Journal of Migration and Health最新文献

{"title":"Breast cancer-specific survival among immigrants and non-immigrants invited to BreastScreen Norway","authors":"Sameer Bhargava ,&nbsp;Jonas Gjesvik ,&nbsp;Jonas Thy ,&nbsp;Marthe Larsen ,&nbsp;Solveig Hofvind","doi":"10.1016/j.jmh.2024.100222","DOIUrl":"https://doi.org/10.1016/j.jmh.2024.100222","url":null,"abstract":"<div><h3>Introduction</h3><p>We have previously shown that immigrants have lower attendance in BreastScreen Norway than non-immigrants and that non-Western immigrants have lower incidence of breast cancer, but more advanced disease.</p></div><div><h3>Purpose</h3><p>To compare breast cancer-specific survival for immigrants versus non-immigrants diagnosed with screen-detected or symptomatic breast cancer.</p></div><div><h3>Material and methods</h3><p>We analyzed data from 28,320 women aged 50–69 diagnosed with breast cancer after being invited to BreastScreen Norway. We divided women into three groups; non-immigrants, immigrants from Western countries and immigrants from non-Western countries. We stratified our analyses according to detection mode (screen-detected breast cancer, interval cancer and cancer detected outside screening), and used cox regression to model the association between immigrants/non-immigrants and time to breast cancer death.</p></div><div><h3>Results</h3><p>Among screen-detected breast cancers, 28.7% were histologic grade 3 among immigrants from non-Western countries compared to 21.3% among non-immigrants. Interval cancers and cancers detected outside screening had larger tumor diameter and a higher percentage were histologic grade 3 and lymph node positive among immigrants from non-Western countries compared to non-immigrants. Hazard ratio (95% confidence interval) adjusted for age and year of diagnosis for time to breast cancer death compared to non-immigrants was 0.70 (0.39–1.27) for immigrants from Western countries and 0.52 (0.23–1.17) for immigrants from non-Western countries.</p></div><div><h3>Conclusion</h3><p>Despite more advanced histopathological tumor characteristics among immigrants from non-Western countries compared to non-immigrants, we did not observe statistically significant differences in breast-cancer specific survival between the two groups. Keeping in mind the low number of breast cancer deaths and possible overestimation of survival among immigrants, this might imply that equity in outcome can be achieved through adequate follow-up and treatment despite inequal access.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"9 ","pages":"Article 100222"},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000126/pdfft?md5=0f26e7d4ce6e7d6f07000e1cfa1a11bd&pid=1-s2.0-S2666623524000126-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140069278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albania and Kosovo-Albania Immigrants' Perceptions of Mental Well-Being and the Psychological Challenges Faced in Malaysia","authors":"Voltisa Thartori ,&nbsp;Nik Ahamd Hisham Ismail","doi":"10.1016/j.jmh.2024.100234","DOIUrl":"10.1016/j.jmh.2024.100234","url":null,"abstract":"<div><h3>Background</h3><p>Immigrants who relocate to a foreign country often face numerous stressors and challenges as they try to assimilate to a new culture. This transition can often have a significant impact on their mental well-being. In this qualitative study, we aim to explore and examine the life experiences of 16 Albanian and Kosovo-Albania immigrants who have settled in Malaysia, as well as those who previously resided in Malaysia but are now living in Australia and Albania.</p></div><div><h3>Objectives</h3><p>This study aimed to investigate two main objectives: (i) to explore immigrants’ psychological problems and how they perceive and approach mental well-being; and (ii) to identify the challenges and barriers that immigrants face in Malaysia.</p></div><div><h3>Methods</h3><p>The data was obtained using a qualitative phenomenological case study, using in-depth semi-structured interviews. The interviews were audio-recorded, transcribed, and thematically analysed.</p></div><div><h3>Results</h3><p>The study's findings indicate that immigrants' mental well-being is positively affected by inner peace, happiness, fulfilling family needs, a balanced life, and self-improvement. On the other hand, challenges related to visa and employment pass issues, difficulty in securing employment status, feeling like a foreigner, and lack of family support have a negative impact on their mental well-being.</p></div><div><h3>Implications</h3><p>The study's findings advocate for targeted support programmes to address the psychological challenges of Albanian immigrants. Prioritising inner peace and self-improvement benefits their mental well-being. Policymakers are encouraged to prioritise reducing employment pass difficulties and fostering an inclusive job market to improve employment opportunities for this community.