Migrant Health Research Articles

Primary health care models for refugees and the involvement of nurses: A systematic review

Abstract Background Primary health care is key to address the health and social needs of refugees. Nurses are often part of multidisciplinary teams in primary health care, but little is known about their roles and responsibilities in refugee health. Our systematic review aimed to synthesise the existing knowledge about models of care (MoC) for refugees in primary care settings and the involvement of nurses in these models. Methods We searched PubMed, CINAHL and Web of Science for literature published in English, Spanish, French and German. For grey literature, we additionally searched Google Search and Scholar, Microsoft Bing and DuckDuckGo. Eligible publications reported on MoC for refugees in a primary care setting and the involvement of nurses. We extracted and synthesised information about the structure of these models as well as the roles and responsibilities of nurses within these. Results 112 publications met our inclusion criteria. Our narrative synthesis focuses on 61 publications with in-depth insights into existing MoC and nurse involvement. We identified 45 MoC, mainly originating from high-income-countries and with almost a third from Australia. The majority of MoC set up a parallel health care structure that refugees could access for a limited period of time. In most MoC, the role of the nurse is described with a relatively high degree of autonomy and with clear areas of responsibility. Clinical and administrative tasks are only part of the nurse’s role, while educational and coordinating activities are often equally important. Conclusions Despite the significant number of refugees in European countries we identified only few reports on MoC specifically addressing their needs. While parallel care structures may be an appropriate approach for a short period of time, integration of refugees into the regular health system is key. Specially trained nurses are well placed to support refugees through a range of measures, including health education and case management. Key messages • Models of Care for refugees could help to navigate within a new healthcare system and ensure that no one is left behind. However, development of and research on such structures are still scarce. • Specially trained nurses are well placed to care for refugees and to support their integration into regular health systems through a range of measures, including health education and case management.

Scoping Review of Health Literacy Interventions among Migrant Communities in Europe

Abstract Background The increase in migration trends in Europe has brought attention to the significant health disparities between migrant and native populations, which are largely rooted in social determinants of health such as economic difficulties, language barriers, and limited access to services. Tailored health literacy (HL) interventions can serve as an intermediate factor between social determinants of health and health outcome, thereby holding great potential for addressing these disparities. Despite a growing body of research on migrant health, there remains a gap in our understanding of effective HL interventions for this population. Methods A scoping review was conducted following the Joanna Briggs Institute (JBI) updated guidelines and the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. Electronic searches were carried out across five databases (PubMed, SCOPUS, Web of Science, PsychINFO, and CINHAL) and supplemented by a manual search. We included European studies on migrant HL interventions, conducted between 2011 and 2023, and published in English or Portuguese language. Results Out of 1018 records, 7 studies met eligibility criteria. Predominantly situated in Northern and Western Europe (85.5%), interventions primarily targeted female migrants (71.4%) through in-person courses (42.9%). Identified intervention strengths included culturally adapted content, migrant engagement, and access to written materials. Gaps included mental health interventions and community outreach. Conclusions This scoping review provides a comprehensive overview of HL interventions targeting migrant populations, highlighting their characteristics, strengths, and gaps. These findings serve as a foundational step towards developing guidelines for effective HL interventions within migrant communities. Key messages • Most European health literacy interventions for migrants target women and are conducted in North or West Europe. • Cultural adaptation and community engagement are key strengths of migrant health literacy interventions, yet gaps remain in mental health support and community outreach efforts.

Screening for congenital Chagas disease in a non-endemic area: a cost-effectiveness analysis

Abstract Background Due to climate changes, immigration, and globalization, Chagas Disease (CD) also afflicts nations without vector transmission. In Europe, congenital CD (cCD) is a significant public health issue, perpetuating the disease: it is crucial to perform CD screening in pregnant women at risk, as the treatment of infants is effective in eradicating the infection. Only a few European regions have a definite algorithm for diagnosing cCD, but no official guidance has been published at the national or European level. To support policymakers, this study aims to outline a cost-effectiveness analysis of CD screening in non-endemic areas, such as Italy, in pregnant women born or arriving from endemic countries and in their newborns. Methods To measure the economic impact of cCD screening, a decision tree model will be used to compare the test option (screening, diagnosis, treatment, follow-up) with no test option (no screening, progression of disease). Model parameters will be taken from relevant scientific literature. The primary outcome will be the Incremental Cost-Effectiveness Ratio (ICER) between the two options. Sensitivity analyses will be conducted to determine how changes in prevalence, transmission rate, screening adherence, and treatment adherence may affect the ICER. Results We expect the ‘test’ option to be cost-effective even with significant reductions in prevalence, transmission rate, adherence to screening or treatment. Threshold levels of these variables will allow to critically extend the results to areas with reduced immigration, patchy distribution of migrants at risk, health logistical limitations, and limited access to care for immigrants. Conclusions Our findings can help policymakers implement official screening programs and diagnostic algorithms for cCD in Italy and other non-endemic countries. This contributes to SDG 3 by combating the spread and burden of neglected tropical diseases and contributing to maternal, child, and migrant health. Key messages • Screening for congenital Chagas Disease in a non-endemic area may be cost-effective and cost-saving. • Study findings could provide useful information for health policymakers to combat Chagas Disease in Europe.

