Refugee Camps Research Articles

Prevalence and severity of periodontal disease in the host community and Rohingya refugees living in camps in Bangladesh.

To assess the prevalence and severity of periodontal disease of the Rohingya refugees and host community in Bangladesh. An unpublished pilot was conducted for the sample size calculation. Two-stage cluster sampling method was used to select 50 participants from refugee camps and 50 from the host community. Structured questionnaire and periodontal examination were completed. Composite measures of periodontal disease were based on the World Workshop (WW) and Centers for Disease Control and Prevention-American Academy of Periodontology. Linear regression models, for clinical attachment level and periodontal pocket depth (PPD) and ordered logistic regression models, for composite measures, were fitted to test the association of periodontal measures and refugee status. Compared to the host community, a smaller percentage of refugees reported good oral health-related behaviours. Refugees exhibited lower levels of bleeding on probing but higher PPD, hence a higher proportion had severe stages of periodontitis. As per the WW, prevalence of periodontal disease was 88% and 100% in the host and refugee groups, respectively. In the unadjusted models, refugees were three times more likely to have severe stages of periodontitis; this association was attenuated when adjusted for confounders (sociodemographic variables and oral health-related behaviours). Prevalence of periodontitis was high both in the host community and refugees. The refugees exhibited a more severe disease profile. The oral health of both groups is under-researched impacting the response of the health system. Large-scale research systematically exploring the oral health of both groups will inform the design and delivery of community-based interventions.

Interventions to promote mental health in the Occupied Palestinian Territories and Palestinian refugees: A scoping review.

The long history of the Palestinian-Israeli conflict has resulted in a public and mental health crisis. Despite the significant mental health burdens facing the Palestinian population in the Occupied Palestinian Territories (OPT) and refugee camps, this issue remains comprehensively unexplored. This scoping review identified mental health interventions and assessed their effectiveness among populations in the OPT and Palestinian refugee camps, while addressing delivery challenges. A scoping review was conducted using 14 databases to include relevant studies published through March 2024 using PRISMA guidelines for scoping reviews. Analyzing 31 intervention studies meeting the inclusion/exclusion criteria, revealed varied outcomes in interventions targeting post-traumatic stress disorder, depression, and overall mental well-being. While some interventions showed potential, others had limited effectiveness, underscoring the complexity of mental health needs in conflict zones. Gender- and risk-specific effectiveness was observed, emphasizing the need for tailored approaches. Challenges like low attendance rates and systemic barriers hindered intervention success. The profound impact of war on children stresses the urgency for targeted interventions. Empowerment and community connectedness are vital for resilience, along with the importance of family and community involvement and research that balances the need for strong evaluation designs with the need for ongoing mental health services. Advocacy for systemic changes is crucial to implement the complex sustainable interventions necessary to assure mental health in any population. This review highlights the importance of holistic, contextually relevant approaches for mental health intervention in OPT and refugee camps, emphasizing rigorous evaluations and community-driven approaches.

The economic lives of refugees

The economic lives of refugees are often viewed as relatively homogeneous, and sources of within-group variation remain largely unexplored. We describe the socio-economic diversity of refugees in one particular region: East Africa. Drawing upon first-hand quantitative and qualitative data collected in Kenya, Uganda, and Ethiopia (n = 8,996), the article systematically compares 12 refugee subpopulations living in seven refugee camps and the three capital cities. In order to identify sources of variation, we examine three main questions: (1) What variation is there in socio-economic outcomes? (2) What strategies and resources do refugees rely upon, and how do these vary? (3) How are opportunities and constraints shaped by differences in institutions and identity? Overall, we show that, although the economic lives of refugees have some distinguishing and common features, they are also heterogeneous by host country, urban/camp context, nationality, and household. We explain why describing and understanding sources of within-group variation matters for research and policy.

