Refugee Populations Research Articles

Development for Empowerment: Mobilising Online and Digital Micro-Credentials for Refugees

Development for empowerment focuses on leveraging education via digital technologies and micro-credentials for training and education as part of the integration, social inclusion and capacity building for displaced persons. Development for empowerment builds upon the previous concepts of development including Amartya Sen’s ‘development as freedom,’ the core concept of education and learning as development, and the use of digital technologies for building human capacity so people can make their own choices and pursue the lives they wish to lead. Development for empowerment for refugees broadens the construct of development and is integral to promoting and nurturing ‘equity, access and success’ amongst refugee populations. The authors highlight critical resources that support the basic tenets of human empowerment such as the UN’s Declaration of Human Rights, the UN’s Basic Needs Approach to Refugees, Maslow’s Hierarchy of Needs, and the key strategies of online delivery and micro-credentials development. Moreover, the authors emphasise that the integration, social inclusion and integration of refugees is a highly complex construct to implement and sustain, thus reflecting the constant tension of refugees’ emotional desire to return home versus rebuilding a new life in a new country. In the final analysis, ‘development for empowerment’ + open and distance learning + digital micro-credentials create a powerful synergy for serving refugees and fulfilling the spirit of preserving human rights through education and the pursuit of one’s chosen life as a precious human ideal.

Chronicity of self-harming behaviors among adolescent teenage girls living in refugee settlements in Northern Uganda

BackgroundSelf-harming ideations demand targeted research due to their persistent nature, especially among female adolescents within refugee populations who face unique challenges that can exacerbate self-harming tendencies. This study aimed to assess the factors associated with self-harming ideations chronicity among female teenagers living in refugee settlement in Northern Uganda.MethodThis cross-sectional study used a pretested questionnaire to assess self-harming ideations and other demographic characteristics. Ordinal logistic regression was used to determine factors associated with chronicity of self-harm ideations.ResultsOf 385 participants, the prevalence of self-harming ideations was 4.2% (n = 16) for acute, 8% (n = 31) for subacute, and 3.1% (n = 12) for chronic. The likelihood of having more chronic self-harming ideations increased with having ever been pregnant (adjusted odds ratio [aOR] = 3.78, 95% Confidence Interval [CI] = 1.57–9.08). However, having a spouse as the family head reduced the likelihood of having more chronic self-harming ideations (aOR = 0.19, 95% CI = 0.04–0.95).ConclusionsThe persistence of self-harming thoughts among female teenagers in Northern Ugandan refugee settlements varies. Pregnancy history is associated with a higher chance of prolonged self-harming thoughts while having a spouse as the family’s head is linked with a lower likelihood. Examining different demographic and familial elements when addressing the mental well-being of female teenage refugees is vital. It stresses the necessity for customized interventions and support networks targeting the reduction of self-harm behaviors among this vulnerable group.

Research with Refugee Populations in North America: Applying the NIH Guiding Principles for Ethical Research

ABSTRACTThis article examines the ethics of research design and the initiation of a study (e.g., recruitment of participants) involving refugee participants. We aim to equip investigators and members of IRBs with a set of ethical considerations and pragmatic recommendations to address challenges in refugee‐focused research as it is developed and prepared for IRB review. We discuss challenges including how refugees are being defined and identified; their vulnerabilities before, during, and following resettlement that impacts their research participation; recruitment; consent practices including assent and unaccompanied minors; and conflicts of interest. Ethical guidance and regulatory oversight provided by international bodies, federal governments, and IRBs are important for enforcing the protection of participants. We describe the need for additional ethical guidance and awareness, if not special protections for refugee populations as guided by the National Institutes of Health (NIH) Guiding Principles for Ethical Research.

Understanding Economic Integration in Immigrant and Refugee Populations: A Scoping Review of Concepts and Metrics in the United States

In an increasingly mobile world, the integration of immigrants and displaced individuals is an important factor in creating cohesive and inclusive societies. Integration has different dimensions; this scoping review examines the conceptualization and measurement of economic integration among immigrants and refugees in the United States. Quantitative peer-reviewed journal papers measuring or conceptualizing the economic integration of first-generation documented adult immigrants or refugees in the United States, as well as relevant conceptual or theory papers on this topic, were included in the review. The search strategy included an online search of the Web of Science Core Collection, PsycINFO, Applied Social Sciences Index and Abstracts (ASSIA), and EconLit. Additional search strategies included scanning the reference lists of studies identified as relevant in the initial database search. An analysis of 72 studies included in the review using a data extraction table reveals seven key domains of economic integration: income and economic security, employment and occupational categories, assets and use of financial services, neighborhood and housing, health, education, and use of public assistance. Income and economic security emerged as the most common indicators of integration in the reviewed studies. Notably, less than half of the reviewed publications had a multidimensional approach to defining or measuring economic integration, and the majority of studies were focused on immigrants, with a smaller proportion dedicated to refugees. This review emphasizes the need for comprehensive frameworks in assessing economic integration among immigrants and refugees, reflecting the multifaceted nature of their economic integration experiences.

