Social care for the migrant population in Spain: needs and strengths of organisations during the COVID-19 pandemic and infodemic

Purpose In the past months, the authors have experienced an exceptional global situation that especially affects the most vulnerable population. This paper aims to analyse the needs, strengths and good practices of the organisations that have continued to study with the migrant population during the health crisis. The main objective was to determine how the health, social and communication crisis has affected the management of the organisation itself, the communications with its direct beneficiaries, the communications with the rest of society, as well as the perception that organisations specialised in migration have about how media has communicated the information of COVID-19 and migrant population. Design/methodology/approach The authors have circulated a questionnaire with open questions that covered the four dimensions previously mentioned. Findings The results show the analysis of the answers of 11 of the most important national and international organisations in the field of migration and refuge that operate in Spain. Originality/value Key issues have emerged related not only to the principal management concerns, internal digital communication, the adaptability of external communication and the major effort required to provide information about migration but also to innovative good practices. That other third sector organisations focussed on migration will be able to apply in the future and in other geographic areas.

Right to health for undocumented migrants in Mexico: from theory to practice in the context of the health system reform

Purpose Undocumented Central American migrants in Mexico are legally eligible for free access to the public health system through the new Instituto para la Salud y el Bienestar (INSABI) health program, but many experience structural vulnerability and stigmatization that prevent them from accessing health-care facilities. The purpose of this study is to investigate the discrepancy between the migrants’ Human Right to health, proclaimed by the Mexican Government and supposedly guaranteed by law, and the reality of the migration process. Design/methodology/approach This study reviewed relevant literature on the health risk factors, social and structural vulnerability, stigmatization and structural violence experienced by undocumented migrants as obstacles to their Human Right to health. It also reviews the current legal framework in Mexico and internationally. Findings This review demonstrates the lack of implementation of the current legal framework in Mexico and identifies a set of complex obstacles to effective access to health for undocumented migrants. Although the migration process itself was not found to be directly associated with major health issues, the social conditions of the migratory journey expose the migrants to serious threats, especially sexually transmitted diseases and tuberculosis. Practical implications This paper makes 10 practical recommendations for interventions collectively involving the state, international and civil organizations and the migrant community. These are especially relevant since the implementation of the INSABI health program in 2020. Social implications The paper lays the basis for influencing Mexican health system stakeholders to improve the health of migrants. Originality/value The sociological barriers to health access for undocumented populations in Mexico have not been fully explored. In addition, this paper provides a unique reflection on opportunities and challenges linked to the 2020 health system reform.

Overview of challenges faced by refugees following resettlement in Houston, Texas: a qualitative study at five refugee resettlement agencies

Purpose This paper aims to conduct a qualitative needs assessment to explore the effectiveness of Houston’s refugee resettlement efforts in the areas of employment, health care and education. Design/methodology/approach Using referral sampling, the authors identified refugee community leaders and staff members at the five refugee resettlement agencies in Houston. The authors conducted 29 qualitative interviews with these contacts from February–August 2017. Findings Recently resettled refugees may struggle to find and maintain employment in Houston due to difficulty accessing public transportation. Refugees seeking medical care in Houston often have difficulty navigating the complexities of the health-care system and communicating with their physicians due to language barriers. Finally, refugee children may have trouble adapting to Houston public schools, sometimes because they have limited experience with formal education. This study provided insights into the challenges Houston refugees face during resettlement and these barriers can be mitigated with policies designed specifically to address them. Practical implications The authors recommend decreasing public transportation fees for refugees, supporting programs that donate used vehicles to refugees, expanding access to English as a Second Language classes for refugee children and adults and giving refugees designated time to learn English upon arrival. Originality/value Houston welcomes more resettled refugees than any other American city. However, few studies have explored the barriers refugees face during the resettlement process.