Impacts of anemia and its determinants among 6–59 months age children residing in Dayniile internally displaced person’s camps, Banadir region, Somalia

Abstract: BACKGROUND: The prevalence of anemia in children under 5 years of age is a multifaceted issue influenced by various factors, leading to diverse findings across studies. This study aimed to assess the prevalence of anemia and its associated factors among children under 5 years of age living in internally displaced persons camps in the Dayniile district of Somalia. MATERIALS AND METHODS: This cross-sectional study was conducted between December 2022 and July 2023 in Mogadishu, Somalia. Blood samples from children under 5 years of age were checked for malaria and parasites, as well as for hemoglobin, erythrocytes, hematocrit, mean cell volume, and hematocrit. SPSS version 27.0.1 was used for data analysis, involving descriptive and inferential statistics. Fisher’s exact test examined anemia associations due to low expected counts. RESULTS: The prevalence of anemia among children under 5 years old was 17.6%. Anemia severity varied from mild (8.4%) to moderate (8.7%) to severe (0.5%). No significant correlation was found between a child’s primary caregiver and anemia status nor between anemia and sex, age, maternal factors, or family income sources. However, the presence of income from other relatives was statistically significant (P = 0.046*), indicating that financial support from extended family members may reduce the incidence of severe anemia in young adults. Children with a history of malaria had notably higher rates of mild and moderate anemia (25.0% and 75.0%, respectively) than those without. CONCLUSION: Our study, along with previous research, underscores the complexity of the prevalence of childhood anemia and its contributing factors. Addressing anemia in children from lower-income families and urban areas requires tailored intervention. In addition, controlling malaria and promoting breastfeeding are essential strategies for reducing the prevalence of anemia in young children. Overall, a multifaceted approach considering socioeconomic, health, and dietary factors is crucial for the well-being of children under 5 years old.

Power in coordinating supply chain projects in humanitarian settings: A case study of Rohingya refugee camps

AbstractHow and why is power used in humanitarian projects? Coordinating organizations, such as UN agencies, carry power and influence over NGOs to advance the interests of beneficiaries. However, coordination can be managed by a single authority or by multiple authorities that share or delegate responsibilities. Furthermore, coordinators may leverage different types of power, including non‐mediated forms like referent and expert power, or mediated forms such as reward, legitimate, or coercive power. This research draws upon 57 interviews regarding organizational behavior with members of international and local non‐governmental organizations (NGOs), UN agencies, and government officials involved in managing Rohingya refugee camps in Southern Bangladesh. The observations suggest that in single‐authority layered projects, referent and expert powers are commonly employed, leading to improvements in quality and delivery performance. Reward power is typically wielded informally and is linked to cost performance. In dual‐layered projects, legitimate power is used to enhance quality and delivery performance. This article's originality lies in its extension of the use of power to multi‐tiered supply chain settings; its contribution is to organizational theory regarding the resolution of principal‐agent issues; and its insights are into the nuanced effects of different types of power based on project types. It offers valuable guidance to policymakers and practitioners, highlighting effective approaches for coordinating inter‐organizational efforts in challenging and unconventional supply chain settings.

A scoping review on occupational therapy services with forcibly displaced individuals in low to middle income countries

This study underscores the distinctive role of occupational therapy in advancing the health and wellbeing of forcibly displaced individuals (FDIs), who often encounter contextual and systemic barriers and medical complications that prevent them from engaging in daily tasks. These injustices can be mitigated through health promotion and prevention strategies that aim to enhance participation in daily life activities. There has been limited research in low- to middle-income countries (LMICs) in relation to occupational therapy services for FDIs despite most FDIs originating from LMICs. To address this gap, this study adopted Arksey and O’Malley’s framework for a scoping review to consolidate existing knowledge on the occupational therapy health promotion and prevention of disease and disability services for FDIs in LMICs. Searches were conducted on six online databases. Six studies aligned with the inclusion criteria. Findings revealed that most occupational therapy services are directed towards refugees in Jordan, which contains one of the largest refugee camps. FDIs from Africa and internally displaced people receive the least number of interventions. The occupational therapy services outlined in the six sources primarily consist of health education talks, early childhood interventions, and health promotion activities centred around various occupations such as work and sports groups. Recommendations for policy guidelines include incorporating occupational therapy services within the stipulated FDI services. Our approach aims to situate the contribution of occupational therapy health promotion and prevention of disease and disability services within the broader context of FDIs’ overall health and wellbeing.

