Risk and Protective Factors For Resilience: A Qualitative Study on Refugee Children in a Community Learning Centre in Malaysia

Children and young people make up around 50% of the humanitarian refugee intake in Australia and New Zealand (over 13 000 people per year) and are arguably the most vulnerable subgroup. The health needs of refugee children and young people have been well documented and include high rates of preventable conditions and psychosocial morbidity. The primary aim of this policy statement is to advocate for timely and high quality health care for every refugee child and young person living in Australia and New Zealand. It recommends that the following are required in order to deliver the most effective health care to refugee children and young people: (i) health service enhancement, (ii) the promotion of research and the development of an evidence base, (iii) dedicated training, and (iv) professional practice. The recommendations range from interventions that involve government leadership to interventions directed at health services and professionals.

This paper describes a protocol for the feasibility evaluation of the Participatory Action Research on Social and Emotional Learning (PARSEL) programme. PARSEL aims to contribute towards the development of academic achievement and resilience among urban refugee students in a community learning centre in an upper middle-income country. The evaluation is a single arm pre-post design using a mixed methods approach, with the main focus on the feasibility of the programme. Measurements of impact are also included as the secondary outcomes of the study. The programme aims to enrol students from refugee background in a community learning centre. The programme is estimated to run for 18 months and the study is due to report in the end of fourth quarter of 2022.

PurposeFew studies explore the long-term health and well-being of refugee children. A longitudinal cohort of refugee children was created to determine health and well-being outcomes over time. This article describes the methodology used to conduct this study, including sample characteristics and effectiveness of recruitment and retention strategies.ParticipantsNewly arrived refugee children settling in a regional part of Australia aged 6 months to 15 years were recruited between 2009 and 2013 and 85% were followed for an average of 31 months.Method and designGeneral practitioners conducted health and pathology examinations shortly after arrival. Additional follow-up assessments were conducted by the research team at an average of 13 months after arrival for the first (year 2) and 31 months for the second (year 3) assessment. Children under 5 years had developmental and children aged 4–17 years had social–emotional screening. Families were assessed for risk and protective factors using a structured interview and the Social Readjustment Ratings Scale. Parent experience of the research was explored.Findings to dateEligibility criteria were met by 158 of 228 (69%) newly arrived children, 61 of whom (39%) were enrolled. Retention was 100% (n=61) at year 2 and 85% at year 3. The study sample was younger than and had an over-representation of African refugees as compared to the eligible population. Parents reported that the research was respectful.Future plansThis study demonstrates that a longitudinal cohort study in refugee children is feasible and acceptable, and retention rates can be high. The establishment of this cohort provides the opportunity to analyse valuable data about the early settlement experience, risk and protective factors and long-term health and well-being outcomes in refugee children. These are necessary to identify refugee children in need of additional support and to guide future service delivery.

Refugee children displaced by war suffer incredible amounts of physical and psychological trauma during and post-displacement. War is not partial to children, and they are subjected to as much extreme violence as adults. This paper explores the mental health of refugee children following war and was guided by the research question: What are the mental health experiences of refugee children displaced by war situations? A secondary data analysis was conducted on publicly available documentary short films and instructional videos on psychological therapy with refugee children and families. The data were analysed through Qualitative Conventional Content Analysis (QCCA). Three major categories emerged regarding the well-being of refugee children: (1) children are not spared from war trauma, (2) children live in perpetual fear and anxiety, and (3) war-related violence ignites aggressive behaviours in children. To increase positive mental health outcomes, school psychologists need to implement trauma-informed therapy that focuses on decreasing psychosocial reactions to war. Culturally responsive therapy is recommended as it places indigenous ways of being at the centre of the healing process.

