Background Refugees tend to have a higher risk of mental ill-health and use mental health services less than the native-born population during their first 10 years in Sweden. Intercultural interactions between refugees and mental health professionals have been described as challenging. Cross-cultural training is proposed as one way to improve care for refugees. Evaluations of such training outcomes are sparse. The overall aim of this study was to evaluate Comprehensive Cross-Cultural Training for mental health care professionals in Stockholm, and to assess training outcomes for participants’ perceived knowledge regarding mental health and care for newly arrived refugee patients, asylum seekers and undocumented refugees. In addition, we analysed the dimensionality of the pre- and post-training questionnaires used. Methods An embedded mixed-method design was applied. We used pre-and post-training questionnaires (n = 248) and conducted six focus group discussions (FGDs) with mental health professionals after training. Quantitative data was analysed by t-tests and factor analysis, qualitative data was analysed using thematic content analysis. Results Participants experienced gained knowledge and new perspectives in all aspects covered in the training. Training led to participants restructuring their existing knowledge. Those who had reported experience of refugee patients and working with interpreters pre-training in the past month, had higher ratings of perceived knowledge. Post-training, there were no significant changes in perceived knowledge between those with, and those without, experience of refugee patients and working with interpreters. Factor analysis resulted in 3 factors for the pre-training questionnaire, explaining 71% of the covariance, and 4 factors for the post-training questionnaire, explaining 78% of the covariance. Findings from the post-training FGDs, revealed that refugee patients were described as challenging. Also, that training promoted empathy towards refugees and strengthened participants’ professional role. Conclusions This cross-cultural training contributed to knowledge development and attitude changes. It was valuable regarding care providers’ professional role. Additional outcomes of the training were that participants not only gained knowledge about refugee mental health care but also restructured their existing knowledge.

BackgroundIn 2015 alone, 5,9 million children under the age of five died. In an attempt to reduce child mortality in Eritrea, the government implemented community-based child health interventions by community health workers (CHWs). Despite progress, challenges remain. In Eritrea, few studies have examined CHWs and community perceptions of child health interventions. The aim of this study was to explore the perceptions of CHWs regarding benefits and challenges of community-based child health interventions in the Maekel region in Eritrea. MethodsAn explorative qualitative study was conducted employing focus group discussions. Data was analyzed using qualitative content analysis. ResultsThe CHWs reported positive aspects such as easier access to health services, generated relationships and support and opportunities to give back to the community. Perceived challenges were: constraints in delivering services, resources and supervision, inadequate knowledge and awareness and juggling multiple roles with no pay. The ministry of health (MoH) in Eritrea prioritizes reducing child mortality but, is still in the process of building and stabilizing the healthcare system. The biggest challenge is to incorporate community level Integrated Management of Childhood Illnesses and Case Management (C-IMCI/ iCCM), involving communities, families and CHWs into the current system of limited resources. ConclusionsThis study indicates the importance of focusing on identifying solutions to the challenges the CHWs faces and understanding factors associated with CHWs motivation. This with the hope of better effectiveness and sustainability of the C-IMCI/iCCM program.