Validity Evidence of the HOPE Teacher Rating Scale-Arabic Version for Identifying Gifted Refugee Students

Exceptionally talented refugee students are often underrepresented in allocating to gifted programs because of inadequate identification methods in Arab countries. This study investigates the Arabic version of the Having Opportunities Promotes Excellence (HOPE) Scale for identifying gifted refugee students. Students ( n = 13,598) from refugee camp schools in Jordan were surveyed in the 2020/2021 academic year. Elementary, middle, and high school teachers ( n = 423) completed the translated Arabic version of the HOPE Scale, measuring 11 items on the academic and social construct of giftedness. Confirmatory factor analysis indicated an excellent fit; however, multigroup confirmatory factor analysis results revealed that the scale needed more invariance across groups. The results suggest that although the HOPE Scale-Arabic version has sufficient validation evidence, careful consideration is required when applying it to different subgroups of refugee students. Constructs of cultural relevance may need to be added to better assess the item’s validity.

Left alone and behind: Experiences of living with incontinence in a Sudanese refugee camp and how WASH practitioners can support

ABSTRACT Being able to manage incontinence with dignity is intrinsically linked to access to appropriate water, sanitation, and hygiene (WASH) services; yet it is overwhelmingly overlooked in humanitarian contexts and not consistently included in WASH interventions. A mixed-methods study (including market assessment) was conducted in two refugee camps in eastern Sudan in late 2022. Tigrayan refugees with incontinence faced extreme challenges to managing it, including no or limited access to necessary hygiene products (such as mattress protectors, toilet chairs, and soap), a lack of water for personal hygiene and washing, and long distances to communal sanitation facilities and distribution sites (or markets) where they often needed to queue or lacked privacy. Refugees with incontinence faced high levels of stigma, shame, and isolation. WASH practitioners need increased awareness of incontinence to carry out quality WASH assessments, to better understand and support people with incontinence. WASH interventions must include appropriate hygiene and non-food items (NFIs) to enable people to manage incontinence at home, and accessible toilets, water points and hygiene and washing facilities. A mixed modality of both in-kind and cash or voucher support can help to ensure hygiene and NFI items are accessible and meet the needs of people living with incontinence.

COVID-19 vaccine acceptance and associated factors among pregnant and lactating women attending maternity care clinics in refugee camps in Jordan.

Despite the advantages of vaccination in preventing maternal and fetal problems, there were many concerns in the medical community regarding vaccine safety for pregnant women, and this has put obstetricians in a challenging situation when it comes to advising their pregnant patients on whether to obtain the vaccine. This study was performed to define the level of acceptance of COVID-19 vaccination and assess the impact of COVID-19 attitudes and knowledge on vaccine acceptance between pregnant and lactating Syrian women who are seeking prenatal care services at the clinics in Azraq refugee camp in Jordan. A quantitative, cross-sectional study utilizing a non-probability convenience sample. A validated and reliable self-administered questionnaire consisting of four sections was used. A total of 412 pregnant/lactating women was recruited The acceptance rate of the COVID-19 vaccine among participants was 86.5%. There was a significant positive moderate association between respondents' attitudes and knowledge around the COVID-19 vaccine and their acceptance of the vaccine (r = .468, p < .001, r = .357, p < .001), respectively. To effectively mitigate the COVID-19 pandemic and achieve collective protection, decision-makers must intensify the efforts in promoting the importance of maternal vaccination, especially in vulnerable communities that suffer the most from pandemic outcomes.

Children and Youths’ Belonging in Protracted Displacement: A Mixed-Methods Study from Kakuma Refugee Camp

Millions of children and youth live in forced displacement. We conducted a mixed-methods study among 729 primary students in Kakuma Refugee Camp to examine the roles of knowledge, experience (direct or indirect), language, and schooling in students’ sense of belonging to their home country and intention to return. We found sense of belonging is associated with knowledge of one’s country and its traditions, fluency in one’s home language, and schooling opportunities. However, these same factors are negatively associated with their intent to repatriate in the near future. The relationship between formal and informal learning appears to encourage a pragmatic sense of belonging to Kenya for the immediate future while any sense of belonging and hope for return to their home countries are projected onto an imagined future.