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100234"},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000242/pdfft?md5=92d579c1f88ebf278c4f8c78650bf938&pid=1-s2.0-S2666623524000242-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141137856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Psychosocial health of migrant careworkers from Southeast Asian countries in Israel: A mixed methods study","authors":"Jordan Hannink Attal ,&nbsp;Ido Lurie ,&nbsp;Yehuda Neumark","doi":"10.1016/j.jmh.2024.100263","DOIUrl":"10.1016/j.jmh.2024.100263","url":null,"abstract":"<div><h3>Background</h3><p>In 2018, 66,859 migrant careworkers were in Israel, most of whom originated from Southeast Asian countries and 81 % of whom are women. Stringent regulations combined with social invisibility creates vulnerabilities that may contribute to emotional distress. This study aimed to assess psychosocial status and determine mechanisms of emotional distress and resilience in this population.</p></div><div><h3>Methods</h3><p>Mixed methods were used in this cross-section study. An online survey measured demographic variables, psychosocial wellbeing using the HSCL-25 questionnaire, general health, perceived social support, cultural identity, and perceived othering. Based on the survey's results, interviews were conducted with a subpopulation of respondents (<em>n</em> = 15) to further understand the mechanisms of emotional distress and resilience, and were analyzed using a postcolonial feminist framework and grounded theory. Data collection took place during 2018–2019.</p></div><div><h3>Results</h3><p>In total, 263 careworkers completed the survey and 15 careworkers were interviewed. The overall prevalence of emotional distress according to the HSCL-25 was 36.8 %, 22.6 % on the anxiety subscale, and 41.8 % on the depression subscale. Emotional distress was associated with female sex, not being parents, poorer general health, high perceived othering, and low perceived social support. Interviews revealed that Israeli policy, and relationships with family in their country of origin and with Israeli employers and their families can either contribute to or mitigate emotional stressors.</p></div><div><h3>Conclusions</h3><p>Symptoms of emotional distress among Southeast Asian migrant careworkers in Israel are frequently reported, and may indicate rates of anxiety and depression higher than in careworkers’ countries of origin and host country. Increased monitoring to protect careworkers’ rights and including mental health services as part of their health insurance plan are warranted.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100263"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000527/pdfft?md5=3474be28f48cc1b7e6347d5141afdf0a&pid=1-s2.0-S2666623524000527-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association of perceived ethnic discrimination and institutional verbal violence with chronic stress in an immigrant sample: The role of protective factors - results from the VIOLIN study","authors":"Felicitas Hauck ,&nbsp;Andrea Borho ,&nbsp;Lucía Romero Gibu ,&nbsp;Mojib Atal ,&nbsp;Sevil Dederer ,&nbsp;Petra Bendel ,&nbsp;Eva Morawa ,&nbsp;Yesim Erim ,&nbsp;Silke Jansen ,&nbsp;Nicolas Rohleder","doi":"10.1016/j.jmh.2024.100260","DOIUrl":"10.1016/j.jmh.2024.100260","url":null,"abstract":"<div><p>Immigrants are exposed to a variety of stressors, such as ethnic discrimination, and therefore experience a higher risk of developing adverse health outcomes. However, the role of potentially protective psychological factors is not well-studied. The present study addresses the question how discrimination and institutional verbal violence (IVV)<span><span>¹</span></span> are associated with chronic stress in an immigrant sample. In addition, this study highlights moderating effects of migration-specific variables (first or second migration generation and citizenship status).</p><p>Participants (<em>n</em> = 232; 69.4 % female) completed an online-survey, which included demographics, questionnaires (Everyday Discrimination Scale, EDS; Perceived Stress Scale, PSS-4; Resilience Scale, RS-11; Self-Compassion Scale, SCS-SF) as well as a self-developed questionnaire on institutional verbal violence. Only participants living in Germany with migration background (self or one parent migrated to Germany) were included.</p><p>Results showed that perceived discrimination and institutional verbal violence were highly associated with chronic stress. Further, self-compassion buffered the connection between discrimination and stress, whereas resilience was no protective factor. The inclusion of migration-specific variables showed that the second-generation sub-group experienced less discrimination-related stress and self-compassion was shown to be particularly protective within this sub-group. Citizenship status did not appear to be a moderator, but especially persons with temporary or permanent residence status, compared to German/EU-citizens, reported higher values of verbal violence and discrimination-related stress.</p><p>These findings highlight the importance of considering not only psychological but also structural and societal protective and risk factors, as they may be differentially associated with immigrants’ stress perceptions. Implications for future research and practical implementations are presented.