African Refugees Research Articles

Navigating hidden borderlands: the role of cultural heritage for black African refugee students in American higher education

ABSTRACT In this conceptual paper, we advance a scholarly conversation about Black African refugee students in the United States. Although agreeing on a universal definition of a refugee is conceptually challenging, for the sake of focus, we define refugees as: individuals who have encountered forced migration, who have lived in the U.S. for less than five years, and who are not yet eligible for U.S. citizenship. While there are also Asian, European, Latin American, and South American refugee groups living in the United States, our paper focuses on Black African refugee students because the anti-Black racism of U.S. society positions them distinctly. Overall, we observe that Black African refugees exist in a metaphorical borderland that hides and (dis)locates their existence. While living within this borderland, Black African refugees engage in different mobilities and tap into their social network capital through cultural heritage. Cultural heritage, which includes both tangible and intangible artifacts, can be a source of psychological and social resilience, buttressing resettlement and reconstruction of identity. We also argue that Black African refugee students exhibit agentic, encouraged, and necessitated hiddenness. We conclude with a closer look into how this population may help higher education scholars arrive at liberatory possibilities that have implications for higher education research. Specifically, we recommend explicitly focusing on refugee student needs, crafting a culturally responsive curriculum and instructions, and facilitating relationships with refugee-supporting community organizations.

An Effective Interprofessional Collaboration to Support African Refugee Students' Oral and Written Language and Social Integration

Purpose: Two faculty members collaborated to advance educational equity by providing a summer camp experience to prevent summer learning loss for African refugee students in preschool through high school. Both faculty members educate university students in graduate programs, one for students aiming to become educators of English to Speakers of Other Languages and the other for speech-language pathology students. Method: Speech-language pathology graduate students provided supports for oral and written language within Tier 1 of a multitiered systems of support framework during camp. Interventions were provided within the context of the camp activities, rooted in the constructs of contextualized intervention, implicit learning, and feedback-free learning. The speech-language pathology students collaborated with the faculty members, camp director, community members, and the campers. Results: The speech-language pathology students learned to provide language support in natural environments, analyze writing, recognize strengths and areas for growth in multilingual learners, establish rapport with individuals from cultural and linguistic backgrounds that differ from their own, collaborate with other professionals, and build campers' confidence and self-esteem. The campers expanded their vocabulary, syntactic, and narrative production and developed teamwork, collaboration, and leadership. Conclusions: This program can be a model for others aiming to collaborate to advance educational equity. Speech-language pathologists have an important role in collaborating with colleagues from other disciplines to provide programs for language and literacy support, even when the students do not have underlying language disorder.

“Sometimes We Struggle, Sometimes We Push Back:” The Educational Experiences and Aspirations of Youth with Refugee Backgrounds from the Horn of Africa

This qualitative article focuses on the high school experiences and post-secondary education (PSE) plans of 57 youth with refugee backgrounds from the Horn of Africa living in Ontario. The article is guided by two conceptual frameworks. The first is an anti-oppressive approach, which helps us examine the structural barriers at school that prevent, impede, and discourage the youth from successfully transitioning to PSE. We then use Yosso’s (2005) community cultural wealth framework to highlight the cultural capital that the youth bring from their homes and communities to navigate the challenges at school and embark on a pathway to PSE. Our findings show that while a significant number of the youth continue to face challenges, some are pushing back on the common narrative that Black African refugees are not capable of attending PSE.

A qualitative study of negative sociocultural experiences of accessing primary health care services among Africans from refugee backgrounds in Australia: implications for organisational health literacy

BackgroundPrimary health care is the first point of contact for patients from refugee backgrounds in the Australian health system. Sociocultural factors, including beliefs and value systems, are salient determinants of health literacy and access to primary health care services. Although African refugees in Australia have diverse sociocultural backgrounds, little is known about the influence of sociocultural factors on their experiences of accessing primary health care services. Guided by the theoretical framework of access to health care, this study examined from the perspective of African refugees how culturally and religiously conditioned, constructed and bound health beliefs, knowledge and practices influence their experiences of access to, acceptance and use of primary health care services and information in Australia.MethodsThis exploratory, qualitative study involved 19 African refugees from nine countries living in New South Wales, Australia. Semi-structured interviews were conducted and recorded using Zoom software. The interviews were transcribed verbatim and analysed using a bottom-up thematic analytical approach for theme generation.ResultsFour main themes were identified. The themes included: participants' experiences of services as inaccessible and monocultural and providing information in a culturally unsafe and insensitive manner; the impact of the clinical care environment; meeting expectations and needs; and overcoming access challenges and reclaiming power and autonomy through familiar means. The findings generally support four dimensions in the access to health care framework, including approachability, acceptability, availability and accommodation and appropriateness.ConclusionAfrican refugees experience significant social and cultural challenges in accessing primary health care services. These challenges could be due to a lack of literacy on the part of health services and their providers in servicing the needs of African refugees. This is an important finding that needs to be addressed by the Australian health care system and services. Enhancing organisational health literacy through evidence-informed strategies in primary health systems and services can help reduce disparities in health access and outcomes that may be exacerbated by cultural, linguistic and religious differences.