Key requirements for achieving EU-wide programme change

Abstract Issue Across the world, thousands of projects aim for equitable improvement in health for people who are experiencing ongoing avoidable stigma, discrimination and disadvantage however very little change is often achieved. Description of the problem In this presentation we explore key requirements for project-level change to ensure EU-wide programme change is achieved. Results The two most common causes of project failure are a) the innovation is not suitable, needed or wanted (also called theory failure) or b) implementation failure. This presentation shares strategies to mitigate risks of project failure through co-design processes and communication, drawing from 30 years of experience from the entire implementation process from ideation to scale up. These experiences include projects from over 30 countries, including partnerships with the World Health Organization, governments and industry focused on health literacy, self-management, care pathways, workplace health, hospital services redesign, First Nations health and migrant health. Common success factors include balancing top-down needs with co-designed inputs and with previous preferred or good practice (which may have come from controlled trial evidence generated in different contexts). The intervention must co-implemented to serve stakeholder’s needs at all levels, from citizens to decision makers. Lessons The United Nations (UN) and private sector apply system-wide approaches to affect large scale change. This knowledge is valuable for large public health programmes aiming to integrate equity and diversity in project processes to minimize implementation failure.

2.Y.1. Communication in participatory health research with refugees and migrants

Abstract Innovative approaches are needed to transform public health research and address health inequities. Participatory Health Research (PHR) is one such approach, which aims to maximize the participation of those whose life or work is the subject of the research in all stages of the research process. PHR has advantages for both research outcomes, including increased relevance, meaningfulness and impact of research, as well as for those involved, in terms of ownership and empowerment to address their health priorities. PHR with migrants has potential to reduce health inequities through the active involvement of migrants in research about their health. In a framework for refugee and migrant health in the WHO European Region, MacFarlane et al. (2022) recommend the research field of migration and health to adopt PHR as the norm, for ethical reasons and to support effective research-policy-practice translation. PHR with migrants is increasingly used but is still rare and adhoc in the field of migration health research. There are also potential practical and ethical challenges that warrant critical reflection. One persistent challenge is communication, where differences in culture, language and knowledge areas need to be considered in multiple ways, for example, in the development of participatory partnerships, in the conduct of data collection that takes place as a result of such participatory partnerships and in dissemination processes. The aim of the workshop is to share different approaches on PHR with migrants and propose solutions to common challenges in communication. The workshop will be structured in a first part where presenters will draw upon their experience in PHR with refugees and migrants covering a broad range of topics relating to communication, and a second part of open discussion with presenters and the audience. The workshop will address two key questions: what challenges have we experienced, and lessons learnt. Anne MacFarlane presents emerging evidence about music and singing as culturally attuned arts based methods that can create innovative opportunities for communication for partnership building, fieldwork and dissemination. Ana Gama presents on using idea-generation workshops with vignettes representing migrants with diverse health-literacy profiles and its potential to address communication challenges. Key messages • Participatory health research with migrants warrants critical reflection around communication, ethics and partnership-building. • In participatory health research, using innovative and creative methods can create opportunities to overcome communication barriers and build meaningful collaborations. Speakers/Panelists Anne MacFarlane University of Limerick, Limerick, Ireland Ana Gama IHMT, Universidade Nova de Lisboa, Lisbon, Portugal

Discrimination against migrants: does social capital moderate harmful effects on mental health?

