 84 studies on treatment effects in adults (pooled N = 6302) and 32 on children and adolescents (pooled N = 1097). Our data show a reduction in symptoms of PTSD, depression and anxiety symptoms in both adults and child/adolescent forced migrants. Pooled pre- to post-treatment effects (effect size Cohen's d) ranged from -1.03 to -0.26 for PTSD, from -0.91 to -0.11 for depression and from -0.91 to -0.60 for anxiety, without there being differences in outcome per study design (i.e., RCT comparison vs. non-RCT comparison vs. single arm treatment study). Treatment effects remained evident over follow-up, and not a single type of treatment stood out as being superior to other treatment types. Structural differences in populations (e.g., regarding country of origin) over studies, however, could have hampered the validity of the comparisons between study characteristics such as treatment type. CONCLUSION: Our findings support the effectiveness of psychological treatment in adult and child/adolescent forced migrants.