Attitudes Towards Dementia Among a Diverse Group of Refugees Resettled in the United States.

Forced migration results in exposure to trauma, interrupted access to healthcare, and loss of social support and may increase dementia risk. Literature on refugees' knowledge of dementia and its risk factors is scant. This study investigates refugee perspectives on dementia and their access to cognitive healthcare in the United States (US). We conducted 6 focus groups and 30 individual in-depth interviews (total of 69 participants) with Arab, African, and Afghan refugees resettled in San Diego, California. Data was coded using inductive thematic analysis. Organized by the socioecological model of health, the following themes emerged: (1) mental trauma due to migration was linked to dementia (individual); (2) fear of dementia and burdening caregivers due to limited support systems (interpersonal); (3) reliance on virtual communities for dementia information and the stress of local community loss increasing dementia risk (community); (4) healthcare providers, both in the US and in refugee camps, didn't address cognitive health concerns (institutions); and (5) discriminatory immigration and healthcare policies as barriers to healthy aging (policy). Despite being a heterogeneous group, refugees share specific experiences, knowledge gaps, and barriers to healthy aging. Tailored interventions and policies are needed to address this population's cognitive health needs. This includes addressing their mental health and social support concerns as well as training clinicians to screen for/discuss dementia with aging refugee patients.

Transcultural Psychiatry in Medical Ethics: Assessing Decision-Making Capacity within the Lens of an East African Refugee.

AbstractA 29-year-old female East African refugee with no formal psychiatric history and a medical history significant for HIV was admitted for failure to thrive and concern for bizarre behavior in the context of abandonment by her husband and separation from her child. After psychiatric evaluation, it was determined that she did not have the capacity to care for herself independently; adult protective services then pursued and was awarded guardianship. While admitted, the patient repeatedly refused medical treatment, had a feeding tube placed for forced nutrition and medications (though she did at one point remove this tube herself), and received two electroconvulsive therapy (ECT) treatments. Soon thereafter, the patient's court-appointed guardian met with the primary medical, psychiatric, and ethics teams to discuss goals of care in the setting of complex social and cultural needs. It was collectively determined that the patient's choices to refuse care (including nutrition, lab work, medications, and ECT) and some repeated behaviors (e.g., denial of divorce, denial of HIV, denial of need for care) could be considered culturally appropriate in the context of the acute stressors leading up to hospitalizations. All teams concluded, therefore, that the patient had the capacity to refuse these interventions and that further forced intervention would pose a greater chance of exacerbating her already-significant trauma history than improving her outcomes. Ultimately, the patient was able to be discharged into the care of her guardian, who would assist her in receiving support from members of her community who share her language and culture.

Examining Programs for Educators in Leadership: A Scoping Review of Strategies to Address Racial Inequities for African Refugee Students in Secondary Education in the U.S.

Examining Programs for Educators in Leadership: A Scoping Review of Strategies to Address Racial Inequities for African Refugee Students in Secondary Education in the U.S.

Examining the clinical validity of the global psychotrauma screen in refugees.