Characterizing the health experience of Tuvaluan migrants in Auckland, New Zealand

Purpose It is predicted that increasing numbers of citizens of the Pacific Island nation of Tuvalu will migrate to New Zealand in the coming decades due to the threat of climate change. Tuvaluans currently living in New Zealand face disparities in income, education and health. This study aims to understand the views of recent Tuvaluan immigrants to Auckland, New Zealand on health behaviors, health care and immigration. Design/methodology/approach The authors conducted semi-structured interviews, key informant interviews and participant observation using a focused ethnography methodology. Findings Participants explained that Tuvaluans in New Zealand do not fully use primary care services, have a poorer diet and physical activity compared to those living in Tuvalu, and struggle to maintain well-paying, full-time employment. Practical implications As Tuvaluan immigration to New Zealand continues, it will be important to educate the Tuvaluan community about the role of primary health-care services and healthy behaviors, facilitate the current process of immigration and provide job training to recent immigrants to improve their opportunities for full-time employment and ensure cultural survival in the face of the threat of climate change. Originality/value This paper contributes to a greater understanding of the challenges to be faced by Tuvaluan environmental migrants in the future and features a high proportion of study participants who migrated due to climate change.

Evaluating the feasibility and acceptability of the Healthy Together program for immigrant and refugee families in Canada

Purpose Healthy Together (HT) is an innovative family education program focused on bringing families together to promote physical activity and healthy eating. The HT program was implemented in 10 community-based organizations across Canada offering services to immigrant and refugee families. The purpose of this study was to explore the feasibility and acceptability of HT when offered to these families. Design/methodology/approach A cross-sectional, non-comparative design was used. Caregiver participants were invited to complete a survey at the end of 15, 30 or 24 HT sessions. Trained program facilitators and directors of community-based organizations also provided feedback on the program. Findings Among the 203 caregiver participants, 135 (64%) were born outside of Canada. These caregivers were more likely to attend 50% or more of the HT sessions than Canadian-born caregivers. Survey responses show that the HT program was acceptable to immigrant and refugee caregivers and held important benefits for families including positive changes in healthy eating and physical activity, strengthening social connections and learning about community services and resources. Areas for enhancing the HT program for immigrant and refugee families were identified by participant caregivers and community organizations delivering the program. Practical implications The HT program demonstrates the value of family-centered program models in supporting immigrant and refugee families in establishing healthy lifestyles and building social connections in ways that hold promise for long-term impact. Originality/value The HT program model demonstrates strong potential to fill gaps in community programming for immigrant and refugee families. Although focused on promoting healthy lifestyles, the program extends additional benefits that can positively influence resettlement trajectories. The findings contribute to the growing field of implementation studies that are focused on expanding the reach and impact of community health interventions in a real-world setting while reaching multiple target populations.

Same but different: meaning-making among refugee and non-refugee youths

Purpose There is substantial research on the experiences, needs and well-being of unaccompanied refugee adolescents, but less is known about existential aspects of their lives. The purpose of the current study is to explore existential meaning-making among unaccompanied refugee children. Design/methodology/approach The informants in this study are young unaccompanied refugees (n = 30) living in Norway, and young Norwegians (n = 46). The authors undertook a secondary analysis of in-depth qualitative refugee interview data and a quantitative analysis of questionnaire data from Norwegian informants. Findings Both the refugee youths and the Norwegian youths expressed that social relationships and connections to others were most important for meaning. Moreover, both groups emphasized the importance of relatedness and generativity, i. e. commitment to worldly affairs beyond one’s immediate needs. The main differences between the two groups were related to the significance attached to religion and to loneliness. Research limitations/implications The comparison between the two groups is only possible to some degree. Secondary analyses have some limitations, as well as strengths. Practical implications The findings may be useful for supporting young refugees, as they provide insights into less-studied aspects of their lives. Originality/value The originality of this study lies in the focus on and broad interpretation of meaning, of secondary data analyses, and of comparisons between youths that are refugees versus non-refugees.

The use of complementary and alternative medicine and pain relievers among refugees resettled in the USA

Purpose The purpose of this study is to describe the use of complementary and alternative medicine (CAM), pain reliever use and the expectations refugees have of physicians about their practice of CAM use in the USA. Individuals with a refugee background are one of the populations who use CAM for treatment. However, to date, there is insufficient empirical evidence to describe CAM use among refugees resettled in the USA. In addition, collecting information about the use of pain relievers would help better understand the experiences of individuals with a refugee background. Design/methodology/approach Data was collected from August 2018 to November 2019 using a self- or interviewer-administered survey from 94 refugees 18 years of age or older who had settled in the USA. Findings This study found the following: CAM practice is very common among refugees resettled in the USA, most refugees use non-prescription pain medicine and refugees prefer to see physicians who understand CAM. This study contributes valuable findings in the usage of CAM among refugees and determines that CAM is commonly used among refugees resettled in the USA for pain management. Originality/value By better understanding CAM, physicians can address a direct need for the refugee population-seeking health care in the USA and other countries that host refugee resettlement.