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100260"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000497/pdfft?md5=152d428c4a6941a6023ec858ba1c01ba&pid=1-s2.0-S2666623524000497-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141953168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors contributing to the mental wellbeing of Afghan migrants in Iran during the COVID-19 pandemic","authors":"Fatemeh Khozaei ,&nbsp;Qamar Ul Islam ,&nbsp;T Ramayah ,&nbsp;Nadia Ayub ,&nbsp;Claus-Christian Carbon","doi":"10.1016/j.jmh.2024.100211","DOIUrl":"10.1016/j.jmh.2024.100211","url":null,"abstract":"<div><p>This study aims to explore the factors contributing mental health of Afghan migrants residing in Iran during the COVID-19 pandemic. With a deep understanding of the unique challenges encountered by migrants, especially during times of crisis, this research delves into the influential factors of experienced anxiety, social cohesion, and stress and their significant contribution to the development of depression among Afghan migrants. The study included a sample of 469 individuals from the Afghan migrant community, aged 15 to 80 years. Data collection took place from December to March 2022 in Iran. The study revealed that anxiety and the burden of the COVID-19 pandemic significantly influenced the occurrence of depression among Afghan migrants. Furthermore, the relationship between these factors and depression was mediated by the experience of stress. Conversely, higher levels of perceived social cohesion in the host country were linked to reduced stress and depression among the migrants. As Afghan migrants in Iran face a heightened risk of developing depression, the importance of social support and integration is underscored by the association between higher levels of perceived social cohesion in the host country and reduced levels of stress and depression. Recognizing the vulnerabilities of this population, it becomes evident that fostering social support networks and promoting integration can play a crucial role in mitigating the negative impact of migration-related stressors and enhancing mental wellbeing among this population.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"9 ","pages":"Article 100211"},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000011/pdfft?md5=fb5aadfbf15ad158c5814b65de73c56a&pid=1-s2.0-S2666623524000011-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139457048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Borders and liminality in the right to health of migrants in transit: The case of Colchane in Chile and Necoclí in Colombia","authors":"Andrea Carolina Jaramillo Contreras ,&nbsp;Báltica Cabieses ,&nbsp;Michael Knipper ,&nbsp;Teresita Rocha-Jiménez","doi":"10.1016/j.jmh.2024.100230","DOIUrl":"10.1016/j.jmh.2024.100230","url":null,"abstract":"<div><p>The absence of the right to health of migrants in transit has evolved into a significant global health concern, particularly in the border regions thus, this study aims to improve knowledge in this area by exploring the effects of the spatio-temporal liminal characteristics at borders in the achievement of the right to health of migrants in transit moving across two of the most transited and dangerous borders in Latin America: Colchane (Chile-Bolivia) and the Darién Gap (Colombia-Panamá). Through a qualitative descriptive multi-case study, we implemented 50 semi-structured interviews (<em>n</em> = 30 in Chile and <em>n</em> = 20 in the Darién/Necoclí) involving national, regional, and local stakeholders. The findings highlight that the fulfilment of the right to health of migrants in transit is hindered by liminal dynamics at the borders. These dynamics include closure of borders, (in)securities, uncertainty and waiting, lack of economic resources, lack of protection to all, liminal politics, and humanitarian interventions. These findings surface how the borders’ liminality exacerbates the segregation of migrants in transit by placing them in a temporospatial limbo that undermines their right to health. Our study concludes that not just the politics but also the everyday practices, relationships and social infrastructure at borders impedes the enjoyment of the right to health of distressed migrants in transit. The short-term humanitarian response; illicit dynamics at borders; migratory regulations; and border and cross-border political structures are some of the most significant determinants of health at these borderlands.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"9 ","pages":"Article 100230"},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000205/pdfft?md5=bcffec3a669ee5882132d26781eb3638&pid=1-s2.0-S2666623524000205-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140756496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intergenerational ambivalence among families with a migrant background caring for older relatives","authors":"Sunita Shrestha ,&nbsp;Alistair Hunter ,&nbsp;Jonas Debesay ,&nbsp;Sanjana Arora","doi":"10.1016/j.jmh.2024.100244","DOIUrl":"10.1016/j.jmh.2024.100244","url":null,"abstract":"<div><h3>Introduction</h3><p>Europe's population is aging and becoming more ethnically diverse due to migration. The growing number of aging migrants has raised concerns about their future eldercare arrangements and their implications for both families and formal care services. Many older non-European migrants prefer family care over formal, long-term care facilities.