Abstract The harmful mental health effects of perceived discrimination are well established. Yet, the role of regional-level social capital in mitigating these effects remains underexplored. Using data from the German Socioeconomic Panel (SOEP; 2010-2021) we apply random effects models to assess the effect of perceived discrimination on mental health (mcs subscale of the SF-12) adjusting for individual socio-demographic factors and regional-level socioeconomic deprivation. We assess interaction with general social capital (civic organisations, electoral turnout, generalised trust) and migrant-specific resources (proportion of non-nationals and share of far-right votes). We juxtapose non-refugee migrants (n = 13478) with refugees subject to mobility restrictions (n = 5558) to assess for bias introduced by selective mobility into regions. In the non-refugee sample, we confirm negative effects of frequent discrimination experiences on mcs (ß: -3.74; 95%CI: -4.39, -3.08). Moderation analyses show insignificant results for general social capital, but a negative interaction effect of proportion of non-nationals (ß: -0.71; 95%CI: -1.34, -0.08). Analyses among refugees confirm the negative effect of discrimination on mcs (ß: -6.29; 95%CI: -7.49, -5.08) and the moderating effect of the proportion of non-nationals (ß: -1.63; 95%CI: -2.78, -0.48), as well as showing a positive moderation effect for generalised trust (ß: 0.84; 95%CI: 0.11-1.57). Results demonstrate the negative implications of living in areas with a high proportion of non-nationals for migrants experiencing discrimination, which may be explained by the higher marginalisation of migrants in these areas and increased service access barriers. The absence of a moderation effect of general social capital appears to be the result of selection bias, with positive effects of generalised trust seen for refugee migrants. Key messages • Ethnic discrimination affects mental health of refugee and non-refugee migrants. • The effect of discrimination on mental health are stronger in areas with higher proportion of non-nationals.

Health disparities among in multicultural and non-multicultural families in South Korea

Abstract South Korea has experienced significant immigrant growth, with international marriages playing a key role in this demographic change. In 2019, international marriages accounted for 10.3% of all marriages, increasing the number of multicultural households. Multicultural families in Korea faced controversies over accepting new members in a society traditionally considered racially and ethnically homogenous. In rural areas, where patriarchal and conservative values prevail, there is greater discrimination and negative perception towards foreigners compared to urban areas, impacting access to healthcare. This potentially adversely affects the health of married immigrants. However, research on this issue is limited. This study aims to examine the differences in health behaviors, access to care, and health status between multicultural and non-multicultural families in rural and urban areas. Using a cross-sectional study design based on the 2023 Community Health Survey, the sample included 228,216 adults from non-multicultural families and 3,373 adults from multicultural families. Adjusted differences in outcome were estimated using regression models, including linear probability and logistic models. Overall, there were minimal or no differences in health behaviors and health status between adults from multicultural and non-multicultural families. However, significant differences were observed in access to care, such as annual health check-ups (0.72 [0.64, 0.81]) and vaccinations (0.84 [0.76, 0.94]). Non-multicultural families showed regional differences in all outcomes, whereas multicultural families exhibited minimal or no regional differences. These findings suggest that multicultural families may face barriers beyond regional environments, limiting their access to care and potentially leading to long-term negative health outcomes. Targeted policy development for multicultural families in Korea is necessary to address this issue. Key messages • Access to health care may vary for individual and local factors, especially for people with different ethnicities or cultures. • Multicultural families may encounter greater barriers than individual and regional characteristics, requiring the development of tailored policies for immigrants and multicultural families.

Are migrant workers at greater risk of workplace deaths? A systematic review and meta-analysis

Abstract Background Globally, 170 million individuals migrate for work. Yet, evidence on their mortality risk remains unclear. Our aim was to synthesize global evidence on migrant worker mortality risk compared to local workers and to identify the multiple intersecting social determinants of mortality. Methods We conducted a systematic review of peer-reviewed literature which reported on mortality outcome of migrant workers. Studies published between 1 Jan 2000 to 17 Jan 2023 in English were searched in MEDLINE, Embase, PsycINFO, and Ovid Global Health. Meta-analysis using random effects model was used to calculate pooled estimates and narrative synthesis was used to develop a data-driven framework on intersectional social determinants. Results Out of 11,495 identified records, 44 were included, of which 11 were pooled in meta-analyses. The combined migrant worker death count was 44,338, with data from 16 countries, including migrants from agriculture, construction, and service industries. Compared to local workers, migrant workers had a higher risk of fatal occupational injury (pooled RR = 1.71, 95%CI: 1.22-2.38, I² = 99.4%), and a lower risk of all-cause mortality (pooled RR = 0.94, 95%CI: 0.88-0.99, I² = 90.7%). Key social determinants associated with increased mortality risk were either migration-related (e.g. lower language proficiency, undocumented status) or labour-related (e.g. precarious employment, labour migration policies) interacting over migrant workers’ life course. Conclusions As the largest evidence synthesis to date, these findings indicate that migrant workers have higher fatal occupational injury rates than local workers, indicating the need for tailored protections for migrant workers. These data confirm that the all-cause mortality advantage observed in migrant populations applies to the working population. Future interventions should be designed to address both migration- and labour-related determinants of migrant worker health. Key messages • Migrant workers have a higher risk of workplace fatality despite being generally healthier than local workers, explained by structural determinants such as precarious employment. • Future interventions must address migration- and labour-related social determinants of health at structural levels, such as extending labour protection laws to migrant workers.