Climate-resilient water resource management for Rohingya refugee camps in Bangladesh

The Rohingya refugee camps in Bangladesh face severe water resource challenges, exacerbated by the impacts of climate change. With a rapidly growing population, the demand for water in these camps has surged, leading to over-extraction of groundwater and deteriorating water quality. Seasonal variations, including monsoons and dry spells, further strain the limited water resources, creating periods of acute scarcity and contamination risks. Climate change intensifies these issues by altering precipitation patterns and increasing the frequency of extreme weather events, jeopardizing the sustainability of current water supply systems. This paper explores sustainable water resource planning strategies tailored to the unique context of the Rohingya camps, emphasizing climate resilience and community-based approaches. By integrating innovative technologies and policy interventions, the study aims to propose solutions that ensure long-term water security for the refugee population. Sustainable water resource planning is crucial for addressing the compounded challenges of water scarcity and quality in Rohingya refugee camps, particularly under the escalating pressures of climate change. As climate change alters precipitation patterns and increases the frequency of extreme weather events, the vulnerability of water systems in these densely populated settlements intensifies. Effective planning must integrate climate resilience, ensuring reliable access to safe water despite environmental uncertainties. This involves adopting adaptive management strategies, leveraging innovative technologies, and fostering community participation to enhance system robustness and flexibility. Sustainable planning not only addresses immediate water needs but also builds long-term resilience, reducing dependency on overstressed groundwater resources and mitigating the impacts of climate-induced disruptions. This paper underscores the importance of holistic and forward-thinking approaches in securing water resources for the Rohingya population in the face of a changing climate. The study identifies critical gaps in current water resource management practices within Rohingya refugee camps and emphasizes the necessity for sustainable planning amidst climate change impacts. Key findings reveal that over-reliance on groundwater, coupled with inadequate infrastructure and seasonal variability, significantly undermines water security. The research recommends the implementation of integrated water resource management (IWRM) strategies, incorporating both traditional and innovative solutions such as rainwater harvesting, solar-powered water purification, and community-led water conservation practices. Enhancing policy frameworks to support sustainable water management and fostering collaborations among stakeholders are also crucial. Furthermore, climate resilience measures, including infrastructure fortification against extreme weather events, are imperative for long-term sustainability. These recommendations aim to establish a resilient water supply system that can adapt to future climate conditions while ensuring equitable access to safe water for the Rohingya population.

The Development and Evaluation of Alternative Communication Strategies to Facilitate Interactions with Refugees in Obstetric Triage: A Preliminary Study

