Asylum-seeking Backgrounds Research Articles

Primary healthcare providers' knowledge, practices and beliefs relating to preventive sexual and reproductive health care for women from refugee and asylum-seeking backgrounds in Australia: a national cross-sectional survey.

Background Many refugee women and women seeking asylum arrive in high-income countries with unmet preventive sexual and reproductive health (SRH) care needs. Primary healthcare providers (HCPs) are usually refugee and asylum seekers' first point of care. This study aimed to identify HCP characteristics associated with initiating conversations and discussing SRH opportunistically during other health interactions. Methods An anonymous online survey was distributed nationally to representatives of health professional organisations and Primary Health Networks. Hierarchical logistic regression analysed factors including HCP demographics, knowledge and awareness, perceived need for training and professional experience with refugee women were included in the models. Results Among 163 HCPs, those initiating conversations ranged from 27.3% (contraceptive care) to 35.2% (cervical screening). Opportunistic discussions ranged from 26.9% (breast screening) to 40.3% (contraceptive care). Positively associated factors included offering care to refugee women or women seeking asylum at least once every 2months 7.64 (95% CI 2.41;24.22, P P P P P P Conclusions Direct professional experience, frequency of service provision, years of practice, and part time work positively influence HCPs' SRH care practices. Enhancing bilingual health worker programs, outreach, education, and support for SRH and cultural competency training are essential to improving the preventive SRH care of refugee women and women seeking asylum.

Characteristics of Sexual Health Programs for Migrants, Refugees, and Asylum Seekers: A Scoping Review.

Social, cultural, and structural determinants of health for migrants, refugees, and asylum seekers can contribute towards poorer sexual health outcomes. People from migrant, refugee, and asylum seeker backgrounds usually use less mainstream sexual healthcare services and have lower levels of sexual health literacy compared with the destination countries' general population. However, there is little collated knowledge about sexual health programs that have been implemented to improve sexual health among these groups. This study aimed to describe the characteristics of programs for improving sexual health among migrants, refugees, and asylum seekers. This study was a scoping review in which Scopus and PubMed were searched for peer-reviewed articles published in English since 2010 from countries similar to and including Australia such as New Zealand, the United States of America, Canada, the United Kingdom, and European Union countries). The final search of databases was performed on 26 June 2023, and resultant studies were inputted into Endnote and Covidence systematic review software to remove duplicates before screening. The study utilised a qualitative approach using inductive thematic analysis of the content of the studies to extract and categorise the characteristics of the program. A total of 3044 articles were screened and 20 were included for data extraction. The included studies were conducted in six countries (the United States of America, Australia, France, Italy, Denmark, and Belgium). The key characteristics of sexual health programs identified included consumer consultation and engagement, cultural appropriateness, language support, peer education, self-directed learning, group learning, financial support, and outreach services. the programs had a combination of these characteristics to ensure that they can improve target population engagement with educational materials and decrease barriers to accessing sexual healthcare. Consideration of migrants, refugees, and asylum seekers' culture, language, socioeconomic characteristics, and access to information and services in the design of the sexual health programs may improve sexual health outcomes among these groups. However, further research is needed to assess the importance and implementation feasibility of the identified characteristics for sexual health programs in specific context.

Working with/beyond ‘language’: insights from a listening walk with young men from asylum-seeking backgrounds in a rural treescape

ABSTRACT This article articulates the affordances and challenges of researching with and beyond language on a listening walk with young men from asylum-seeking backgrounds in a rural treescape. Offering methodological and conceptual provocations for creative multilingual research, the article does not (re)present a traditional research encounter with fixed methodologies and confident findings. Rather, it stories a research encounter, anchored in participatory practice and developed conceptually through post-research puzzlement that critically unpacks and embraces vulnerabilities associated with the roles of language, feelings and understanding in social research.

Conceptualising the art of belonging for young refugees and asylum-seekers: reflections from England and Sweden

ABSTRACT The concept of belonging has grown in prominence in research and policy relating to new arrivals from refugee and asylum-seeking backgrounds. Arguably, belonging is replacing integration and inclusion as the panacea to perceived problems associated with places and societies where new arrivals settle. Belonging is also prominent in the literature about formal and informal educational contexts. This paper problematises the concept of belonging. It draws on findings from a research project which explored how young, forced migrants, newly arrived in Europe, could be supported through engagement with arts and culture to achieve a sense of belonging in their new place. Interview data and observational fieldnotes illustrate how belonging and unbelonging are experienced through an informal education programme of arts and culture in two cities in Sweden and England. The paper sheds light on the complexity and ambiguity of belonging for the participants, arguing that ‘to belong’ is not an unequivocally positive experience for new arrivals. In an era of increasing migration, the paper calls for a new language for belonging which recognises this complexity and acknowledges that the process of belonging is reciprocal involving those who have newly arrived and those in situ in the communities in which newcomers settle.