The Global Psychotrauma Screen (GPS) is a brief transdiagnostic screener that covers a broad range of trauma-related disorders as well as risk factors known to influence the course of symptoms. We analyzed data from African war refugees in Australia (n = 70), including the GPS, the Structured Clinical Interview for DSM-5 Disorders (SCID-5), the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), and the Brief Resilience Scale (BRS). Using the Youden's J Index to examine the clinical validity of the GPS subscales measuring PTSD, dissociation, depression, and generalized anxiety disorder (GAD), we found that a PTSD subscale score of 3 or higher, and a depression and dissociation subscale score of 1 or higher, was optimally efficient for detecting a probable diagnosis (Youden's J = 0.76, J = 0.72, and J = 0.90, respectively) with high sensitivity and specificity. We were unable to test the GPS clinical validity for GAD due to the low GAD occurrence. The GPS resilience item was not related to the total score (r = 0.02), indicating low convergent validity for resilience. Risk factors, including current stressors and childhood trauma history, were related to more severe GPS symptom scores, while lack of resilience, social support, and history of mental illness were not. We conclude that the GPS may be a useful screening tool for PTSD, depression, and the dissociative subtype in refugees.

Livelihood Precarity of Migrants: Perspectives of African Refugees in Durban, South Africa

Migrants and refugees face numerous socioeconomic and institutional challenges in the host cities and countries. They are excluded from full participation in the labor market, which makes them vulnerable to poverty. To survive, migrants and refugees join the informal economic sector. Informed by the Sustainable Livelihoods Framework (SLF), the article examines how African refugees in Durban make and maintain their livelihoods, including their encounters with marginalization. Participants were drawn from Congolese, Rwandese, and Burundian community groups living in the inner city of Durban. The snowballing sampling method was key in identifying the participants, while face-to-face interviews were used for data collection. The findings show that African refugees in Durban pursue diverse forms of livelihood in the informal sector. They are faced with numerous challenges, such as a lack of start-up capital, weak social networks to protect themselves and their businesses, bureaucratic challenges, discrimination, and xenophobic attacks. Regardless of these challenges, migrants still forge ahead by starting their businesses and making a living under the circumstances of precarity and marginalization.

NEREA AMORÓS ELORDUY - Architecture as a Way of Seeing and Learning. The built environment as an added educator in East African refugee camps

NEREA AMORÓS ELORDUY - Architecture as a Way of Seeing and Learning. The built environment as an added educator in East African refugee camps

Responding to health literacy of refugees in Australian primary health care settings: a qualitative study of barriers and potential solutions

BackgroundOrganisational health literacy is a promising area of research that enables a focus on how systems and services can be designed in ways that are responsive to populations with varying states and levels of health literacy, knowledge, and practices, including African refugees. The challenge is how organisations and professionals do this in practice, and research in this area is in its early stages. This qualitative study examined barriers to implementing health literacy responsive care practices in primary health care settings in Australia. It also offered suggestions to potentially address the barriers to improving organisational health literacy.MethodsRefugees (n = 19), primary health care professionals (n = 14), and other key stakeholders (n = 19) were recruited through convenience and snowball strategies from three states in Australia: New South Wales, Victoria, and Queensland. All but one participant was interviewed face-to-face via Zoom. Semi-structured interview guides were used to guide the conversations. Transcriptions from audio recordings were analysed using directed content analysis.ResultsThirteen themes were extracted from the data. Themes were organised into the following categories: structural and systemic, organisational context, individual professional level, individual patient level, and socio-community level. Major structural and system-level factors affecting organisational health literacy included rigid systems and structures and limited time. Key organisation-level factors included inflexible organisational processes and policies, institutionalised othering, discrimination and racism, and lack of interpreters. Individual professional factors were poor communication with patients and cultural knowledge gaps. Linguistic issues and service mistrust were key individual patient-level factors. Socio-community factors included limited community engagement. Participants identified potential solutions to help services navigate out of the barriers and improve their response to health literacy.ConclusionThe findings suggest that mainstream services and organisations could improve timely and appropriate health care access and utilisation for refugees through strategies such as designing services and health literacy programs with refugee communities, promoting health literacy champions in the workforce, integrating health literacy and culturally responsive care plans and strategies into organisational priorities.