3.O. Scientific session: Migrant labour exploitation and health: How can research foster protection of migrant workers?

Abstract Migrant workers sustain essential industries such as the food supply chain, construction, and domestic and care work. They tend to perform onerous and risk-laden tasks at low pay without employment or health protections, and often under exploitative terms (e.g., debt bonding, piecework). Current evidence on associations between migration, employment terms and conditions, and health indicates profound inequities in work-related health outcomes for migrant workers. Although the COVID-19 pandemic highlighted these disparities and their potential social and public health implications, migrant workers continue to be overlooked by public health scholars and policymakers. Supranational regulations (such as EU directives) and national policies rarely consider migrants in their role as workers, and little research is dedicated to questions at the intersection of migration, employment, and health. The invisibility of migrant workers is also a matter of disciplinary and sectoral silos, with different aspects of migrant labour regulated separately by Ministries of Immigration, Labour, Agriculture, Health, and others. These silos create incompatible, context-contingent definitions, terminologies, and administrative categorizations, leading to inconsistent data collection and data gaps which, in turn, translate into policy blind spots. Data that are comparable across contexts and that refer to migration, employment/work and health are generally scarce. For some sectors and contexts, virtually no data exist; e.g., for migrant workers in agriculture, construction, and domestic work, and for migrant workers in low- and middle-income countries. There is barely any evidence about interventions to improve the structures that dictate migrant workers’ employment conditions or obligations of employers. Given the limited participatory research with migrant workers, we have a very poor understanding of their views and viable intervention options, and migrant workers’ voices thus also remain absent from policymaking. This workshop aims to contribute to greater visibility of - and ultimately action on - migrant labour exploitation in research and policy. To this end, it will map current challenges and shortcomings in generating evidence on the links between migration, work/employment, and health; and it will suggest ways to improve research and interventions to address migrant workers’ health, based on the speakers’ experience in developing intervention-focused evidence in different contexts. The workshop will conclude with an open discussion to identify further relevant questions and elaborate steps towards better research and greater protections for mobile worker populations. Key messages • Harm from exploitative working conditions among migrant workers is substantial, yet data collection methods and intervention designs are limited. • For public health research to effectively help protect the health and rights of migrant workers, it is essential to share methods and insights across disciplines to drive research for action.

Social participation and depression among resettled Syrian refugees: examining a moderated mediation of social support and bonding or bridging social capital.

Aspects of social capital, including social participation and social support, are among the factors influencing refugee mental health after resettlement. However, the mechanisms by which these aspects interact with one another and affect mental health remain unclear. This study investigates whether social participation influences depressive symptoms via social support and whether this influence is more prominent for Syrian refugees participating primarily in coethnic (bonding) networks compared to cross-ethnic (bridging) networks during the early stages of resettlement. Using data from a cohort of 464 Syrian refugees recently resettled in Sweden, a moderated mediation analysis was conducted with multigroup structural equation modelling to investigate the mediatory role of social support in the association between social participation and depressive symptoms as well as the moderating role of bonding networks (social participation with other Syrians) versus bridging networks (social participation with Swedes) in this relationship. Frequent social participation, compared to rare or no participation, was significantly associated with lower depressive symptoms, regardless of whether participation included a broad or limited range of activities. Social support only mediated this relationship for those with primarily bonding networks, indicating that the mediation itself was moderated by network type. While participating in both bridging and bonding networks was associated with lower depressive symptoms, bonding networks amplified the effect of social participation on depressive symptoms via increased social support, resulting in an overall twofold decrease in depressive symptoms compared to those with bridging networks. These findings indicate that the frequency of social participation may be a more important consideration for fostering mental well-being in recently resettled refugees than the specific types of activities. Furthermore, while both bonding and bridging social networks confer mental health benefits, access to coethnic networks in early resettlement appears to provide a particularly crucial source of social support.