Purpose: In this pilot study, we investigate the potential of pictographs to facilitate communication and accelerate care for non-English speaking birthing people in triage. The immigrant and refugee populations have been steadily increasing in the United States; reproductive age women are a large percentage of those who seek medical care. Barriers to care include timely access to interpreters, which can delay treatment. Pictographs have been used successfully in medicine in various situations such as pharmaceutical instruction and symptom description. We searched extensively for obstetric triage pictographs with little success. To address this, we created a pictograph sheet specifically for common obstetrical complaints. Methods: The most common reasons for visiting triage were ascertained. From these, key topics were identified for drawings. For each topic, the authors drafted scripts for a list of relevant actions. The actions for each topic were then represented by a professional illustrator in pictographs. Pictographs were developed using the following guidelines: focus on actions people should take, include prompts within pictures such as labels or arrows and exclude nonessential details such as room background and elaborate borders. After the pictographs were developed, its appropriateness, accuracy and relevance were reviewed and validated by two experts with experience in women’ care. The experts perceived that the drawings represented the actions well in a simple and clean manner. The following concerns were depicted: decreased fetal movement, abnormal vaginal discharge, rupture of membranes, vaginal bleeding, vision changes, shortness of breath, nausea, contractions, headaches, and overall assessment of wellbeing. Focus groups were developed collaboratively with Della Lamb, a resettlement agency. Inclusion criteria included women of reproductive age who are non-English speaking and currently pregnant. These focus groups were held at the University Health. Two focus groups were created: one with refugees from Afghanistan and one with refugees from the Congo. Each focus group was guided by a licensed medical interpreter of their native language: Dari and Swahili, respectively, and ranged from 3 to 4 participants. One by one the pictograms were introduced to the group. Each participant was asked what they think the illustration represents. For participants’ comfort, groups were not recorded; instead, notes were taken by observers during and after the discussion. The participants read the text and pictographs and were asked to identify if pictographs were clear, understandable, and acceptable. Results: Congolese Focus Group: Participants’ ages varied in their 30s. All had recently immigrated to the United States and lived in Missouri for less than 6 months. They were in the second trimester of their pregnancy and had at least one prenatal visit in the United States. They were all multiparous women with previous uncomplicated vaginal deliveries in their native country. All could read and write in Swahili but spoke no English. They all had no previous experience with the medical health system in the United States. Afghani Focus Group: Participants’ ages varied in their 20-30s. All had recently immigrated to the United States and lived in Missouri for less than 3 months. 3 women were in their second trimester, 1 was in her third trimester. Aside from 1, the rest (3) were multiparous women with previous uncomplicated vaginal deliveries in their native country. 3 of them could read and write in Dari but spoke no English. They all had no previous experience with the medical health system in the United States. Comprehension was significantly different between the two groups. Overall, the Congolese group of women misunderstood the purpose of the pictographs. No picture was understandable to the patients. It was also apparent that the patients did not realize these were issues for which to come to triage. There was also ambiguity regarding the color, i.e. they did not correlate green with nausea. The general prohibition sign was also absent in meaning for them. However, all of the patients expressed interest in learning what each picture meant and would like to have that option there if they came to triage and could not get an interpreter. The Dari group did not understand shortness of breath or nausea. However, they were familiar with the other symptoms and able to identify those as reasons to come to triage. The patients were also familiar with colors and scales. Conclusion: The pictograph-based approach might be an effective tool in developing health-care instructions for immigrant women with limited literacy skills. However, research is needed regarding limitations due to cultural backgrounds. Future research is also needed to compare the effect of pictograph-enhanced instructions with written text-based instructions on adherence to instructions and health outcomes.

The Gaziantep Model: Integrated Mother-Child Health Services for Healthy Communities After Disasters

This article discusses the Gaziantep Model, which focuses on integrated mother-child health services in the aftermath of disasters, with a particular focus on the 2023 earthquakes in Turkey. The model emphasizes the importance of maternal and child health in building healthy communities post-disaster and offers a comprehensive approach to address physical and mental health. The Gaziantep model uses a hybrid structure of mobile and fixed healthcare services to provide care at both individual and societal levels. It also recognizes the importance of healthcare staff's well-being. The article highlights the significant impact of the earthquakes, including damage to healthcare facilities and the strain on healthcare personnel, especially in regions with a high population of Syrian refugees. Gaziantep, with its existing maternal and infant mortality challenges, serves as a suitable province for implementing this model. The article emphasizes the long-term consequences of disasters on maternal and child health, including increased risks during pregnancy, mental health issues, and developmental challenges for children. The Gaziantep model aims to foster collaboration among various agencies and organizations, develop targeted interventions, and collect data to improve maternal and child health, reduce burnout among medical personnel, and enhance the overall well-being of communities. It involves the partnership of Gaziantep University, the ZERU Association, Gaziantep Provincial Health Directorate, and Gaziantep Municipality. Overall, the Gaziantep Model offers a comprehensive approach to address the unique healthcare needs of mothers, children, and families in the aftermath of disasters, with a focus on collaboration and long-term community health.

