Abstract
BackgroundIn Malaysia, refugees and asylum-seekers are a vulnerable group that often face circumstances in which their health and wellbeing can be compromised. This qualitative study sought to examine the key health concerns and barriers to healthcare access among refugees and asylum-seekers in Malaysia through the lens of healthcare professionals, program staff and experts on refugee and migrant health.MethodsWe conducted 20 semi-structured in-depth interviews with experts, healthcare professionals, program managers or executives from UN agencies, public healthcare facilities, civil society organizations, and academic institutions in Malaysia. Interviews were transcribed and analyzed both deductively and inductively using thematic analysis.ResultsParticipant narratives highlight that the health needs of refugees and asylum-seekers in Malaysia are complex. As reported, access to healthcare is underpinned by numerous social, cultural and economic determinants compounded by a legal environment that lacks inclusivity of refugees and asylum-seekers. Apart from the health risks associated with the migration process, limited access to comprehensive healthcare post-arrival remain a problem for refugees and asylum-seekers in Malaysia. Key barriers to healthcare access are linked to poor health literacy and the lack of awareness on one’s right to healthcare; language and cultural differences; protection issues resulting from a lack of legal status; and an inability to afford healthcare due to inadequate livelihoods. Overall, poor access to healthcare is perceived to have detrimental consequences on the health status of refugees, asylum-seekers and its host population, and may incur greater costs to the health system in the long run.ConclusionComprehensive efforts in practice and research that tackle the social, cultural and economic determinants of health, and more inclusive health policies are crucial in strengthening healthcare access among refugees and asylum-seekers in Malaysia. Practical recommendations include improving the health literacy of refugees and asylum-seekers for better navigation of the health system; bridging language and cultural gaps through translation support and inter-cultural orientation; implementing policies grounded in the right to healthcare for all regardless of legal status and in the interest of public health; and establishing a larger evidence base to drive policy development and implementation for refugee health within the Malaysian context.
Highlights
In Malaysia, refugees and asylum-seekers are a vulnerable group that often face circumstances in which their health and wellbeing can be compromised
In addressing the health concerns of refugees and asylum-seekers in Malaysia, refugees’ health care needs, access to healthcare and its barriers were explored in depth
Participants perceived that the Ministry of Health (MoH)’s cost-cutting measures targeting the foreigner fees and the lack of focus on comprehensive healthcare for refugees and asylum-seekers would only lead to greater financial costs to the health system in the long run. This qualitative study addresses a gap in existing literature by identifying the key health concerns and barriers to healthcare access among the refugee and asylumseeker population in Malaysia through the lens of healthcare professionals, program managers or executives, and experts on refugee and migrant health
Summary
In Malaysia, refugees and asylum-seekers are a vulnerable group that often face circumstances in which their health and wellbeing can be compromised. Refugees and asylum-seekers often encounter circumstances in which their health and well-being are compromised Despite these health needs, access to health care for refugees is often restricted in host countries, and this is exacerbated by various reasons such as a lack of inclusive policies, language and cultural barriers, financial ability to afford, and legal status [2]. Data collection Two of the researchers (FLHC, HLQ) conducted in-depth interviews in English either face-to-face or via Skype with the participants, each interview lasting an average of 60 min in length These were done at a time and site based on the participants’ availability and preference. The field notes for one of the interviews in which the participant preferred not to be recorded were typed out into a separate note sheet
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