Housing and health for people from refugee and asylum-seeking backgrounds: findings from an Australian qualitative longitudinal study

BackgroundFor people from asylum-seeking and refugee backgrounds, housing and the re-establishment of home are key social determinants of health. Research highlights the inequities faced by asylum seekers and refugees in the housing markets of high-income resettlement countries, resulting in their overrepresentation in precarious housing. There is also emerging evidence of the relationship between housing and health for this population relating to lack of affordability, insecurity of tenure, and poor suitability (physical and social). The mechanisms by which housing impacts health for this group within these housing contexts, is however, understudied - especially overtime. This qualitative longitudinal study aimed to address this gap.MethodsSemi-structured interviews were conducted with 25 people from asylum-seeking and refugee backgrounds in South Australia, recruited through a community survey. Thematic analysis of interview data across three time points over three years identified four material and psychosocial mechanisms through which housing contributed to health outcomes via psychological and physical stressors - physical environment; stability; safety; and social connections, support and services. The study also identified additional health promoting resources, particularly elements of ontological security. The dynamics of these indirect and direct mechanisms were further illuminated by considering the impact of international, national and local contexts and a range of intersecting social factors including gender, country/culture of origin, family circumstances, immigration status, language skills, income, and health status.ConclusionsRebuilding a sense of home and ontological security is a key resettlement priority and crucial for wellbeing. More comprehensive strategies to facilitate this for refugees and asylum seekers are required.

Co-designing a Physical Activity Service for Refugees and Asylum Seekers Using an Experience-Based Co-design Framework.

People from refugee and asylum seeker backgrounds resettling in Australia often experience intersecting risks for poor mental and physical health. Physical activity can promote better health outcomes, however there are limited programs tailored for this population. Therefore, understanding how to support refugees and asylum seekers to engage in physical activity is crucial. This paper aims to describe how the experience-based co-design (EBCD) process was used to identify priorities for a new physical activity service for refugees and asylum seekers. Using an EBCD framework we conducted qualitative interviews and co-design workshops with service users (refugees and asylum seekers living in the community) and service providers at a community Centre in Sydney, Australia. Sixteen participants, including eight service users and eight service providers engaged in the EBCD process over 12-months. The interviews revealed common themes or 'touchpoints' including barriers and enablers to physical activity participation such as access, safety and competing stressors. Subsequent co-design focus groups resulted in the establishment of five fundamental priorities and actionable strategies; ensuring cultural and psychological safety, promoting accessibility, facilitating support to access basic needs, enhancing physical activity literacy and fostering social connection. Using EBCD methodology, this study used the insights and lived experiences of both service users and providers to co-design a physical activity service for refugees and asylum seekers which is safe, supportive, social and accessible. The results of the implementation and evaluation of the program are ongoing.

Health susceptibility perceptions among Iranian, Afghan and Tajik minorities in three Nordic countries

PurposeThis research paper aims to delve into the perceptions of health susceptibility among Iranian, Afghan and Tajik individuals hailing from asylum-seeking or refused asylum-seeking backgrounds currently residing in Finland, Norway and Sweden.Design/methodology/approachSemi-structured interviews were conducted between May and October 2022 involving a sample size of 27 participants. An adapted framework based on the health belief model along with previous studies served as a guide for formulating interview questions.FindingsNotably influenced by cultural background, religious beliefs, psychological states and past traumatic experiences during migration journeys – before arrival in these countries till settling down – subjects’ perception of health concerns emerged significantly shaped. Additionally impacting perspectives were social standing, occupational status, personal/family medical history, lifestyle choices and dietary preferences nurtured over time, leading to varying degrees of influence upon individuals’ interpretation about their own wellness or illness.Practical implicationsInsights garnered throughout the authors’ analysis hold paramount significance when it comes to developing targeted strategies catering culturally sensitive health-care provisions, alongside framing policies better aligned with primary care services tailored explicitly around singular demands posed by these specific communities dwelling within respective territories.Originality/valueThis investigation represents one among few pioneering initiatives assessing perceptions regarding both physical and mental well-being within minority groups under examination across Nordic nations, unveiling complexities arising through intersecting factors like individual attributes mingling intricately with socio-cultural environments, thereby forming unique viewpoints towards health-care belief systems prevalent among such population segments.