</p></div><div><h3>Objective</h3><p>The objective of this study is to explore the family caregiving arrangements for older Pakistani migrants from the Ahmadiyya community in Norway.</p></div><div><h3>Methods</h3><p>This exploratory qualitative study recruited 19 women between 25 and 62 years of age who were family caregivers for older adults. Semi-structured individual (18) and group interviews (2) were conducted in Urdu and English.</p></div><div><h3>Findings</h3><p>Our analysis reveals four main themes: the need to share caring responsibilities with family, balancing personal relations in managing care, lack of privacy while caregiving, and feelings of inadequacy.</p></div><div><h3>Conclusion</h3><p>While rotational care for older family members offers benefits such as the sharing of responsibilities and more privacy, reliance solely on family care arrangements led to greater ambivalence among family caregivers and provoked doubts about the ability to continue caring for older relatives in the future. Our findings highlight the urgent need to establish modes of collaboration with formal care systems to ensure the support and well-being of both older adults and their family caregivers.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100244"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000333/pdfft?md5=c3fca7504efad8699464ce2b3fa21da9&pid=1-s2.0-S2666623524000333-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141639142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing care deficits in Ireland's international protection accommodation system: Lessons learned in COVID-19 and beyond","authors":"Felicity Daly ,&nbsp;Jacqui O'Riordan","doi":"10.1016/j.jmh.2024.100255","DOIUrl":"10.1016/j.jmh.2024.100255","url":null,"abstract":"<div><p>Responding to the need for qualitative research that reveals the lived reality of how forced migrants endured the COVID-19 pandemic this paper presents findings from eleven interviews with asylum seekers residing in Ireland's Direct Provision (DP) accommodation system that detail care deficits before, during and after COVID-19 along with analysis of how care is discussed within Irish policy documents concerned with the health and wellbeing of asylum seekers. The research contributes personal testimony and documentary evidence of the inability of DP to properly adapt to the pandemic and its failure to protect the health and wellbeing of asylum seekers given pre-existing care deficits. The paper argues that an ethic of care practiced for and with asylum seekers must ensure they are not re-traumatised, and their health disparities are not exacerbated during public health crises and beyond. The findings are relevant to efforts to reform how international protection responsibilities are enacted in Ireland and other destinations of forced migrants, including EU member states.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100255"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000448/pdfft?md5=18de0f4faacfd2da19b7b9d9526688a9&pid=1-s2.0-S2666623524000448-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141849519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myanmar migrants living along the Thailand-Myanmar border: Experiences related to pandemic and migration decisions","authors":"Wei-Ti Chen ,&nbsp;Chengshi Shiu ,&nbsp;Rachel H. Arbing ,&nbsp;Khin Moe Myint ,&nbsp;Khine Myint Oo ,&nbsp;Shu-Sheng Lai ,&nbsp;David Tanoko ,&nbsp;Sarah Oung ,&nbsp;Poy Yamada ,&nbsp;Saiyud Moolphate ,&nbsp;Thin Nyein Nyein Aung ,&nbsp;Myo Nyein Aung","doi":"10.1016/j.jmh.2024.100259","DOIUrl":"10.1016/j.jmh.2024.100259","url":null,"abstract":"<div><h3>Importance</h3><p>In Myanmar, amid political and civil unrest, droves of Burmese are displaced to neighboring countries including Thailand. Since the COVID-19 pandemic, little is known about the available healthcare services and health and well-being among refugees and migrant workers within resettlement areas along the Myanmar-Thailand border.</p></div><div><h3>Objective</h3><p>To explore the unmet needs of migrants along the Thailand-Myanmar border during the COVID-19 pandemic and their reasons for leaving Myanmar.</p></div><div><h3>Design</h3><p>A qualitative study that used focus groups with migrant schoolteachers and school masters was undertaken. An interpretative analysis approach was used to analyze the data from the focus group sessions. The study followed the COREQ (COnsolidated criteria for REporting Qualitative) checklist.</p></div><div><h3>Setting</h3><p>In July 2022, community stakeholders from migrant schools located in the vicinity of Mae Sot, Thailand were referred to the study team.</p></div><div><h3>Participants</h3><p>A purposive sample of 17 adult participants was recruited from 4 migrant schools. The participants were schoolteachers and schoolmasters who had traveled from Myanmar to Thailand 1 to 20 years ago.</p></div><div><h3>Main Outcome(s) and Measure(s)</h3><p>Thematic analysis was used to scrutinize qualitative data for the outcomes of health and well-being, barriers, and reasons for migration.