Syrian refugee young adults as community mental health workers implementing problem management plus: Protocol for a pilot randomized controlled trial to measure the mechanisms of effect on their own wellbeing, stress and coping

This pilot randomized controlled trial protocol aims to (1) assess the impact on the wellbeing of Syrian refugee young adults (18–24 years) of being a community mental health worker (CMHW) implementing WHO's evidence-based psychosocial intervention - Problem Management Plus (PM+) - with adults in their community, and (2) identify the mechanisms associated with the outcomes of enhanced wellbeing and coping, and reduced stress among these CMHWs. Over 108 million people have been forcibly displaced as of the end of 2022. Mental health consequences of these displacements are significant, yet human resources for health are not sufficient to meet the needs. A large proportion of refugee populations are youth and young adults (YA). Evidence indicates their engagement in supporting their communities leads to their own enhanced wellbeing and that of their community. This trial trains Syrian refugees to serve their communities as CMHW (n=19) or tutors (n=19) and compare wellbeing, stress and coping outcomes between these two groups and a control group (n = 40). We will also assess 7 mechanisms as potential pathways for the interventions to influence outcomes. Surveys will assess outcomes and mechanisms, hair samples will measure stress cortisol. The primary analysis will use a Bayesian Hierarchical Model approach to model the trajectories of the mechanisms and primary study endpoints over time for individuals in each of the arms. Our results will elucidate critical mechanisms in which engagement of young adults to support their community enhances their own wellbeing. Trial registrationNational Institutes of Mental Health, NCT05265611, Registered prospectively in 2021. Lebanon clinical trials registry #LBCTR2023015206, Registered in 2023.

Access to Labour and “Differential Inclusion” for Young Venezuelan Migrants in Ecuador

Young migrants and refugees provide important inputs concerning production and social reproduction mechanisms (care work) that reproduce unequal but highly profitable patterns of accumulation around the world. The expansion of globalisation and neoliberalism has deepened such social dynamics, leading to a “multiplication of labour.” The diversification and heterogenization of migrant labour within neoliberal frameworks raise ethical and human rights concerns, including issues related to fair wages, working conditions, and access to social protections. After a neoliberal era in Latin America, the emergence of post‐development politics in the region led to increased efforts to address the needs of these populations. This article seeks to contribute to debates about “differential inclusion” in South–South migration and access to labour and social protection by analysing a specific case study of young Venezuelans, a recently growing phenomenon that has a great impact on the region. Ecuador is noteworthy because it hosts one of the largest populations of Venezuelan migrants and refugees and has adopted a human rights perspective in conjunction with public investments in social policy, health, and education. Despite efforts to legalize the work status of Venezuelan migrants, a more restrictive policy began to be implemented in 2019 that limited their access to formal labour and social protection. Within these complex dynamics of differential inclusion, instead of seeing these young migrants and refugees as victims, we analyse their resilience strategies of accessing social provisions while coping with informality and irregular status, as well as conditions of multiplication of labour. Using four real‐life stories as examples taken from a larger ethnographic study, we illustrate how dynamics of differential inclusion intersect with the gender, age, and legal status of young Venezuelans in Ecuador. The case studies are complemented with structural explanations from 6,000 household surveys collected between 2017 and 2020.

Burden of Disease in Refugee Patients with Diabetes on the Island of Lesvos-The Experience of a Frontline General Hospital.

We sought to evaluate the degree of hyperglycaemia in refugees with known or recently diagnosed diabetes, to assess cardiovascular comorbidities and diabetes complications, to review and provide available therapeutic options, and to compare, if possible, the situation in Lesvos with other locations hosting refugee populations, thus raising our awareness towards barriers to accessing healthcare and managing diabetes in these vulnerable populations and to propose follow-up strategies. We retrospectively studied 69 refugee patients (68% of Afghan origin, 64% female) with diabetes mellitus (81% with type 2 diabetes), who were referred to the diabetes outpatient clinics of the General Hospital of Mytilene, Lesvos, Greece, between June 2019 and December 2020. Age, Body Mass Index, diabetes duration, glycaemic control (HbA1c and random glucose), blood pressure, estimated renal function, lipid profile, diabetes complications and current medication were documented at presentation and during subsequent visits. For all patients with type 1 diabetes and type 2 diabetes, age at presentation was 17.7 and 48.1 years, BMI 19.6 kg/m2 and 28.9 kg/m2 and HbA1c 9.6% and 8.7%, respectively (all medians). One-third (29%) of patients with type 2 diabetes presented either with interrupted or with no previous pharmacological treatment. Insulin was administered to only 21% of refugees with poorly controlled type 2 diabetes. Only half of the patients (48%) with hypertension were taking antihypertensive medication and one-sixth (17%) were taking lipid-lowering medication. Forty-two per cent (42%) of patients were lost to follow-up. Our results showed that a significant portion of refugees with diabetes have either no treatment at all or have had their treatment discontinued, that insulin is still underutilised and that a significant portion of patients are lost to follow-up. It is essential to enhance our ability to identify refugees who may be at risk of developing diabetes or experiencing complications related to the disease. Additionally, it is important to expand access to crucial treatment and monitoring services. By improving our policies for managing non-communicable diseases, we can better support the health and well-being of these vulnerable populations. Furthermore, it is vital to recognize that Greece cannot bear the burden of the refugee crisis alone; international support and collaboration are necessary to address these challenges effectively.