Background A number of refugees and asylum seekers have increased dramatically in recent years. More than 250 million people worldwide are considered as refugees (United Nations High Commission for Refugees, 2018), among whom more than 50% are children. General health and especially psychological health of the refugee and asylum seeking children are an emerging, however, not well explored issues. In this study, we aimed to review the literature on the psychological health of refugee children. Methods We performed a literature search and descriptive analysis of studies published until July 2019, through MEDLINE and Science Direct databases. We identified literature on psychological health state of refugee and asylum seeking children. We analysed results of 16 studies. Results The study found that refugee children are facing severe psychological health issues, such as Post-traumatic stress disorder (PTSD), depression, anxiety, sleep disorders, behavioural problems. We identified 3 phases of psychological trauma and stress among refugee children: stress due to conflict in their home countries, stress during migration, and upon the arrival to host country. Our analysis reviled integration difficulties such as racism and bulling as important stress factors for the refugee children. Studies found that prevalence of PTSD is more than 54% among refugee children residing in Norway, significantly higher than in reference population. The studies identified the need of regular mental health assessment and preventive care, psychological counselling services for the refugee children. All included studies showed significantly higher stress among refugee children when compared to local children in host countries. Conclusions Rehabilitation services and follow-up supportive programs should be implemented to improve the mental health status of refugee children; these interventions will also contribute to their better integration. Key messages Screening and regular monitoring provided by host countries healthcare system is crucial to identify high risk children. More research is needed to better investigate the psychological health state and needs of refugee children.

Background: Anaemia is a global public health problem affecting children from both industrialised and developing countries with major consequences for health, social and economic development. Although the burden of anaemia is high among refugee children due to their living conditions, its determinants are not yet clearly identified and documented in Ethiopia.Objective: To assess the magnitude and contributing factors of anaemia among refugee preschool children of the Kebribeyah refugee camp.Methodology: A cross-sectional study with an analytic component was conducted in the Kebribeyah refugee camp during March 2010. A total of 399 refugee children aged between 6 and 59 months were randomly selected and assessed for anaemia status using HemoCue® devices.Results: The prevalence of anaemia was 52.4%. Most of the anaemic children, 36.6%, were classified as having moderate (Hb 7–9.9 gm/dL), followed by severe, 10.5%, (Hb < 7 gm/dL) while the remaining 5.3% had mild anaemia (Hb 10–10.9 gm/dL). The age of the child, paternal educational level, number of children younger than five years of age in the household, sharing/selling part of ration, inadequacy of ration stock, presence of diarrhoea, personal hygiene of the child, stunting and underweight were significantly associated with anaemia.Conclusion: The purpose of this study was to demonstrate that anaemia is a severe public health problem among young refugee children and to document its major predisposing factors. In the Kebribeyah refugee camp, these included inadequate food rations, insufficient micronutrient composition, lack of provision of non-food items, selling and sharing of food rations, poor environmental sanitation, poor housing conditions, lack of nutrition/health education and disease (diarrhoea). A comprehensive nutrition service together with a holistic public health-focused approach to empower refugees to prevent the onset of anaemia by engaging in homestead small-scale food production for income generation and improving the integration and collaboration between beneficiaries, food donors and humanitarian aid organisations would be crucial in addressing the consequences of anaemia in the Kebribeyah refugee camp.

Introduction Children and adolescents from socially vulnerable families experience social as well as health-related disadvantages at a very early age. Resilience research increasingly focuses on general psychosocial protective factors and their positive role as an effective health resource. In this research, the influence of some selected protective factors on a healthy lifestyle in the target group of secondary school students is shown. Methods Using a method of a cluster analysis, a theory-led lifestyle typology was developed based on the variables ‘physical-sport activity' and ‘media consumption patterns'. Four lifestyle clusters were identified: sports-active frequent media users, sports-active low media users, sports-inactive frequent media users und sports-inactive low media users. The study examined how the resilience factor ‘physical fitness' (measured by the 6 min run) as well as personal, family and social protective factors were manifested in the respective clusters. Results In the sporty-active clusters, the proportion of children with good physical fitness was high (47%). In the sporty-inactive clusters, however, this proportion was only about 23%. Approximately 71.5% of the children in sporty-active clusters reported good health and health-promoting behavior, while in sporty-inactive clusters this percentage was 49.2%. Trusting and appreciative parent-child relationship and positive sibling ties were mentioned more frequently in sporty-active clusters than in sporty-inactive clusters. Discussion Regular exercise and moderate use of media have a positive effect on protective resilience factors. These can be considered as ‘health-enhancing' lifestyle characteristics in health-related behavior. Personal, family and social protective factors interact with physical activity and are effective health resources: physically active children are more resilient to stressful environmental situations. Key messages Regular exercise and moderate use of media have a positive effect on protective resilience factors. Protective resilience factors are ‘health-enhancing' lifestyle characteristics in health-related behavior.