Understanding the drivers of electricity access and willingness to pay for reliable electricity in African refugee settlements: Evidence from Zambia, Malawi, and Uganda

This study investigates electricity access and willingness to pay for reliable electricity among refugees living in settlements in protracted situations in Sub-Saharan Africa. Field data from 1322 respondents in Dzaleka (Malawi), Adjumani (Uganda), and Meheba (Zambia) reveal varying access rates ranging from under 20 % to approximately 80 %, with older and wealthier settlements reporting higher values. Also, the level of access is low (Tier 0 to 3) and supply is unreliable. Average willingness to pay differs across locations (the household mean in Meheba is 4.5 times larger than in Adjumani and more than double that in Dzaleka) but is similar in relative terms (corresponds to about 10 % of the local monthly income). Also, the distribution of the willingness to pay within each location is left-skewed, with a significant share of respondents indicating a value of zero (28 % of households in Adjumani). Using socio-economic data collected from the field, we identify and analyse a set of potential drivers of electricity access and willingness to pay. The regression models' results confirm the crucial role of income, identify certain key end-user characteristics, and reveal the awareness of the benefits of electricity services as a significant driver for households. These findings emphasise the urgency of addressing electricity access disparities and the critical role of tailored interventions and policies promoting affordability and income-generating opportunities for refugees in protracted situations. Preliminary insights into the complex role of drivers specific to the humanitarian energy context (prior electricity access, humanitarian aid, and years spent in the settlement) suggest further research.

Selected Non-communicable Disease Risk Factors and Mental Health of South African Durban-based Refugees: A Cross-sectional Study

Background Non-communicable diseases (NCDs) are the leading contributor to mortality and morbidity worldwide, with refugees considered more susceptible to NCDs. Refugees often encounter difficulties in accessing healthcare, resulting in delayed diagnostic assessment and treatment of mental disorders and NCDs, leading to the deterioration of the condition. The study aimed to ascertain the prevalence of risk factors for NCDs and mental health among South African Durban-based refugees. Methods This cross-sectional study was conducted among 121 randomly selected South African Durban-based refugees. Data on the metabolic risk factors for NCDs were collected using a modified version of the World Health Organisation (WHO) STEPwise approach to (NCDs) surveillance (STEPS) instrument. Participants' mental health disorders were determined with a Global Mental Health Assessment Tool-Primary Care Version questionnaire. Results A significant 38.80% of participants had normal BMI [x2 (5, n=47) = 82.55, p<.001], 24.0% were overweight [x2 (5, n=29) = 82.55, p<.001], 25.6% were obese class l [x2 (5, n=31) = 82.55, p<.001]. A significant 77.1% [x2 (2, n=64) = 76.79, p<.001] of the participants had desirable cholesterol levels, and 62.3% [x2 (2, n=71) = 44.57, p<.001] had normal fasting glucose levels. A significant 26.1% [x2 (4, n=31) = 64.82, p<.001] and 46.2% [x2 (4, n=55) = 64.82, p<.001] were classified as having hypertension stage I and II, respectively. A non-significant 32.2% and 25.0% experienced depression and anxiety. Conclusions The prevalence of hypertension and high BMI levels combined with mental disorders underscores the importance of healthcare service delivery to this vulnerable population in SA.

Protocol of the study: Multilevel community-based mental health intervention to address structural inequities and adverse disparate consequences of COVID-19 pandemic on Latinx Immigrants and African refugees.

The NIMH-funded Multilevel Community-Based Mental Health Intervention to Address Structural Inequities and Adverse Disparate Consequences of COVID-19 Pandemic on Latinx Immigrants and African Refugees study aims to advance the science of multilevel interventions to reduce the disparate, adverse mental health, behavioral, and socioeconomic consequences of the COVID-19 pandemic that are a result of complex interactions between underlying structural inequities and barriers to health care. The study tests three nested levels of intervention: 1) an efficacious 4-month advocacy and mutual learning model (Refugee and Immigrant Well-being Project, RIWP); 2) engagement with community-based organizations (CBOs); and 3) structural policy changes enacted in response to the pandemic. This community-based participatory research (CBPR) study builds on long-standing collaboration with five CBOs. By including 240 Latinx immigrants and 60 African refugees recruited from CBO partners who are randomly assigned to treatment-as-usual CBO involvement or the RIWP intervention and a comparison group comprised of a random sample of 300 Latinx immigrants, this mixed methods longitudinal waitlist control group design study with seven time points over 36 months tests the effectiveness of the RIWP intervention and engagement with CBOs to reduce psychological distress, daily stressors, and economic precarity and increase protective factors (social support, access to resources, English proficiency, cultural connectedness). The study also tests the ability of the RIWP intervention and engagement with CBOs to increase access to the direct benefits of structural interventions. This paper reports on the theoretical basis, design, qualitative and quantitative analysis plan, and power for the study.

Long-term benefits to psychological health and well-being after ceremonial use of Ayahuasca in Middle Eastern and North African immigrants and refugees.

