Policies and initiatives/programs that promote health and self-care in asylum seekers living in high income countries: a narrative review

Abstract

Purpose This paper aims to identify health-care entitlements that exist for asylum seekers with chronic non-communicable disease (CNCD) that promote their health and self-care, and to explore health policies, initiatives and programmes with the potential to foster self-care in this populace. Design/methodology/approach Narrative review of literature conducted by searching EMBASE, CINAHL, WEB OF SCIENCE and PSYCINFO databases for articles published from 2010 to 2021. Included articles focussed on policies, programmes or initiatives with the potential to promote health in adult asylum seekers residing in high-income countries. Studies inclusive of other migrant groups such as undocumented migrants and those with mental health conditions were excluded. Eleven studies fitting the inclusion criteria were assessed against the study objectives. Findings Free access to health-care services and pharmaceutical products, free access to food banks and supermarket model food banks, English and cooking lessons, community integration training sessions and culturally competent health-care workers were found to promote health and self-care. There is little research on self-care and health promotion in adult asylum seekers with CNCD. CNCDs represent high burden of disease in asylum seekers but have a low priority in reported research. Originality/value This narrative review is the first to explicitly focus on asylum seekers in high-income countries with CNCD, excluding mental health conditions, and to explore initiatives, programmes and policies that enhance health promotion to facilitate self-care in this populace.

Attitudes and Knowledge of, and Preferences for Learning about Cultural Competence: A Study of Pharmacy Students from One Australian Pharmacy Program

“…Identifying existing knowledge through the survey established baseline knowledge, perspectives and views to inform potential intervention(s) types and to address knowledge gap(s) in the future. The rationale for assessing students' knowledge on diseases prevalence and their views on healthcare entitlements was informed by the previously identified link between empathy, cultural awareness and competence [22,23] and the high disease burden of chronic-non-communicable diseases (CNCDs) such as diabetes and hypertension in this populace [9,10]. Empathy is known to foster cultural sensitivity, which is the building block for cultural competence [21][22][23].…”

“…It is well documented that there is a high disease burden of chronic non communicable diseases (CNCDs) such as diabetes, hypertension and respiratory diseases in asylum seekers [9,10,36,37]. CNCDs disease are often life-long diseases, and some require drastic changes in lifestyle [38], which may be a challenge for healthcare consumers, as they may try to balance their cultural beliefs with the expected healthy lifestyle.…”

“…CNCDs disease are often life-long diseases, and some require drastic changes in lifestyle [38], which may be a challenge for healthcare consumers, as they may try to balance their cultural beliefs with the expected healthy lifestyle. The challenges of improving treatment compliance and promoting a change of lifestyle such as diet are surmountable when healthcare professionals incorporate cultural competence with the knowledge on CNCDs prevalence to drive positive patient outcomes [9,10]. The above stipulated power of cultural competence and knowledge on CNCDs in this populace is vital for emerging pharmacists.…”

“…Cultural competence has been reported as being critically important when dealing with CALD populations to bridge the health inequity gap [9,10]. Cultural competence is recognised as having five domains: (1) cultural awareness-recognition of cultural differences between one's culture and that of others; (2) cultural knowledge-knowing cultures of other ethnic or cultural groups; (3) cultural skills-having skills that enable one to interact with people from diverse cultures; (4) cultural encounters-having been exposed to people of diverse cultural backgrounds; and (5) cultural desires-motivation of wanting to engage with people from diverse cultures to understand their culture [11,12].…”

“…In this study, the focus was on cultural competence, which is a broad concept that incorporates a number of domains: that is, cultural knowledge, awareness, skills, encounters and desires, which are all relevant for emerging healthcare professional students, to address the cultural needs of clients/patients from diverse backgrounds [9][10][11][12]. Cultural safety is creating a safe environment that addresses the inherent power imbalance between a healthcare provider and consumers, and cultural responsiveness focusses on healthcare services that respond to the cultural needs and backgrounds of consumers [25][26][27].…”