Many refugee children have not only suffered from their negative past experiences but also faced challenges to cope with their current difficulties and to improve themselves for a better future. Education is a strategy to assist these refugee children in tackling these difficulties, and a key factor in ensuring the success of education is the quality of teachers. This study uses the job demands and job resource model as a framework to understand the job demands of teachers at refugee community learning centres in Malaysia and their available resources, and the resources that the teachers need to meet their job demands. Purposive sampling was used to recruit 52 refugee teachers, and focus group discussion was used to collect data. Thematic analysis was then used to analyze the data. The results showed that the main difficult job demands are handling the classroom due to the lack of facilities, space and professional training. The diversities in students’ language levels and cultural backgrounds and the psychological problems of students increase the difficulties in classroom management. Support from different parties to provide relevant resources is needed for refugee teachers to tackle their job demands so that a better-quality education can be provided to refugee children.

ABSTRACTThis paper discusses some of the ethical issues encountered when involving refugee children in research. It draws on a study that aims to investigate how young Syrian refugee children experience Early Education, in one English local authority. This small-scale qualitative piece of research was developed in response to the deepening refugee crisis outlined by United Nations High Commissioner for Refugees (UNHCR) in August 2013 which suggested that as a result of the conflict in Syria, 740,000 refugees were under the age of 11. The study involves four children and their families – who were resettled in England through the Syrian Vulnerable Person Resettlement scheme (2017). Also involved are four Early Childhood and Education Care settings. The research field is complex and the ‘customised methods and methodologies’ which have been adopted, to respond well to the challenges of the field, are described. Ethical issues concerning the conceptualisation of refugees, a narrative of trauma and location of positionality are expanded. The researcher has developed power-sensitive ethical research practices to help manage issues of positionality; negotiate access in the field; develop authentic relationships; address issues of cultural bias in self and others, and navigate the challenges of researching with very young refugee children.

editorial reviewed

New approaches to interventions for refugee children.

This paper uses a framing derived from refugee and child rights conventions to analyse the positioning of young refugee children and their families in Aotearoa New Zealand’s resettlement policies, early childhood curriculum and early childhood education (ECE) funding policies. It also analyses data from interviews with participants from ECE settings who are working with refugee children and families, to discuss how policy is experienced in ECE practice, and makes recommendations about future policy directions. Main findings are that the Refugee Resettlement Strategy has critically important goals for refugee resettlement, but outcomes are narrowly defined and future-focused. While the ECE curriculum, Te Whariki, offers a strong basis for refugee families and children to come to belong and participate in Aotearoa New Zealand, and to have their own culture upheld, the rights of the young refugee child have no visibility within resettlement and ECE funding policies. We argue that a rights-based framework, focused on the young refugee child within their wider family, offers a productive lens through which to analyse refugee resettlement and ECE policies.