Refugees and immigrants can experience complex stressors from the process of immigration that can have lasting and severe long-term mental health consequences. Experiences after ayahuasca ingestion are shown to produce positive effects on psychological wellbeing and mental health, including anecdotal reports of improved symptoms of trauma and related disorders. However, data on the longitudinal health impact of naturalistic ayahuasca use in Middle Eastern and North African (MENA) immigrant and refugee populations is limited. The current longitudinal online survey study was conducted to gather prospective data on ceremonial ayahuasca use in a group (N = 15) of primarily female MENA immigrants and refugees and to provide further insight into the patterns and outcomes surrounding that use. The study sought to assess self-reported changes in physical and mental health, well-being, and psychological functioning, examine relationships between aspects of individual mindset (e.g., psychedelic preparedness) prior to ayahuasca use and observed outcomes during (e.g., subjective drug effects) and afterwards (i.e., persisting effects), characterize risks and negative experiences, and describe trauma exposure and personal history. Our findings revealed ceremonial use of ayahuasca is associated with significant improvements in mental health, well-being, and psychological functioning, including reductions in depression, anxiety, and shame, and increases in cognitive reappraisal and self-compassion. Most participants reported no lasting adverse effects and experienced notable positive behavioral changes persisting months after ingestion. While preliminary, results suggest naturalistic ayahuasca use might hold therapeutic potential for MENA populations exposed to trauma prior to and during the process of migration.

When the homo deamon went digital: writing Africa’s transgender refugee diaspora

Abstract From an online African lesbian, gay, bisexual, transgender and intersex (LGBTI) news and information website, launched in 2000, called Behind the Mask (BtM) to Sokari Ekine’s foundational 2004 blog Blacklooks, the digital has been crucial to queer African studies and, indeed, queer Africa. In this brief exploration, I navigate through the realms of queer African studies, African digital humanities, and African literary studies, using them as my guiding framework to uncover the digital emergence of an African transgender refugee diaspora. I suggest that this diaspora is producing content explicitly aimed back at the African continent to shape and deploy the reality of what it means to be transgender and African. In so doing, they are actively authoring themselves into existence.

Media Framing of African Refugee Migration to Europe: An Analysis of Narrative Constructions From Selected Global Media Houses in 2023

The framing of migrants from Africa to Europe on the global media is complex and quite obscure. The manner in which media tells a story is quite critical as it has the potential to influence the discernment of the public from different parts of the world. The main goal of the study was to examine how the global media houses portrayed African migrants to Europe in 2023.This was guided by two specific objectives:To examine the global media outlets' coverage of African refugee migration to Europe and to analyze the language used by the media to describe African refugees, assessing for bias, stereotypes, or stigmatization. The study was guided by the framing theory. The study employed a qualitative method design to conduct a detailed analysis of media framing surrounding African migration to Europe. Data was collected from all the global media houses with a sampling frame from three major media houses which included: The Cable News Network (CNN), The British Broadcasting Corporation (BBC), and the Eastern Africa. Data was analyzed using thematic content analysis. Findings indicated that, how global media houses cover the migration of people from Africa to Europe exposes the intricate narrative formed by a variety of both negative and positive views. While the CNN and BBC comprise varied perspectives to the issues, The Eastern Africa gives insight into the regional circumstances surrounding the migration problem as well as the humanitarian concerns. Across all the examined media houses (CNN, BBC, The Eastern Africa), there is an inclination towards portraying the African migrants in negative light, underscoring their impact on destination states. There were instances of Bias and stereotypes that could potentially lead to stigmatization. The study recommended that there is need for balanced reporting from media houses, there needs for some ethical considerations in reporting and that media houses should mainly focus on their role of creating awareness and advocacy.