‘It is a university where I felt welcome’: poems of asylum-seeking students’ sense of coherence in Australian higher education

ABSTRACT Current social and political arrangements of higher education are inequitable for students from asylum-seeking backgrounds. In many countries, their access to university is limited and if they are accepted, their status as forced migrants puts them at multiple disadvantages. This inequity is in contrast with the universal aim of higher education institutions to serve all people and their societies. Utilising a voice centred relational method (VCRM) and the theoretical lens of Aaron Antonovsky’s salutogenesis, this article is a poetic presentation of the experiences of asylum-seeking students in Australian universities. We show that higher education can provide asylum-seeking students with the means for safety (making life manageable), belonging (making life comprehensible), and success (making life meaningful). Thus, we argue that higher education institutions have the potential to help facilitate students’ sense of coherence, which in salutogenetic terms refers to their ability to comprehend their own situation, and the capacity to use the resources available. However, asylum-seeking status poses barriers in achieving this, and this inequity should be addressed.

Ethical Considerations in Research With People From Refugee and Asylum Seeker Backgrounds: A Systematic Review of National and International Ethics Guidelines

Refugees and asylum seekers may experience challenges related to pre-arrival experiences, structural disadvantage after migration and during resettlement requiring the need for special protection when participating in research. The aim was to review if and how people with refugee and asylum seeker backgrounds have had their need for special protection addressed in national and international research ethics guidelines. A systematic search of grey literature was undertaken. The search yielded 2187 documents of which fourteen met the inclusion criteria. Few guidelines addressed specific ethical considerations for vulnerable groups much less people with refugee and asylum seeker backgrounds. One guideline explicitly addressed vulnerability for refugees and asylums seekers. To ensure members of ethics committees and researchers consider the potential challenges of conducting research with these groups, guidelines may need to be supplemented with a refugee and asylum seeker specific research ethics framework. Such a framework may be necessary to optimally protect people with refugee and asylum seeker backgrounds in research.

The wellbeing and support experiences of parents and caregivers from South and Southeast Asian refugee backgrounds during the First 2000 Days: A systematic review

There is growing scholarly attention concerning the wellbeing experiences of people from refugee and asylum-seeking backgrounds, particularly in relation to antenatal and postnatal care in countries of resettlement. However, less is known about early childhood support for refugee and asylum-seeking parents during the First 2000 Days of a child's life (conception to age five). There is also little understanding of the needs of refugees and asylum-seekers from South and Southeast (S/SE) Asia for whom there may be unique cultural considerations regarding parenting and support. This systematic review therefore aimed to explore the emotional and physical wellbeing and support experiences of refugee and asylum-seeking families (mothers, fathers, and other family members with caregiving roles) from S/SE Asia during the First 2000 Days. This review was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). We identified publications through a systematic search of six databases. Eligible papers were peer-reviewed, primary data studies published in English, conducted in middle- to high-income countries of resettlement, and included data that could be disaggregated for S/SE Asian families. Of 5,770 publications, 13 articles met inclusion criteria. While our review aimed to explore the experiences of various family members, included papers focused primarily on the experiences of refugee women. Our review found that S/SE Asian refugee parents reported various challenges to physical and emotional wellbeing during the First 2000 Days ranging from nutrition and diet concerns to feelings of anxiousness, grief, isolation, and feelings of distress in healthcare settings. Parents also expressed a level of trust and satisfaction with maternity care during resettlement, however, these experiences were challenged by a lack of culturally responsive care. Findings speak to the importance of informal social supports for S/SE Asian refugee parents, and culturally safe, formal supports where parents feel comfortable to voice their concerns.

‘Having a good friend, a good neighbour, can help you find yourself’: social capital and integration for people from refugee and asylum-seeking backgrounds in Australia

ABSTRACT Social networks and access to resources are important to refugee integration but there is limited research with people from refugee and asylum-seeking backgrounds. This mixed methods paper reports on the social capital of refugees and asylum seekers and relevance to settlement satisfaction and integration. Surveys were completed by 423 adult refugees and asylum seekers living in South Australia. Additionally, semi-structured interviews were conducted with 65 participants, purposively sampled from the survey, and analysed thematically. The survey indicated that satisfaction with social networks (neighbourhood, ethnic/cultural and general) was associated with satisfaction with social support, which were in turn associated with a sense of belonging and overall happiness with life in Australia. The interviews illustrated how bonding and bridging ties facilitated access to resources by providing emotional support, a sense of belonging and hope, and safety and security through friendship and connection, and the provision of practical support. However, there were limited linking ties and differing access to social capital across characteristics such as region of origin, immigration status, financial situation, English skills, and time in Australia, which can contribute to inequities over time. Overall, our findings highlight the importance of facilitating access to social capital to assist with resettlement and integration.