Continuous chains: childhood maltreatment and intimate partner violence victimization among displaced women in a war context

BackgroundChildhood victimization has been associated with long-term psychological effects and an increased risk of being victimized in later life. Previous research has primarily focused on sexual abuse during childhood, and a wide range of consequences have been identified. However, a significant gap remains in our understanding of the complex interaction between different forms of childhood abuse and violence in later life, particularly in the context of broader social stressors such as armed conflict and displacement.MethodsThis study examines the association between exposure to different types of childhood maltreatment in the context of family and intimate partner violence (IPV) among displaced women living in refugee camps in northern Iraq. Structured interviews were conducted by trained female psychologists with 332 women aged between 20 and 62 years.ResultsResults indicated that over one-third of the participating women reported experiencing at least one occurrence of IPV by their husbands within the past year. In addition, participants reported experiences of different types of maltreatment (physical, emotional, and sexual violence and physical and emotional neglect) perpetrated by family members in their childhood. While all forms of childhood maltreatment showed an association with IPV within the past year, only emotional childhood maltreatment was found to be a significant predictor of IPV in a multivariate analysis.ConclusionThe study highlights the ongoing impact of child maltreatment and its contribution to increased vulnerability to IPV victimization in later life. In addition, this study describes the specific cultural and contextual elements that contribute to IPV in refugee camps.

Overuse of antibiotics for urinary tract infections in pregnant refugees, Lebanon.

To determine whether adding urine culture to urinary tract infection diagnosis in pregnant women from refugee camps in Lebanon reduced unnecessary antibiotic use. We conducted a prospective, cross-sectional study between April and June 2022 involving pregnant women attending a Médecins Sans Frontières sexual reproductive health clinic in south Beirut. Women with two positive urine dipstick tests (i.e. a suspected urinary tract infection) provided urine samples for culture. Bacterial identification and antimicrobial sensitivity testing were conducted following European Committee on Antimicrobial Susceptibility Testing guidelines. We compared the characteristics of women with positive and negative urine culture findings and we calculated the proportion of antibiotics overprescribed or inappropriately used. We also estimated the cost of adding urine culture to the diagnostic algorithm. The study included 449 pregnant women with suspected urinary tract infections: 18.0% (81/449) had positive urine culture findings. If antibiotics were administered following urine dipstick results alone, 368 women would have received antibiotics unnecessarily: an overprescription rate of 82% (368/449). If administration was based on urine culture findings plus urinary tract infection symptoms, 144 of 368 women with negative urine culture findings would have received antibiotics unnecessarily: an overprescription rate of 39.1% (144/368). The additional cost of urine culture was 0.48euros per woman. A high proportion of pregnant women with suspected urinary tract infections from refugee camps unnecessarily received antibiotics. Including urine culture in diagnosis, which is affordable in Lebanon, would greatly reduce antibiotic overprescription. Similar approaches could be adopted in other regions where microbiology laboratories are accessible.

PREVALENCE AND ATTITUDE OF WOMEN REGARDING CESAREAN SECTION IN DUHOK CITY-KURDISTAN REGION

Background: The decision of pregnancy delivery mode is important for both mother and fetus health. Although the advancement in surgical approach of cesarean section, the cesarean section has a negative impact on mothers and fetuses health. Objective: To assess the rate of cesarean section in a sample of women in Duhok city and their attitudes toward cesarean section. Methodology: Present study was a descriptive cross sectional that carried out in Obstetrical &amp; Gynecological Clinics of Maternity Hospital, Primary Health Care Centers, Internally Displaced and Refugee Camps and Private Obstetrics Clinics at Duhok city-Kurdistan region/Iraq through duration period of one year from first of November, 2021, to 31st of October, 2022 on sample of four hundred pregnant women. The decision of previous cesarean section for studied women was done by Senior Obstetrician &amp; Gynecologist according to different reasons (clinical or non-clinical). Results: The history of previous cesarean section was positive in 39.8% of pregnant women, with a common frequency of one cesarean section (58.5%). Most pregnant women perceived that normal delivery is better, while 9% perceived that cesarean section is better. In the same way, 87% of pregnant women preferred normal delivery, while 13% preferred cesarean section. Only 20% of pregnant women believed that cesarean section is the normal way of delivery, while 68% of them thought that mother with a history of cesarean section has a normal delivery in the future. However, 79% of pregnant women believed that mother had a risk of death during cesarean section. Conclusions: The cesarean section rate in Duhok city is higher than acceptable recommended rate, although the positive attitude of pregnant women toward normal vaginal delivery.

