Public Health Aspects of Refugee Health: A Review of the Evidence on Health Status for Refugees Globally (original) (raw)
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The Challenges of the Health Care Providers in Refugee Settings: A Systematic Review
Prehospital and Disaster Medicine
Background: All over the world, migration is affecting millions of people who either choose or are forced to leave their countries of origin. Health is considered to be one of the important aspects of migration that is highly influenced by the circumstances created by mobility within or across countries. In the context of forced migration, it is well-established that refugees are susceptible to various diseases and other health conditions which might occur or deteriorate based on the health systems and health care provision in receiving countries. There is a considerable amount of research on the challenges encountered by refugees in receiving countries, in terms of health care systems and services. However, there seems to be little focus on the health care providers’ perspectives of the challenges in health care provision in refugee settings. This review aims to explore some of the articles discussing the challenging issues surrounding refugee health from a provider’s perspective. ...
Refugees: towards better access to health-care services
The Lancet, 2016
The migration crisis is one of the most pressing global challenges, as worldwide displacement is now at the highest level ever recorded. Latest global estimates by the UN Commissioner for Refugees (UNHCR) show that 59•5 million people are forcibly displaced as a result of persecution, conflict, generalised violence, or human rights violations.1 The estimated refugee population reached an unprecedented 19•6 million individuals worldwide in 2015-half of them being children-and the number is steadily increasing, with Syria as the leading country of origin of refugees.1,2 A lengthy drought preceded the Syrian crisis that led to a large movement of people into cities and contributed to instability. Recent evidence suggests that risks of such droughts in the region are more than doubled as a result of climate change.3 More than a million refugees and migrants arrived in the European Union in 2015.4 The growing influx of vulnerable populations poses many challenges to host countries, not least with regard to preparedness and resilience of health systems and access to health-care services. Furthermore, increasing numbers of refugees are likely in future as a result of a complex combination of driving forces, such as faltering and unequal economic growth, population increases, conflicts and environmental change. The need to develop more effective approaches that respond to the health needs of displaced populations and address the root causes of displacement is therefore imperative. A refugee is someone who "owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality, and is unable to, or owing to such fear, is unwilling to
Refugee health: an approach to emergency situations
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Refugee Health is intended to be an operational manual for those who must make strategic and operational decisions in the field, and this comprehensive book deals with far more than just medical issues. The first manual, produced 20 years ago, was mainly devoted to clinical ...
Health and social problems of refugees
Social Science & Medicine, 1992
Today over 15 million refugees are scattered around the world, most of them in poor Third World countries [New Sci.. DD. 1415. September 19911. But whether they seek 'safe havens' in rich or poor countries thky continhd-to suffer. from the malaisd of being uprooted, struggling to survive in new and alien environments. Their health and social problems extend beyond the obvious emergency short-term phase. It is now clear that the number of refugees has increased beyond expectations and most have stayed long enough to expect final resettlement in their countries of asylum, a process which requires wider, more comprehensive and long-term management and rehabilitation interventions. This paper will attempt to highlight issues of health and social problems in their wider context, surveying comprehensive and integrated approaches in assessing the needs of refugees, whether they are in developing or industrialised countries, with emphasis on the latter and, when appropriate, using the United Kingdom experience as an example.
Refugee Health: A Moral Discussion
Journal of Immigrant and Minority Health, 2018
The world is currently witnessing the greatest refugee crisis of all times. 1 According to the United Nations Refugee Agency, the current number of forcibly displaced people is 65.6 million worldwide, including refugees, asylum seekers, internally displaced people and stateless persons [1]. These people live in a political limbo with very limited access to resources to meet their basic needs such as housing, healthcare, sanitation, education, and employment. Among all these problems, however, health has a special status. Literature shows that refugees have a higher rate of mortality and morbidity compared to the host community in country of asylum. They are faced with a greater risk of psychological problems, and communicable and chronic diseases. Many studies show that refugees have a higher rate of morbidity and mortality because of the situation in their country of origin and also conditions in their country of asylum, such as overcrowded refugee camps, poor sanitation and under-nourishment. In addition, they encounter barriers to access to healthcare services in host countries [2]. These barriers include language and cultural differences, discrimination from the public and from some health professionals, mistrust and financial constraints [3]. Recently the attention of the international community on refugees has increased significantly due to tragic instances such as the heartbreaking picture of a young boy drowned at the shores of the Aegean Sea or the devastating photos of women, children and elderly in inhumane conditions. However, this attention was not sufficient to solve the basic problems such as the limitations of international law to define the legal status of refugees. The governments of host countries continue not to include refugees in their national policies due to the fact that they do not reside in their country and consider them as temporary guests. The lack of formal citizenship and national bonds, still constitute the leading factors that limit the responsiveness of the national governments and international community to the Correspondence to: A. M. Ozgumus; P. E. Ekmekci. Author Contributions The article basically depends on a literature. The literature review was done by the first author, Ms. Ozgumus, with the guidance of Dr. Ekmekci. Data and statistics which may be referred are gathered by Ms. Ozgumus and Dr. Ekmekci. Then, the first version was drafted by Ms. Ozgumus and reviewed by Dr. Ekmekci, so that the ideas in the article was developed further. After that the article was reviewed and finalized by both authors. Conflict of interest We hereby indicate that there is no conflict of interest. Ethical Approval All authors have reviewed and approved the manuscript and agree with its submission to the Journal of Immigrant and Minority Health. The study does not involve any human subject. Therefore, no institutional review board approval is needed. 1 We use the term "refugee" for all people who run away from their home countries due to political unrest, war, infringement of human rights, regardless of their legal status, such as refugee, asylum seeker, stateless or person under temporary protection.