Housing in Place: Housing, Neighbourhood and Resettlement for People from Refugee and Asylum Seeker Backgrounds in Australia

Housing is an important part of building a new life for people from refugee and asylum seeker backgrounds. However, relatively little is known about how housing and neighbourhood experiences affect resettlement and integration. This paper explored experiences of housing and neighbourhood for refugees and asylum seekers in South Australia, Australia. A survey was completed by 423 participants, recruited through service providers, community networks and snowball sampling. Data was analysed using frequencies, chi-square analyses and multivariate logistic regression. The study identified aspects of housing and neighbourhood that were important to participants, as well as highlighting key problems. Housing satisfaction and neighbourhood satisfaction were positively associated, but housing satisfaction was lower than neighbourhood satisfaction. Both were significantly associated with overall satisfaction with life in Australia, although only neighbourhood satisfaction remained significant in the final multivariate model (alongside region of origin, visa and financial situation). Overall, the findings suggest that where housing is situated may be more important for resettlement satisfaction and integration than the housing itself. Policy and practice implications of the findings are discussed, alongside considerations for conceptualising integration.

Arts-Based Approaches to Languages Education with Refugee-Background Learners in the Early Years: Co-Creating Spaces of Hope

Young learners with refugee experiences face a constellation of challenges particular to forced migration and resettlement. Experiences of trauma, violence, poverty, and disrupted or limited access to formal education and healthcare can have complex and long-term impacts on learning. Further, the sociocultural and linguistic challenges of undertaking education in unfamiliar schooling systems in transit and resettlement countries can also impede learner engagement and obscure individual strengths. However, like all student cohorts, children with refugee and asylum seeker backgrounds are also unique, with individual personal, sociocultural, and linguistic attributes on which to draw. While these assets may be overlooked or obscured in traditional educational contexts, arts-based approaches to instruction can offer generative and affirming learning spaces that illuminate individual strengths and provide powerful rejoinders to deficit constructions. This article provides an overview of recent research that explores vibrant and innovative arts-based approaches to languages instruction for refugee and asylum-seeker background learners in the early years. The article takes the form of a scoping study of literature using Arksey and O’Malley’s framework to map the field of research, document novel instructional approaches, and identify key themes. Our discussion is oriented toward educators who seek to innovate their own instructional practice. In addition to exploring the creative avenues for language instruction described in the literature, we consider key themes that emerged inductively from our analysis including the agentic value of arts-based instructional practices, the role of narrative in articulating experiences of place and identities, and the significance of arts-based connections between home and school linguistic repertoires.

What do we know about how women with forced migration experiences access tertiary education in resettlement contexts? A scoping study

ABSTRACT There has been a growth of scholarly interest in the experiences of people with refugee and asylum seeker backgrounds as they seek to access tertiary education in resettlement. While gender is frequently identified as a key factor that impacts equitable participation in tertiary studies, the educational challenges for women with forced migration experiences (WFME) are often incidentally identified, rather than a targeted focus of inquiry. Here, we map the scholarly literature that explicitly focuses on the tertiary educational experiences of WFME, using a scoping study methodology (Arksey and O’Malley 2005) to explore current understandings and suggest future research directions. In analysing WFME-focused literature spanning the last ten years, we consider what is known about the barriers and facilitators to engagement, and the ways in which gendered experiences intersect with issues of language, culture, and socioeconomic and visa status to create particular constellations of gendered disadvantage that are specific to WFME.

Learning challenges of culturally and linguistically diverse students: A framework for psychological assessment

Australian schools are experiencing an increase in enrolments for students from culturally and linguistically diverse backgrounds. Many of these students, who are frequently from migrant, refugee or asylum-seeker backgrounds, progress academically, but a small number experience learning challenges. In these circumstances, practitioners (school psychologists and guidance counsellors) assess the students to determine underlying factors contributing to limited academic progress, and ways in which the student’s learning can be supported and enhanced. However, formal assessment can be challenging due to language and cultural barriers. Considering the gaps in the research and training, the present article proposes an assessment framework and highlights strategies that can be adopted by practitioners at schools to enrich their decision-making and assessment process. Two case studies are used to highlight factors that can impact students’ academic difficulties. Further interview protocols and assessment measures that can be used to assist these students and their families are discussed. Ways in which school authorities can guide and support these students in the classroom and in the school are examined.

An investigation of unmet health-related information and healthcare services needs of people with asylum-seeking backgrounds

An investigation of unmet health-related information and healthcare services needs of people with asylum-seeking backgrounds

Approaches to delivering appropriate care to engage and meet the complex needs of refugee and asylum seekers in Australian primary healthcare: A qualitative study.