Redefinition of Gender Roles in Times of Crisis: A study of Displaced Person Camps in the Central-North Region of Burkina Faso

Redefinition of Gender Roles in Times of Crisis: A study of Displaced Person Camps in the Central-North Region of Burkina Faso

Maternal Depression and Associated Factors Among South Sudanese Refugee Mothers in Gambella&amp;apos;s Tierkidi Refugee Camp: &amp;lt;i&amp;gt;A Cross-Sectional Study&amp;lt;/i&amp;gt;

Background: Maternal depression stands out as the prevailing psychiatric condition during pregnancy, with its detrimental impacts posing significant consequences for both the mother and the fetus. Nearly a quarter of women will encounter depression at some stage in their lives, with the majority experiencing it during their childbearing years. Refugee women face elevated susceptibility to mental health disorders, with rates surpassing those of host populations. Objective: The objective of this study is to determine the prevalence of maternal depression and the associated factors with it among South Sudanese refugee women living in the Gambella region, in the Tierkidi refugee camp in 2023. Method: A community-based cross-sectional study conducted within the Gambella region&amp;apos;s Tierkidi refugee camp in Ethiopia involved 452 randomly selected participants who were pregnant and had given birth within the past 12 months. Data collection utilized a pretested structured questionnaire administered through interviews. Data coding and entry were performed using Epi-Info version 7.2, with subsequent analysis conducted in SPSS version 23. Descriptive statistics and logistic regression were employed to identify associations between the outcome variable and explanatory variables. The strength of association was assessed using odds ratios at a 95% confidence interval, and associations were deemed significant at a p-value of less than 0.05. Results: In this study, the prevalence of maternal depression was found to be 31.5% (95% CI: 27.4-37.8). Significant associations were observed between maternal depression and unmarried marital status (AOR = 13.39, 95% CI: 3.11-57.7), unplanned pregnancy (AOR = 6.76, 95% CI: 2.13-21.4), intimate partner violence (AOR = 5.4, 95% CI: 2.32-12.4), number of pregnancies (AOR = 4.85, 95% CI: 2.56-9.17), and history of abortion (AOR = 3.97, 95% CI: 1.07-14.7). Conclusion: The study revealed a high prevalence of maternal depression among pregnant mothers with infants less than 12 months old. Factors such as being unmarried, experiencing unplanned pregnancy, having a history of abortion, a higher number of pregnancies, lack of social support, and a history of intimate partner violence were found to be significantly associated with maternal depression.

Risk factors associated with Rohingya refugee girls' education in Bangladesh: A multilevel analysis of survey data.

In Bangladesh, the world's largest refugee settlement currently shelters approximately onemillion Rohingya refugees who fled Myanmar to escape military persecution. Educating a significant number of young Rohingya, roughly half of whom are female, presents a significantchallenge. Despite the presence of learning centres (LCs) across refugee camps, Rohingya girls may encounter specific barriers to accessing education due to exposure to various risks, such as violence, child marriage, and trauma stemming from past military oppression. This paper investigates the association between these risk factors and Rohingya girls' likelihood of attending LCs, and how this association may vary across refugee camps. Using survey data and employing three-level multilevel logistic regression models, I find that girls are less likely to attend LCs if they are at risk of encountering sexual abuse, child marriage, and psychological distress or trauma. These factors explain considerable variation in girls' LC attendance between camps and between households. In addition to providing more schooling opportunities to Rohingya children, prioritising girls' safety, protecting them from forced and child marriage, and supporting their psychological well-being require increased policy attention.

RSV Infection in Refugees and Asylum Seekers: A Systematic Review and Meta-Analysis.