Depression, posttraumatic stress of migrants and refugees in Germany – a cross -sectional study

Abstract Background Research shows associations between migration status and mental health conditions (e.g., depression). Yet, few representative data on migrants’ health are available. We aim to provide representative data on depression, and posttraumatic stress (PTSD) among migrants in a representative sample in Northwestern Germany. Methods We conducted a longitudinal study with two measurement points using a standardized assessment instrument in a representative sample of 18-65 years olds in Germany. Here we report on the baseline data. To assess socio-demographic characteristics (gender, age, marital status employment status, household income and migration status) we developed a standardized instrument. To assess depression, we used the Patient Health Questionnaire (PHQ-9), to assess PTSD we used the Harvard Trauma Questionnaire (HTQ-5). To investigate associations of migrant status with depression, and PTSD we estimated linear regression models. Results The analytical sample for this study includes n = 437 (male: n = 181, female: n = 256) individuals (age: M = 44.48, range: 18-65). In the total sample 15.1% (n = 66) showed symptoms of depression, and 6.5% showed PTSD (n = 26). Depression was more frequent in migrants than in non-migrants (22.1% vs. 13.4%, p = 0.043; 66.7). Crude linear regression models showed statistically significant associations between migration status and depression (B = 1.998, 95% CI: 0.831; 3.165, p < 0.001), and PTSD (B = 0.204, 95% CI: 0.085; 0.333, p = 0.002). However, models adjusted for gender, age, marital status employment status, household income and migration status suggested significant associations between migration status and PTSD (B = 0.136, 95% CI: 0.009; 0.263, p = 0.036), but not for depression. Conclusions Longitudinal data are needed to better understand trajectories between mental health conditions, PTSD and migration status. Living situation after the migration is of critical importance for mental health of migrants.

Health status by time of arrival among Ukrainian refugees in Norway

Abstract Background Over 75000 refugees from Ukraine have come to Norway since February 2022. Previous studies show that the refugees have poor health for several domains, and reports suggest that those fleeing Ukraine at later stages have even poorer health. However, more systematic knowledge is lacking. This study aimed to measure self-reported health in a sample of adult refugees from Ukraine according to month of arrival to Norway in 2022. Methods Data were collected via an online, digital questionnaire, in a cross-sectional study design between 28.10.22 - 31.01.23. Recruitment was via multiple potential physical and social media contact points, including asylum reception centres, municipalities, non-profit organisations, and Facebook groups for refugees in Norway. The survey included self-reported health outcomes: overall health, oral health, presence of long-term illnesses or disabilities, and a short version of Hopkins Symptom Checklist (HSCL-5). Results Among 727 respondents, 82% were female, 65% aged 30-49 years, 69% had higher education and 53% responsibility for children in Norway. 383 arrived February-April (T1), 200 May-August (T2) and 144 September-December (T3). Compared to T1, later periods had higher proportions of males, a younger age distribution and lower proportions with higher education. Proportions reporting poor/very poor overall health, presence of long-term illness, and long-term disability were highest in T3. Oral health and HSCL-5 showed an opposite trend, with lower proportions reporting poorer health in both later periods. Respondents in T3 were still more likely to report poor health and long-term illnesses after adjusting for sex, age and education. Conclusions Respondents arriving later in 2022 generally reported poorer long-term health, but less psychological distress than those arriving earlier. These findings may help to inform planning of health services to refugees from Ukraine, especially in areas receiving large numbers of refugees. Key messages • Refugees from Ukraine arriving earlier to host countries appear to have generally better health compared to those arriving later. • Refugee health services should plan and scale accordingly when large numbers of refugees are expected as a result of international crises.