This study aimed to provide insight and learnings from Australian general practitioners in facilitating positive interactions with refugee and asylum seeker patients and the role they play in helping those community members engage with healthcare. We conducted semi-structured individual remote interviews with 12 general practitioners (GPs) who worked in areas with high refugee and migrant populations. Interview transcripts were coded inductively and deductively, based on the research questions, using Thematic Analysis. Extensive debriefing and discussion took place within the research team throughout data collection and analysis. Creating a culturally safe environment was an initial step taken by GPs to minimise the inherent power imbalance, in addition to applying the principles of trauma-informed care (TIC) to appropriately listen and respond to their patients' needs and individual social circumstances. GPs at times were involved in using their role to advocate on behalf of their patient and played a key role in helping build their patients' health systems literacy. This study highlights the important role that GPs play in advocating and engaging refugee and asylum seeker patients, as well as helping them navigate the healthcare system. Whilst GPs practice can be made more efficient through experience and time; to deliver the care required GPs need to provide care in response to the individual's capacity and social circumstances. Enabling time and the application of the principles of TIC and cultural safety may allow for GPs to provide the quality of care that is needed in supporting patients from refugee and asylum seeker backgrounds.

Durable supports for refugees in higher education through resisting short-termism and organisational memory loss: illustrative cases from Australia and Germany

ABSTRACT Recently, an increasing number of students from refugee and asylum-seeking backgrounds (SRABs) entering universities in settlement countries such as Australia and Germany have necessitated the establishment of a variety of supports, both as formal programs and informal ad-hoc networks. However, to date, little attention has been paid to the organisational conditions surrounding such supports. This study thus examined these conditions through the conceptual lens of organisational memory loss. Based on the two illustrative cases of Australia and Germany, it was described how building durable and responsive supports for SRABs is undermined by structural, ideological, and temporal imperatives that erode the possibilities for a sharable organisational memory. Furthermore, it was argued that similar to global arguments for durable pathways to settlement, universities need to develop and deliver lasting expertise and durable student supports by focusing on preserving organisational memory.

Radical acceptance: teachers who support students with migrant, refugee, and asylum seeker backgrounds

ABSTRACT The importance of preparing teachers to support the cognitive, social, and emotional success of students with migrant, refugee and asylum seeker backgrounds cannot be overstated. It is a universal concern. The recommendation presented are based on evidence provided by teachers and executive staff of one school with a reputation for exemplary practices in supporting the students, parents and wider communities of migrants, refugees, and asylum seekers as part of a larger qualitative study. The information provided by the teacher participants illustrated the incorporation of a critical foundation of reflection and reflexivity. The specific content in professional learning includes knowledge of the neuroscience of trauma and its potential impact on learning, the importance of language for integration and criticality of retaining heritage culture and customs in identity formation, developing critical capacity and professional experiences are not discrete, but are interpolated into an overall perspective that reflects the deliberate, focused development of the capacity for radical empathy. Distinct from other types of empathy, radical empathy requires not only practice and purposefulness but a deep critical knowledge and acceptance of self. It demands judicious examination of the deeply held attitudes, values and beliefs that are held by individuals preparing to support these students.

Practitioner competencies for working with refugee children and young people: A scoping review.

Research indicates that refugee and asylum seeker children and young people often require specialised psychological support. Competencies have been established as helpful in guiding the training, education and ongoing professional development of practitioners working in specialised areas. To date there has been no comprehensive review of the literature concerning practitioner competencies for working with refugee or asylum seeker children and young people. This scoping review therefore aimed to synthesise all literature regarding practitioner competencies that are considered important for working in the area of mental health with refugee and asylum seeker children and young people. Literature was sourced from PsycINFO, Scopus, and PubMed. Studies were included if they: a) were published in peer-reviewed journals, b) were published in English, c) were published in the last 25 years, d) collected primary data, e) related to children and/or young people (defined as aged under 25) with refugee or asylum seeker backgrounds, and f) discussed practitioner competencies (in relation to refugee or asylum seeker children or young people). Nine articles met criteria and a deductive thematic analysis identified six key competencies: 1) knowledge of the complexity of needs of refugees; 2) use of holistic approaches; 3) ability to work in co-ordination with others in the child's network; 4) ability to build therapeutic relationships; 5) seeking feedback; and 6) cultural competency. Further empirical research that directly aims to identify practitioner competencies, from both the practitioner and client perspective, will support the challenging work done by practitioners working with refugee and asylum seeker children and young people.