Study of mental health perceptions among Central African refugee populations and host communities in the East Cameroon region

IntroductionCameroon’s eastern region faces numerous security challenges linked to successive crises in the Central African Republic, particularly with the massive influx of refugees especially since 2013. Official UNHCR figures speak of 349,409 Central African refugees present on Cameroonian soil. These are both refugees already well established in their host communities, and new arrivals. Since the post-electoral crisis in CAR at the end of 2020, the situation has gradually stabilized in the Kadey department, but remains volatile due to daily insecurity in the northern regions of the Central African Republic.ObjectivesWith a view to meeting the mental health and psychosocial support needs of the region’s population and better integrating refugees into their host communities, it was necessary to obtain a more exhaustive picture of the population’s perception of mental health, to understand the mechanisms of psychosocial support at community level and any differences between refugees and the indigenous population.MethodsA mixed methodology with quantitative and qualitative data was chosen for a more detailed analysis. The survey was carried out in two communes in the Kadey department: Kentzou and Kette. The sample was disaggregated to take account of the socio-demographic characteristics and to enable to make comparisons between the situations of host communities, living in refugee sites and outside sites. For quantitative data, 205 the individuals responded to a questionnaire. 12 individual interviews and 12 Focus Group Discussions (involving 60 participants ) guided by semi-structured questions were used to collect qualitative data from key members of the community.ResultsAnalysis of quantitative and qualitative data has confirmed the successful integration of Central African refugees into the host community. Nevertheless, there is a difference between these two groups in terms of their perception and understanding of the definition of mental health, mental health disorders and treatment options. Thus, there was a clear difference in training and awareness needs between the host and refugee communities.ConclusionsBased on the qualitative and quantitative results of our assessment, a number of recommendations have been drawn up. It would be interesting to find a balance in the definition, attribution of causes and treatment of mental disorders between the traditional, mystical and cultural vision and the psychological and psychiatric one. It would be important to encourage refugee communities to return to some of their traditional practices, and to allow several visions of the human being to coexist between a traditional and a more medical vision.To address the lack of resources for mental health care in the Kadey area, more training in mental health and psychosocial support is needed for health and social workers in the area.Disclosure of InterestNone Declared

CONFLICTS AND VIOLENCE: THE CHALLENGES OF PROTECTING REFUGEES IN SUB-SAHARAN AFRICA

This paper examines the challenges of protecting refugees in sub-Saharan Africa. Reviewing available and relevant literature on refugees and their displacement in this region, it argues that people are compelled to flee their homes and seek refuge across international borders due to poverty, instability, conflict, and climate-related emergencies. They are then placed in overcrowded camps, frequently for extended periods. In theory, African refugees can access one of the most progressive protection schemes in the world. In practice, they confront insurmountable obstacles to their human rights, including coerced return, prejudice, arbitrary detention and arrest, limitations on their freedoms of speech and movement, and violations of their social and economic rights. Refugee law, which was created in the language of human rights and applies to people who are already highly vulnerable, disappears from view amid the poor human rights records of many African countries. From an in-depth argument and reflection on the literature, considering the differing voices and arguments, this paper communicates how, given the rise in extremism and political instability in sub-Saharan Africa, regional security is at risk if the inadequate protection given to refugee camps is not addressed.

Behavioural risk factors for non-communicable diseases among South African Durban-based refugees: a cross-sectional study.

Behavioural risk factors for non-communicable diseases (NCDs) are rising among refugees, increasing chronic disease prevalence that causes morbidity and mortality. This study aimed to ascertain the prevalence, awareness and management of behavioural risk factors for NCDs among South African Durban-based refugees. A once-off quantitative, cross-sectional design was conducted on the behavioural risk factors for NCDs among 122 randomly selected Durban-based refugees using a modified version of the World Health Organisation (WHO) STEPwise approach to NCDs surveillance (STEPS) instrument. Participants' awareness and management of risk factors for NCDs were determined with a behavioural NCD awareness and management of behavioural NCD risk factor questionnaire. Smoking and alcohol prevalence were 4.1% and 20.7%, respectively, with 40.8% consuming fewer than five servings of fruit and/or vegetables daily. Participants performed more than 150 min of moderate physical activity per week. A significant 30.8% (p < 0.001) was aware that consuming alcohol poses an extremely large risk, similarly for smoking (38.7%; p < 0.001]. A significant 56.2% (p < 0.001) believe that regularly eating raw vegetables presents no risk, likewise for being physically active (51.7%; p < 0.001). A significant 40.6% (p < 0.001) of the participants always drink water or non-alcoholic drinks to manage their alcohol consumption, 54.2% (p < 0.001) manage their unhealthy diet by sometimes filling half their plates with fruits and vegetables, and 49.2% manage their physical activity levels by sometimes choosing a range of physical activities (p < 0.001). Refugees' lack of awareness of behavioural risk factors for NCDs highlights the importance for health service providers to present health promotion programs to make refugees aware of their behavioural NCD's risk factors and how it impacts their health.