</p></div><div><h3>Results</h3><p>Three main themes were identified: “issues related to the pandemic”, “teenage marriage and pregnancies” and \"migration decisions\". The issues related to the pandemic included behavior changes in children, a diminished quality of education, and barriers to receiving COVID-19 vaccines and accessing other health care. There were more dropouts due to teenage pregnancy/marriage during the shelter in place mandate. Migration decisions were affected by concerns over health, civil unrest, and military harassment.</p></div><div><h3>Conclusions and Relevance</h3><p>This study presented the difficulties experienced by Myanmar migrants currently living along the Thailand-Myanmar border. The reasons for leaving Myanmar included health and safety. Suspending education during the pandemic caused more school dropouts due to teenage pregnancy/marriage. Additionally, behavioral changes in children, a diminished quality of education, barriers to receiving COVID-19 vaccines and access to other health care services were reported. Future studies should focus on how migration stress and access to mental health care impact the migrant population.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100259"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000485/pdfft?md5=a172887907f2b1fba189aee690196cee&pid=1-s2.0-S2666623524000485-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Providing continuity of care for people living with noncommunicable diseases in humanitarian settings: A qualitative study of health actors' experiences in Lebanon","authors":"C. Akik ,&nbsp;Z. El Dirani ,&nbsp;R. Willis ,&nbsp;C. Truppa ,&nbsp;C. Zmeter ,&nbsp;S. Aebischer Perone ,&nbsp;J. Roswall ,&nbsp;R. Hamadeh ,&nbsp;K. Blanchet ,&nbsp;B. Roberts ,&nbsp;M.F. Fouad ,&nbsp;P. Perel ,&nbsp;É. Ansbro","doi":"10.1016/j.jmh.2024.100269","DOIUrl":"10.1016/j.jmh.2024.100269","url":null,"abstract":"<div><h3>Objective</h3><div>The burden of non-communicable diseases (NCDs) is increasing among populations living in humanitarian settings. Continuity of care (CoC) involves following an individual over time and across different levels of healthcare (management, longitudinal, informational and interpersonal continuity); it is an essential component of good quality, person-centred NCD care. Providing CoC is particularly challenging in humanitarian crises where health care access may be interrupted or restricted. This paper aimed to explore health actors’ experiences of continuity of hypertension and diabetes care for Syrian refugees and vulnerable Lebanese in Lebanon.</div></div><div><h3>Methods</h3><div>We conducted 20 in-depth qualitative interviews with health actors, including eleven with health care providers at four urban-based health facilities supported by international humanitarian agencies that provide NCD care to Syrian refugees and vulnerable Lebanese, one representative of a governmental institution, one international delegate and seven humanitarian actors. Thematic analysis, combining inductive and deductive approaches, was guided by a conceptual framework for NCD models of care in humanitarian settings. We reported our findings against the conceptual framework's domains relating to health system inputs and intermediate goals, reflecting on their impact on the domains of CoC.</div></div><div><h3>Findings</h3><div>Existing health system weaknesses and novel challenges (the economic crisis, COVID-19 pandemic and Beirut blast) to continuity of NCD care were identified. Health system input challenges: governance and financing (weakened governance, limited central financing, historical dependence on local NGOs for primary healthcare, a dominant private sector), health workforce (exodus of health care providers from the public system), inconsistent medicines and equipment supplies, and limited health information systems (no unified system across institutions or levels of care, lack of formal referral systems, and inconsistent facility-level data collection) contributed to limited public primary care, poorly integrated within a fragile, pluralistic health system. These factors negatively impacted the intermediate health system goals of access, standardisation and quality of NCD care for Syrian refugee and Lebanese patients, and collectively hampered the management, longitudinal, informational and interpersonal continuity of NCD care in Lebanon.</div></div><div><h3>Conclusion</h3><div>We recommend that humanitarian actors continue the work underway with the Lebanese Ministry of Public Health to align with and strengthen health system inputs, including supporting health governance through the accreditation process, exploring new funding mechanisms, strengthening the workforce via task sharing and training, supporting the medication supply chain, improving access to facilities and service quality, and supporting the development, standardisatio","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":"10 ","pages":"Article 100269"},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142418455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}