Life after trafficking: reintegration experiences of human trafficking survivors in Nigeria

Purpose Reintegration programs have emerged as part of the regimes of care for survivors of human trafficking. However, empirical analysis of the reintegration outcomes for survivors remains limited in the African context. Hence, this paper aims to examine the challenges and opportunities of reintegration assistance programs for survivors of human trafficking in Nigeria. Design/methodology/approach Drawing on qualitative methods of data collection and analysis, this study conducted semi-structured interviews with repatriated women who have accessed reintegration assistance in Nigeria, and data was analyzed using thematic analysis. Findings The findings suggest that while the reintegration programs might address the procedural aspect of reintegration, the achievement of substantive reintegration remains incomplete. This is because of the structural conditions of the context within which reintegration is supposed to occur. Practical implications There is a need to take seriously the distinction between the reintegration of survivors into a new community or a former community in the design of a regime of care for survivors of human trafficking in Africa. Crucially, the focus on procedural reintegration should not also divert attention away from the structural conditions and reforms needed to ensure survivors achieve substantive reintegration. Originality/value This paper contributes to the limited literature on life after trafficking and demonstrates the strengths and limitations of reintegration programs as a regime of care for survivors of human trafficking. In addition, this study empirically grounded the theoretical distinction between different aspects of the process of reintegration.

The association of cultural and environmental factors with mental health among Asian immigrants

Purpose During exposure to new cultures, immigrants face numerous life changes and challenges, which negatively affect mental health, yet environmental supports may address these concerns. This study aims to examine how neighborhood quality, acculturation and acculturative stress are associated with immigrants’ mental health. Design/methodology/approach The sample consisted of 511 Asian immigrants who were born in their country of origin and immigrated to the USA. Path analysis using analysis of moment structures (version 22.0) was conducted to test the hypothesized model. Findings The results from the path analysis indicated that perceived neighborhood quality and acculturative stress had direct effects on mental health among Asian immigrants. The study also found a significant indirect pathway to mental health where more favorable perceptions of neighborhood quality were associated with higher levels of acculturation and lower levels of acculturative stress, which, in turn, resulted in better mental health. Originality/value The results of the study highlight the importance of improving neighborhood quality as a means by which to facilitate cultural adjustment/adaptation to US culture and thus, improve mental health among Asian immigrants. In addition, the authors suggested considering cultural origin in designing health programs and/or policies for Asian immigrants, which could promote mental health among Asian immigrants. Based on the results of the model, this study produced insightful information and suggestions on how to improve Asian immigrants’ mental health more effectively.

The direct and indirect effects of parental trauma on child adjustment for resettled refugees in Australia

Purpose Understanding the effects trauma has on refugee parents and consequently, their children, is the first step in interrupting the intergenerational transmission of trauma. This study aims to investigate the impacts of parental exposure to trauma pre-settlement on parent and child reports of developmental difficulties as mediated by parental post-traumatic stress symptomology and harsh parenting. Design/methodology/approach The study included 414 refugee children (age M = 14.04, SD = 2.00; 48.3% female) and their caregivers (age M = 41.78, SD = 5.24, 77% female). The sample was drawn from the Building a New Life in Australia study, a large, representative cohort study of resettled refugees in Australia. Only data collected where both parents and their children could be matched were used in this study. Findings Results indicated that trauma was significantly associated with increased parental post-traumatic stress disorder (PTSD) symptoms in all models and was negatively, albeit weakly, associated with lower levels of harsh parenting in the overall model which combined parent and child reports. Trauma also had a weak, positive indirect effect on developmental difficulties via parental PTSD in both the overall model and the model assessing parent-rated developmental difficulties. In all models, harsh parenting was associated with increased developmental difficulties, although harsh parenting did not act as a significant mediator of the effects of trauma or parental PTSD. Originality/value Results suggest that prior traumas had less of an adverse effect on parenting and child adjustment as was expected. Parenting, however, was strongly associated with poor child adjustment, indicating that this may be a key factor to encourage positive adjustment for refugee children.