Journal of Migration and Health最新文献

{"title":"Intergenerational ambivalence among families with a migrant background caring for older relatives","authors":"","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":null,"pages":null},"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":"","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":null,"pages":null},"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":"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":null,"pages":null},"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":"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":"","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":null,"pages":null},"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":"Myanmar migrants living along the Thailand-Myanmar border: Experiences related to pandemic and migration decisions","authors":"","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":null,"pages":null},"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":"Psychosocial health of migrant careworkers from Southeast Asian countries in Israel: A mixed methods study","authors":"","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":null,"pages":null},"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 impact of the health microinsurance M-FUND on the utilization of health services among migrant workers and their dependents in Thailand: A case-control study","authors":"Andrea König ,&nbsp;Jarntrah Sappayabanphot ,&nbsp;Li Liang ,&nbsp;Steffen Fleßa ,&nbsp;Volker Winkler","doi":"10.1016/j.jmh.2024.100236","DOIUrl":"https://doi.org/10.1016/j.jmh.2024.100236","url":null,"abstract":"<div><h3>Background</h3><p>Even though Thailand has launched multiple migrant health policies, migrants still face various barriers in accessing health care. To some extent, these barriers may be reduced by health microinsurance. The M-FUND is a low-cost, not-for-profit health protection scheme for migrant workers in Thailand, created by Dreamlopments Social Enterprise and Foundation to support sustainable access to quality healthcare services for migrants. We aimed to investigate the impact of the M-FUND on utilization of health services.</p></div><div><h3>Methods</h3><p>Over a period of three months, we conducted quantitative face-to-face interviews with 408 M-FUND members, and 452 age, sex and location matched non-member controls in Tak Province, Thailand. We compared utilization of health services between members and non-members using logistic regression controlling for a number of socio-demographic variables and variables related to migration such as years in Thailand, legal status, etc.</p></div><div><h3>Findings</h3><p>M-FUND members were more likely to have utilized outpatient services (adjusted odds ratio: 1·74, 95 % confidence interval: 1·24–2·44), inpatient services (2·96, 1.11–7·92), and emergency care (1·89, 0·78–4·56), although the latter was not statistically significant. Members were more likely not to have purchased medicines over-the-counter (1·67, 1·22–2·27) than non-members. Members were also more likely to have utilized any additional specific service during a consultation (2·31, 1·49–3·58) including any type of imaging method (2·62, 1·29–5·29) and blood tests (1·64, 0·99–2·71). There were some differences between men and women, but most were not statistically significant.</p></div><div><h3>Interpretation</h3><p>The M-FUND health microinsurance was positively associated with the utilization of all major types of health services among migrant workers and their dependents in Thailand. For migrants, particularly vulnerable migrant workers and their dependents, the M-FUND appears to be a good approach to reducing barriers to health care. This study of the impact of health microinsurance for migrants provides important information for policy and program planners in the field of migrant health. However, more research is needed on health microinsurance schemes for migrants in different settings and for other underserved communities as well as the sex-specific impact on health service utilization.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000266/pdfft?md5=f886084713c0f3d53248d28a04e76e83&pid=1-s2.0-S2666623524000266-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140951496","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":"Barriers and facilitators for the sexual and reproductive health and rights of displaced Venezuelan adolescent girls in Brazil","authors":"","doi":"10.1016/j.jmh.2024.100252","DOIUrl":"10.1016/j.jmh.2024.100252","url":null,"abstract":"<div><h3>Background</h3><p>The crisis in Venezuela has forced almost eight million people to flee to mainly neighbouring countries, including Brazil. Half of the displaced Venezuelans are women and girls, with adolescent girls facing distinctive challenges to their sexual and reproductive health during displacement and settlement. The aim of this study is to understand the barriers and facilitators for the sexual and reproductive health of adolescent Venezuelan girls residing in Brazil.</p></div><div><h3>Methods</h3><p>The study used qualitative methods, including semi-structured interviews with 19 Venezuelan migrant adolescent girls conducted in Boa Vista and Manaus. We analysed transcripts using thematic analysis, and mapped findings to a theoretical framework based on the Bronfenbrenner Socio-ecological Model, which we adapted to explore how intersectional vulnerabilities at the individual level interact with contextual factors creating barriers and facilitators for health and rights of migrant adolescent girls.</p></div><div><h3>Results</h3><p>Venezuelan adolescent migrants in Brazil face practical and structural barriers in realising their sexual and reproductive health and rights in four areas: menstruation; family planning, contraception and sexually transmitted infection; prenatal, childbirth and postnatal care; and preventing gender-based violence. The reported barriers were lack of knowledge around sexual and reproductive health rights, exposure to violence and lack of access to age-appropriate healthcare services. Mitigating factors included education (both in the family setting and at school); prevention activities undertaken by health services; care provision from non-governmental organisations and international agencies; and best practices in local health services.</p></div><div><h3>Conclusions</h3><p>Host states must take action to enhance the right to sexual and reproductive health for adolescent migrants to allow them to make autonomous, independent and informed choices. A socioecological perspective on sexual and reproductive health and rights can help formulate intersectional policies that interconnect different levels of adolescent migrants’ experience.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000412/pdfft?md5=223335a8501e396e67bc2c871b4576f9&pid=1-s2.0-S2666623524000412-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141848507","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":"Growing up in transit. Personal development and resistance of migrant adolescents travelling through Mexico unaccompanied","authors":"","doi":"10.1016/j.jmh.2024.100245","DOIUrl":"10.1016/j.jmh.2024.100245","url":null,"abstract":"<div><p>Mexico is a major global migration corridor. The last decade has seen an increase in adolescents travelling unaccompanied from Guatemala, Honduras and El Salvador, mainly due to violence and natural disasters. This group of migrants is exposed to migration risks such as trafficking and exploitation, as well as multiple deportations and long waiting times without appropriate access to health and education services. These conditions have significant documented adverse impacts on health and mental health, but the impact on personal development has been less explored. Thus, this article aims to explore the impact of migration transit on identity and resilience of unaccompanied migrant youth, psychosocial mental health constructs that are important for wellbeing and personal development. Through 47 semi-structured interviews conducted with migrant youth and different migration workers in summer 2021 in two migrant shelters in Mexico City and Guadalajara, we found that possibilities for identity building for migrant youth were restricted in a context of curbed freedom. Violence and poverty led to loss of crucial formative years, pushing many to aspire only to work – regardless of the type of work. Resilience overlapped with resistance but was generally maintained with cultural narratives of goal achievement, faith and hope. Strong responsibility towards sending remittances to family made family one of the main goals of the migration journey. Workers highlighted how regional migration management, underlined by discriminatory policies which place profit and national security ideology before a recognition of common humanity, is a considerable barrier to funding services and advancing access to rights for youth. <strong>However, youth showed recognition of their own agency and humanity, which represents an important basis on which to build a counter-discriminatory vision and management of this migration.</strong> Results are reported according to COREQ guidelines.</p></div>","PeriodicalId":34448,"journal":{"name":"Journal of Migration and Health","volume":null,"pages":null},"PeriodicalIF":3.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2666623524000345/pdfft?md5=67834569af6425a36539775e5f973a7d&pid=1-s2.0-S2666623524000345-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141639144","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":"","doi":"10.1016/j.jmh.2024.100269","DOIUrl":"10.1016/j.jmh.2024.100269","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Findings&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion&lt;/h3&gt;&lt;div&gt;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":null,"pages":null},"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}