This study is entitled An Exploration of IQ, EQ and Spiritual Quotient (SQ) Elements in the Human Re-Engineering Program (HRP) Practices: A Study on the Drug Rehabilitation Centre in Malaysia. This study involved four drug rehabilitation centres in Northern Malaysia which are Perak, Penang, Kedah and Perlis. However, the rehabilitation centres involved in this study came from three different states only which are Cure and Care rehabilitation centre (CCRC) Kampung Selamat, Penang, Klinik Cure & Care 1 Malaysia, Bukit Mertajam, Penang, Cure & Care rehabilitation centre (CCRC) Batu Kurau, Perak and Cure & Care Rehabilitation Centre (CCRC) Bukit Chabang, Perlis. This study using Qualitative Method and Exploratory Research. Therefore, to explore the phenomenon an in-depth interview has been conducted with one officer of the CCRC and at least 3 patients of the CCRC. In total, 17 respondents had been interviewed for this research. All the respondents are male. Results of the study showed that approximately only 30% of the patients recover. However, this figure is still doubtful due to no exact statistic revealed. The reasons why they are failed to sustain themselves after being freed from the CCRC due to peer’s factor (40%), low of self-confidence (30%) and weak of religious practice (30%). Family support is one of the main factors contributed to their recovering process as 90% of the respondents admitted that. Majority of the patients admitted that peers’ factor is the main reason they involved with the drug abuse (50%) besides self-exploration (30%) and other factors (20%). In order to rebuild the self-confidence, rehabilitation centre used multi programs such as religious activity, peer’s guidance or group maker (Pembimbing Rakan Sebaya (PRS), and therapy community. This study also revealed that 3 out of 4 rehabilitation centres used more than 50% of SQ program in their healing process, 20-25% on EQ activities and IQ activities. Amongst favourite SQ activities are Iqra’ class, which is learning how to read the Quran, and Halaqah is where they will discuss about religion and do some self-reflection. Family support and religious commitment and practices are the main contributor to patient’s recovery survival after they are freed. As a conclusion, healing process in the rehabilitation centre highly influenced with Spiritual Quotient programs besides others. This shows that internal strength gained via religious commitment and attachment besides continuous practices will be a significant factor of the recovering.

Article 22 guarantees the substantive application of all Convention rights to the particular situation of asylum seeking and refugee children, and also guarantees them protection and assistance in advancing their immigration and residency status claims and in overcoming the hurdles posed by international migration channels, including guarantees of due process. The rights of refugee and asylum-seeking children can be analyzed in relation to four essential attributes. First of all, Article 22 insists upon appropriate protection and humanitarian assistance. Refugee children are not granted a special status under the Convention, but they are not given any lesser status. They are to be treated as children first and foremost and not as migrants per se, in the sense that national immigration policy cannot trump child rights. The basic rights to education, health, and child welfare of these children needs to be protected to the same extent, and as much as possible, as children who are nationals of the host country. The second attribute preserves the rights of refugee children not only under the Convention but under all other international human right treaties and humanitarian instruments binding on the relevant States Party. These may include, for many governments, the 1951 Refugee Convention, the Convention on the Reduction of Statelessness, the Geneva Conventions and the Hague Convention for the Protection of Minors, 1961, among others. A third attribute of Article 22 insists upon the duty to protect and assist refugee children. This entails a clear duty to provide children with appropriate due process rights throughout their asylum and refugee claims procedures, including the child’s right to be heard and participate in all the processes determining the child’s residence or immigration status, border admission, deportation, repatriation, detention, alternative measures, or placement, including best interest determination processes. The fourth and final attribute of Article 22 asserts that two basic principles should guide each activity with the refugee child: the best interests of the child and the principle of family unity.

The need to shield young children from adversity is well documented, and reflected in both UK policy and the current UK Labour government’s pledge to ‘set every child up for the best start in life’. Yet, conversely, the UK operationalises a raft of measures to create a ‘hostile environment’ for asylum seekers and refugees. The hostile environment policies force asylum-seeking and refugee children to endure poverty and insecurity, associated with negative consequences for children’s physical, social, emotional and educational development. This paper employs critical phenomenology to understand the material, psychological and phenomenological effects of the ‘hostile environment’ on young asylum-seeking and refugee children in the UK. Data is drawn from semi-structured interviews with parents from 11 asylum-seeking and refugee families with young children (0–8). The findings reveal that asylum-seeking children are forced to live in conditions of material adversity and a state of limbo characterised by insecurity that pervades all aspects of their lives. Refugees have more stability than asylum seekers, but the psychological and phenomenological effects of living under hostile environment conditions continue to persist. The parents in this study expressed how they felt the cumulative effects of material adversity and insecurity negatively influenced their mental state and negatively impacted their children. As such, this paper indicates the contradiction between these negative effects of the hostile environment and the ‘best start in life’ for young children that the previous and current UK Governments ostensibly support. The paper is timely as the 2024 election of the new Labour Government presents a significant opportunity to influence policy responses to asylum seekers.