Respiratory diseases, including respiratory syncytial virus (RSV) infections, are common reasons for seeking healthcare among refugees and asylum seekers. A systematic review with meta-analysis was designed to appraise all the available evidence on RSV infections among individuals in refugee camps. Three medical databases (PubMed, Embase, and Scopus) as well as the preprint repository medRxiv.org were searched for eligible observational studies, and the collected cases were pooled in a random-effects meta-analysis model. Heterogeneity was assessed using the I2 statistics. Funnel plots and a regression analysis were calculated for analyzing reporting bias. Eventually, six studies were retrieved from three areas (Bangladesh, Thailand, and Kenya), with pooled estimates of 129.704 cases per 1000 samples (95% CI 66.393 to 237.986) for RSV compared to 110.287 per 1000 people for influenza A (95% CI 73.186 to 162.889), 136.398 cases per 1000 people (95% CI 84.510 to 212.741) for human adenovirus (HAdV), 69.553 per 1000 people (95% CI 49.802 to 96.343) for parainfluenzavirus (PIFV), and 60.338 per 1000 people (95% CI 31.933 to 111.109) for human metapneumovirus (hMPV). Using influenza A as a reference group, the risk for a positive specimen was greater for RSV (relative risk [RR] 1.514, 95% CI 1.396 to 1.641) and HAdV (RR 1.984, 95% CI 1.834 to 2.146) and lower for influenza B (RR 0.276, 95% CI: 0.239 to 0.319), PIFV (RR: 0.889, 95% CI 0.806 to 0.981), and hMPV (RR 0.594, 95% CI 0.534 to 0.662). In summary, high rates of RSV infections were documented among individuals sheltered in refugee camps, stressing the importance of specifically designed preventive strategies.

Child feces disposal practices in humanitarian and non-humanitarian settings across 34 low- and middle-income countries

Globally, safe sanitation has improved significantly in the last two decades, but unsafe child feces disposal remains a growing challenge in many regions, exposing household members and communities to infectious pathogens. The drivers associated with child feces disposal in several contexts including humanitarian settings are not well understood. This study investigated child feces disposal (CFD) practices and associated factors in low- and middle-income countries, including in humanitarian settings. Data from 352,173 women in 34 countries, collected between 2012 and 2021 through Demographic and Health Surveys (DHS), were used. We utilized multivariate logistic regression to assess CFD practices among children under two years old and the factors linked to these practices. We incorporated data from the United Nations High Commissioner for Refugees (UNHCR) regarding refugee camps' locations in the analysis. Time series and local spatial autocorrelation analyses were run to examine changes in safe CFD practices over time and space, respectively. Results showed minimal improvement in safe child feces disposal over the past decade, with 55.6 % of respondents in non-humanitarian settings and 38.1 % in humanitarian settings improperly disposing of feces. Improper CFD significantly correlated with increased odds of diarrhea in non-humanitarian settings (OR 1.09 95 % CI: 1.05–1.13) but not in humanitarian settings (OR 1.14 95 % CI: 0.53–2.49). The most significant factors (p < 0.05) associated with safe CFD included being in the richest wealth quintile (OR 3.27 95 % CI: 3.06–3.49), having basic education (OR 1.28 95 % CI: 1.22–1.33), children eating solid food (OR 1.53 95 % CI: 1.48–1.57), improved sanitation access (OR 1.88 95 % CI: 1.81–1.96), and listening to radio at least weekly (OR 1.40 95 % CI: 135–1.46). Policymakers and development partners must include safe CFD guidelines in national policies and programs, as well as prioritize investments in household-level sanitation and educate caregivers about safe CFD practices.

Social work with encamped refugees: reflections from Tongogara refugee camp in Zimbabwe

ABSTRACT In this article, we draw on our joint experiences as social work practitioners and researchers in a rights-restricting practice context, a refugee camp. We reflect on social workers’ roles in navigating the conundrum, that is, advocating against and in some unfortunate instances, perpetuating exclusionary systems. Refugee camps are physical zones designed to disentitle refugees of rights reserved for citizens. Faced with structural restrictions, social workers working with refugees have negotiated for rights with and on behalf of their clients at the center of their practice. We offer accounts of contextual application of anti-oppressive social work approaches for refugee wellbeing and access to rights like shelter, water, food, health, education, livelihoods, nutrition, sanitation, and protection. In the second half of our analysis, we offer a critical analysis of human rights education in Zimbabwean schools of social work given the manifest rights violations in the country’s refugee welfare practice context. We examine the extent to which the pedagogy of human rights and notions of indiscriminate human development, democracy, and justice are infused in curricula to equip aspirant social workers with the requisite skills to transform their practice orientation from social control to the social change function which the practice context demands.

Time and Power in Azraq Refugee Camp: A Nine-to-Five Emergency. By Melissa Gatter

Time and Power in Azraq Refugee Camp: A Nine-to-Five Emergency. By Melissa Gatter