Co-creation of migrant health interventions in Portugal: Insights from the VO(I)CES project

Abstract Background International migration is increasing both globally and in Europe, highlighting the need for responsive interventions that cater to the diverse needs and strengths of migrants. Although genuine involvement of stakeholders in the design and implementation of interventions is vital to enhance their relevance, responsiveness, and ownership, co-created migrant health interventions remain limited. This study aims to address this gap by collaboratively developing health literacy interventions with meaningful involvement from migrants and professionals from both the social and health sectors. Methods As part of the VO(I)CES project, twelve idea-generation workshops were conducted in Portugal, applying the Ophelia (Optimising Health Literacy and Access) process, engaging over 70 stakeholders (migrants, social and healthcare professionals). To guide discussions, these workshops used case vignettes developed from 16 health literacy profiles that were identified in a previous study among 1,126 migrants. The discussions aimed at eliciting detailed insights into the potential actions that are responsive to migrants’ challenges. Results Several key interventions were identified by the stakeholders, including the enhancement of cultural and linguistic training for healthcare providers, the use of community health agents/mediators to improve service delivery and community engagement, and the creation and dissemination of multilingual, multi-format health information materials. Specific interventions for groups experiencing increased vulnerabilities such as pregnant women were also proposed, alongside suggestions for creating citizen spaces and improving digital skills among healthcare staff. Conclusions The co-creation approach facilitated the development of tailored context-specific interventions that are anticipated to enhance health literacy, improve healthcare accessibility, and promote health equity for migrants. Key messages • Ideas Generation Workshops provide a platform for a wide range of groups to have their say and know their voice is being heard. • Co-creation tailors interventions to diverse needs, avoiding a one-size-fits-all approach.

Investigation of usage of antenatal care services by Syrian immigrant pregnant women and the frequency of anaemia and hypertension during the pandemic.

During the pandemic period, the use of health services by disadvantaged groups such as immigrants has deteriorated. The study aims to evaluate the use of antenatal care services by Syrian pregnant women during the pandemic. It is a cross-sectional type of study. The population consisted of 495 pregnant women who applied to the Extended Migrant Health Center (EMHC) between August 2020 and December 2022. Demographic data and pregnancy-related health records were examined through the system records, without any contact with the pregnant women. The percentage of pregnant women who had timely follow-up for each antenatal visit were 11.5% (n=56), 17.2% (n=80), 20.0% (n=88), and 17.4% (n=73), respectively. Only 17.7% (n=87) of the pregnant women made the recommended number of visits during their pregnancy period. The recommended number of follow-ups was statistically significantly higher in women with high-risk pregnancies (p=0.045). Of the pregnant women, 27.4% had anaemia and 2.4% had hypertension. The use of antenatal care in immigrant pregnant women is very low. Interventions are needed in this regard. Increasing the utilization of antenatal care services by immigrant pregnant women is extremely important for both the health of the pregnant woman and the health of the baby.

COVID-19-related worries: A longitudinal study comparing migrants and non-migrants in Norway

Abstract Background Health- and economic-related worries during the COVID-19 pandemic contributed to worsening of mental health, particularly affecting migrants in vulnerable situations. However, this differential impact was only clear some months into the pandemic, and there is little evidence about any differences in health and economic worries between migrants and non-migrants as the pandemic developed. To close this knowledge gap, we assessed the changes in COVID-19-related worries reported by migrants compared to non-migrants in Norway throughout the pandemic. Methods Our study analyzed data from three time points (April-20, January-21, March-22) for 25,305 participants of the Bergen in Change study, including 509 (2%) migrants from Asia, Africa, or Latin America (LATAM), and 1250 (5%) migrants from other regions. Worries were assessed using questions on COVID-19 infection fear, job security, and economic stability. Analysis methods included descriptive analysis, chi-squared, Sankey plots, and logistic regression, adjusting for age, gender, education, and type of work. Results Migrants from Asia, Africa and LATAM reported health worries more often than non-migrants [OR (95%CI) 1.9 (1.3-2.8)] without clear changes over time, 0.9 (0.7-1.3). Migrants from Asia, Africa, and LATAM, as well as from other regions, also reported economic worries significantly more often than non-migrants [3.1 (2.5-3.9) and 2.1 (1.8-2.4) respectively] at baseline. Each additional year into the pandemic increased the odds of economic worries by a factor of 1.3 (1.0-1.6) for migrants from Asia, Africa, and LATAM compared to non-migrants. The odds ratio for migrants from other regions over time was stable, 1.0 (0.9-1.1). Conclusions Migrants, especially those from Asia, Africa, and LATAM, reported more pandemic- related worries than non-migrants, and this persisted over time. Identifying and understanding these worries could guide preventive measures to enhance mental health in migrant population. Key messages • Throughout the pandemic, migrants reported more COVID-19-related worries than non-migrants, a trend that persisted over time and was greater among migrants from Asia, Africa, and Latin America. • Identifying the differential impact of COVID-19 on migrants’ groups and understanding the factors involved is essential for guiding healthcare interventions to improve migrant health.