2024
Background Healthcare access and equity are human rights. Worldwide conflicts, violence, and persecution have increased the number of people from refugee or refugee-like backgrounds. Because urban areas are already densely populated, governments have aimed to increase refugee resettlement in rural and/or regional areas. Because of the complex healthcare needs of refugees, this creates challenges for healthcare service providers. Identifying barriers to accessing healthcare in rural areas is therefore important to better inform policy settings and programmes that will provide culturally appropriate patient-centred care to the refugee community. Methods This review scoped 22 papers written in English between 2018 and July 2023 from five countries (Australia, New Zealand, Germany, Bangladesh, and Lebanon) in order to provide an overview of the barriers and possible solutions to facilitate refugees' access to healthcare. Results The reviewed literature summarised the perceptions of at least 3,561 different refugees and 259 rural health service providers and/or administrators and identified major challenges. These include communication (illiteracy in the resettlement country language and lack of a suitable interpreter), lack of cultural awareness of health services, discrimination, and access difficulties (transportation, availability of health specialist services, cost). As a consequence, it was identified that improving access to affordable housing, employment through credential recognition, competence-level education for children, facilitating language training, and adapting health information would increase resettlement and encourage access to healthcare. Conclusions Refugees face significant barriers to accessing and engaging with healthcare services. This impacts their integration into rural communities and increases the prevalence of psychosocial issues like feelings of loneliness, low self-esteem, a lack of autonomy, and a lack of empowerment over informed decision-making, especially for women, jobless men, and the elderly. These findings support the need for additional support for refugees and healthcare providers to improve language proficiency and cultural competency. Policymakers need to improve the availability and accessibility of employment, housing accessibility, and service mobility. Additionally, more research is needed to assess the efficacy of emerging innovative programmes that aim to close the gap by delivering culturally appropriate patient-centred care to refugee communities in rural areas.
New paradigms for refugee health problems
Social Science & Medicine, 1992
paradigms that have shaped our understanding of refugee health are indentified: the objectification of refugees as a political class of excess people, and the reduction of refugee health to disease or pathology. Alternative paradigms are recommended: one to take the polyvocality of refugees into account, and one to construe refugees as prototypes of resilience despite major losses and stressors. The article is organized into three sections, mirroring the life history of refugees from internal displacement in the country of origin to asylum in a second (usually neighboring) country, and for some, to permanent resettlement in a third country. In each of the three sections, the primary topics that are treated in the literature are identified, and key problems identified for discussion.
Refugees health crisis and Social determinants of health SDH
European sting, 2023
This article examines the challenges faced by Ukrainian refugees during resettlement in Europe and emphasizes the importance of addressing social determinants of health. Drawing lessons from past refugee crises, it highlights the significant health risks refugees encounter, including infectious diseases, malnutrition, and mental health issues due to the grueling conditions of their journeys and resettlement. Access to healthcare remains a primary concern, with many refugees coming from countries with weak health systems or fleeing conflict and natural disasters, complicating the management of chronic and acute health conditions. Overcrowding, lack of clean water, and poor sanitation further exacerbate health risks. Mental health support is crucial, as refugees often experience trauma, leading to increased rates of depression, anxiety, and PTSD. Addressing social determinants of health, such as food, water, and sanitation, is essential for improving overall health outcomes. The article underscores the importance of ensuring Ukrainian refugees' access to healthcare and mental health services, adhering to their rights as enshrined in international law, and tackling the root causes of displacement to prevent future crises. Non-discrimination in healthcare access is emphasized, aligning with international human rights law protections.
Public Health, 2006
This paper aims to provide a framework for primary health care services to meet the recognized health needs of refugees and asylum seekers that can be used in planning and evaluating services for this group. Review: Primary care services for refugees and asylum seekers are reviewed and presented in terms of a tripartite framework of gateway, core and ancillary services. Gateway services facilitate entry into primary care by identifying unregistered patients and carrying out health assessments. They are typically undertaken by nurse-led outreach services and specialist health visitors. Core services provide full registration and may be provided by dedicated practices or by mainstream practices, with or without additional support. Ancillary services are those that supplement and support core services' ability to meet the additional health needs of this group. They include language and information services, close links with community-based organizations, specialist mental health services and services for survivors of torture and organized violence, as well as targeted health promotion and training of health workers. Conclusions: The framework can be used for education and training, planning and commissioning, and to provide criteria for comparison and evaluation. The paper suggests that a lack of published evaluations and reports about interventions for refugees and asylum seekers constrains further policy development that could build on the strengths of such interventions. It also stresses the importance of ancillary services to successful mainstream provision.