Refugee Health: An Ongoing Commitment and Challenge

Efird, Jimmy T.; Bith-Melander, Pollie

doi:10.3390/ijerph15010131

Cited by 15 publications

(6 citation statements)

References 25 publications

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“…Immigration into Europe has reached an all-time high, and provision of coordinated healthcare poses an enormous challenge for receiving communities [ 1 , 23 , 24 ]. Medical care is key in management during humanitarian crises as the current, and especially for refugee woman, that are at increased risk for adverse pregnancy outcomes, caretaking strategies need to be adapted [ 3 , 25 , 26 ].…”

Section: Discussionmentioning

confidence: 99%

Pregnancy Related Health Care Needs in Refugees—A Current Three Center Experience in Europe

Dopfer

Vakilzadeh

Happle

et al. 2018

IJERPH

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Background: Immigration into Europe has reached an all-time high. Provision of coordinated healthcare, especially to refugee women that are at increased risk for adverse pregnancy outcomes, is a challenge for receiving health care systems. Methods: We assessed pregnancy rates and associated primary healthcare needs in three refugee cohorts in Northern Germany during the current crisis. Results: Out of n = 2911 refugees, 18.0% were women of reproductive age, and 9.1% of these were pregnant. Pregnancy was associated with a significant, 3.7-fold increase in primary health care utilization. Language barrier and cultural customs impeded healthcare to some refugee pregnant women. The most common complaints were demand for pregnancy checkup without specific symptoms (48.6%), followed by abdominal pain or urinary tract infections (in 11.4% of cases each). In 4.2% of pregnancies, severe complications such as syphilis or suicide attempts occurred. Discussion: We present data on pregnancy rates and pregnancy associated medical need in three current refugee cohorts upon arrival in Germany. Healthcare providers should be particularly aware of the requirements of pregnant migrants and should adapt primary caretaking strategies accordingly.

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Section: Discussionmentioning

confidence: 99%

Pregnancy Related Health Care Needs in Refugees—A Current Three Center Experience in Europe

Dopfer

Vakilzadeh

Happle

et al. 2018

IJERPH

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“…These include language barriers, inadequacies in cross-cultural communication, high level of trauma-based experiences that compound mental and physical health, varied educational backgrounds, limited health literacy, and discrimination in both the community and health care setting. 23 The I-Care program is a multidisciplinary care model that engages a care manager as a liaison between a medical team and a network of community health navigators to address the disproportionate burden of uncontrolled chronic disease and barriers to care for a vulnerable patient population. This clinical model has established a trusted line of communication and means to care access through a Somali-speaking care manager, who is a former resettled refugee to Syracuse.…”

Section: Discussionmentioning

confidence: 99%

Integrated Care Management to Improve Diabetes Outcomes in Refugee and Immigrant Patients (I-Care)

et al. 2021

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Purpose: Refugee and immigrant patients face significant barriers to health care and are more likely to have poorly controlled chronic disease than the general U.S. population. I-Care aims to improve health equity for refugees and immigrants who face a disproportionate burden of chronic disease. Methods: Refugees and immigrants with uncontrolled diabetes and associated cardiovascular risk factors were enrolled in a care management program within an academic adult medicine clinic. The program utilized a care manager to coordinate care and services between designated primary care providers, affiliated clinical teams, and community partners. Health literacy, chronic disease parameters, and care utilization were assessed at enrollment and 8–12 months later. Results: A total of 50 refugees and immigrants were followed for 8 to 12 months. Clinical parameters found a reduced mean HbA1c from 9.32 to 8.60 ( p =0.05) and reduced low-density lipoprotein mean from 96.22 to 86.60 ( p =0.01). The frequency of normal blood pressures was 9 (18%) at enrollment and 16 (32%) at 1 year. The cumulative frequency of emergency room visits decreased from 66% to 36% and hospitalizations from 22% to 8%. Rates of comprehensive care monitoring, including monofilament testing and one-time ophthalmology visits, increased from 60% to 82% and from 32% to 42%, respectively. Cumulative frequency of interdisciplinary support engagement with pharmacy and nutrition visits increased from 58% to 78% and from 26% to 38%, respectively. Conclusion: This program highlights the importance of a multidisciplinary community-engaged care model that has demonstrated improvement in quality metrics and health care costs for refugees and immigrants.

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“…The possible reasons behind misunderstanding between wet nurses and infants’ family members were mainly security issue of child adoption and future demand of any rendition in lieu of breastfeeding by wet nurses. When dealing with a refugee population, proper understanding of the socio-cultural and economic context aids the process [31]. The Rohingya community is highly influenced by religious beliefs and community leaders, locally referred to as Majhi .…”

Section: Discussionmentioning

confidence: 99%

Breastfeeding support through wet nursing during nutritional emergency: A cross sectional study from Rohingya refugee camps in Bangladesh

Azad

Rifat²,

Manir³

et al. 2019

PLoS ONE

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Background/ObjectivesThis study examined the best practices with regard to infant and young child feeding in emergency (IYCF-E) program. This was done by observing a breastfeeding support scenario through wet nursing in Rohingya refugee camps in Cox’s Bazar, Bangladesh.MethodsInformation on demographics, IYCF-E knowledge, wet nursing support, type of constraints faced, and possible ways to overcome such constraints was collected through face-to-face interviews with 24 conveniently selected wet nurses. Linear regression was used to analyze the associations.ResultsMean age of wet nurses was 21.6 years; 16.67% had adequate knowledge about IYCF-E; and 29.17% had prior knowledge about wet nursing. Mean age of supported infants was 1.29 months, and 58.33% had a familial relationship with the wet nurses. Duration of breastfeeding support was significantly associated with the wet nurse’s age, age of the wet nurses’ youngest children, familial relationship with infants, knowledge about IYCF-E, and follow-ups from community nutrition workers (Ps <0.05). The status of facing problems (58.33%) was negatively correlated with duration of wet nursing, although this association was not statistically significant. The most extensively reported problems were as follows: misunderstandings with the infant’s family (85.71%), family workload and time limitations (21.43%), household distance (42.86%), and family members’ poor compliance (21.43%). Counseling from community nutrition workers (64.29%) and mediation by community leaders (57.14%) played key roles in mitigating such problems. Self-satisfaction (37.50%), counseling (62.50%), and religious inspiration (58.33%) were key motivators behind dedicated breastfeeding support.ConclusionWet nursing in the Rohingya refugee camps in Cox’s Bazaar, Bangladesh, was associated with several factors involving both supply and demand. The present findings may help design better IYCF-E programs in similar context.

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Refugee Health: An Ongoing Commitment and Challenge

Cited by 15 publications

References 25 publications

Pregnancy Related Health Care Needs in Refugees—A Current Three Center Experience in Europe

Pregnancy Related Health Care Needs in Refugees—A Current Three Center Experience in Europe

Integrated Care Management to Improve Diabetes Outcomes in Refugee and Immigrant Patients (I-Care)

Breastfeeding support through wet nursing during nutritional emergency: A cross sectional study from Rohingya refugee camps in Bangladesh

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