Awareness and knowledge about Female Genital Schistosomiasis among European healthcare workers

Abstract Background Female Genital Schistosomiasis (FGS) is a gynaecological manifestation of persistent infection with Schistosoma haematobium, which can lead to severe consequences, such as miscarriage and infertility. It is estimated to affect 56 million women globally, mostly in sub-Saharan Africa (SSA). Most migrants in Europe are female, often from SSA and therefore at risk of FGS, hence healthcare workers (HCWs) knowledge of FGS is essential for the provision of adequate care. This study aims to assess awareness and knowledge of FGS among European HCWs to inform strategies to improve the management of migrant health. Methods In June 2023 - January 2024 we conducted a cross-sectional online survey targeting medical doctors (MDs), nurses and midwives (NMs) working in fields of infectiology, gynaecology, urology, family, travel, internal or occupational medicine. The prevalence of FGS awareness and knowledge was estimated, Poisson regression was used to identify factors associated with MDs’ awareness of FGS. Results Among 922 surveyed HCWs, 43.7% (CI95%: 39.6-47.9) of MDs and 12.0% (CI95%: 8.8-16.0) NMs have heard about FGS. FGS awareness among MDs was associated with work in clinics for migrants (prevalence ratio (PR)=1.33, CI95%: 1.10-1.59) and specialization, being lower for gynaecology (PR = 0.67; CI95%:0.51-0.88), and family medicine (PR = 0.42, CI95%:0.30-0.59). Among MDs, 7.1% (CI95%: 5.1- 9.5) had medium knowledge, while 25.3% (CI95%: 21.8-29.0) had low, and 67.6% (CI95%: 63.7-71.4) no knowledge on symptoms, complications or diagnostic tools for FGS. FGS knowledge was mostly acquired through academic curricula (34.7%), scientific literature (28.4%) and conferences (25.6%). Conclusions The study shows limited awareness of FGS among European MDs and NMs, and highlights that European HCWs may not be adequately prepared to deal with diseases that are gaining relevance on the European continent due to the global connectivity and the dynamic nature of our societies. Key messages • In Europe, the health specialities that are the first point of patient access to the health system show a low level of awareness and knowledge of Female Genital Schistosomiasis. • Rising knowledge of FGS among European HCWs through academic curricula and continuous medical education is important to ensure adequate diagnosis and management of disease in migrant populations.

Association between Thai language proficiency and adherence to COVID-19 protective behaviors (CPB) among Myanmar migrant workers in Southern Thailand.

The association between host country language proficiency and disease prevention among migrants is underexplored. The objective of this study is to assess the extent to which self-reported command of the Thai language is associated with adherence to COVID-19 protective behaviors (CPB) among Myanmar migrant workers in Thailand. We distributed a self-administered structured questionnaire in Burmese language to 1,050 Myanmar migrant workers in Southern Thailand from September 2022 to January 2023. The questionnaire included background characteristics, self-reported Thai language proficiency based on the Common European Framework Reference (CEFR), and self-reported CPB adherence at residence and workplace. We analyzed data using descriptive statistics and multivariate linear regression analysis. Although slightly less than half of the participants reported CEFR A1 level or higher in Thai speaking and listening skills, less than 10 percent did so for reading and writing skills. Workplace COVID-19 preventive adherence scores were initially found to be significantly associated with A1 level or higher speaking and listening skills. However, after adjusting for confounders, these associations were not statistically significant (Speaking skill's Adjusted Beta = 0.713, 95% CI = -0.011, 1.437; Listening skill's Adjusted Beta = -0.367, 95% CI = -1.087, 0.353). No significant associations were found between any language skill domain and residence COVID-19 preventive adherence scores for both unadjusted and adjusted analysis. The study findings may have implications for relevant stakeholders in migrant services, migrant health, and infectious disease control. However, information biases, language barriers, and lack of generalizability should be considered as caveats in the interpretation of the study findings.

A systematic review of protective and promotive factors in refugee mental health

A systematic review of protective and promotive factors in refugee mental health

Enhancing the mental health of refugees and asylum seekers through music interventions

Enhancing the mental health of refugees and asylum seekers through music interventions

Lessons Learned About Safety Nets for Refugee Arrivals and Health Outcomes.

Lessons Learned About Safety Nets for Refugee Arrivals and Health Outcomes.