Barriers and Facilitators to Co-Creating Interventions with Refugee and Migrant Youth: A Process Evaluation with Implementors

The rise in children experiencing forced displacement and the associated negative mental health effects have led to the proliferation of novel interventions targeting their educational development and mental health and psychosocial support (MHPSS) needs. To improve the acceptability and effectiveness of these interventions for refugee communities, co-creation is often used. However, there is a need to understand the mechanisms that support the co-creation process. This paper explores the process of co-creation within the REFUGE-ED project: an international consortium identifying, co-creating, and implementing educational and MHPSS interventions for refugee youth. The data are drawn from consortium members and site staff who participated in a range of meetings, focus groups, and interviews which occurred before, during, and after the implementation. A qualitative content analysis grounded in the (updated) Consolidated Framework for Implementation Research (CFIR) was then used to identify barriers to and facilitators of the co-creation process. Although numerous barriers and facilitators were identified only two traversed both categories and every stage of the co-creation process: namely, the quality of interpersonal relationships and the clarity of the implementation plan. We discuss relevance of these two factors to the field of co-creation as a means to adapt health interventions targeting youth refugee populations. Considerations, needs, and recommendations for future co-creation interventions are also outlined.

Prevalence and predictors of depression, anxiety, and stress among refugees in Egypt

BackgroundMany Refugees show multiple distressing psychological and mental health problems associated with stressful and adverse conditions in host countries. Even though Egypt is one of the top five destination countries hosting refugees and asylum-seekers in the MENA region, there is a lack of studies investigating mental health problems among refugees in Egypt. This study aimed to assess the prevalence and predictors of depression, anxiety, and stress symptoms among refugees living in Egypt.MethodsA total of 398 refugees aged 18 and above were interviewed from migrants’/refugees' community centers in Giza, Alexandria, Dakahlia, and Damietta governorates. A predesigned structured interview questionnaire was used to collect socio-demographic and migration-related variables. The Arabic Version of Depression Anxiety Stress Scales (DASS-21) was used to assess the presence and severity of the three negative emotional states.ResultsNearly two-thirds of the participants were Syrian (66.4%). The majority resided in Alexandria and Giza governorates (75.9%), were females (73.4%), and were married (71.1%). The most reported migration difficulty was housing (41.5%). Anxiety symptoms were reported among 63.3% (95% CI: 58.59%- 68.05%) of sampled refugees, followed by depression (61.3%, 95% CI: 56.52%-66.10%), and stress symptoms (51.5%, 95% CI: 46.56%-56.36%). Results of regression analysis showed that; female gender predicted anxiety (aOR 2.419, 95% CI: 1.485–3.941, p < 0.001) and stress (aOR 2.053, 95% CI: 1.197–3.519, p = 0.009), while younger age groups (18–25 yr. and 26–50 yr.) compared to the older age group (51 yr. and older) predicted depression (aOR 4.529, 95% CI: 1.696–12.097, p = 0.003 and aOR 2.177, 95% CI: 1.270- 3.733, p = 0.005, respectively) and stress (aOR 4.334, 95% CI: 1.556–12.074, p = 0.005 and aOR 1.808, 95% CI: 1.023–3.193, p = 0.041, respectively). Residence in Alexandria, housing, and employment difficulties predicted anxiety (aOR 2.354, 95% CI: 1.420–3.902, p < 0.001, aOR 1.726, 95% CI: 1.073–2.778, p = 0.025, and aOR 3.044, 95% CI: 1.248–7.425, p = 0.014, respectively), depression (aOR 1.949, 95% CI: 1.163–3.266, p = 0.011, aOR 1.666, 95% CI: 1.036–2.681, p = 0.035, and aOR 3.216, 95% CI: 1.321–7.828, p = 0.010, respectively), and stress (aOR 2.450, 95% CI: 1.431–4.195, p < 0.001, aOR 1.911, 95% CI: 1.187–3.078, p = 0.008, and aOR 4.482, 95% CI: 1.867–10.760, p < 0.001, respectively).ConclusionMental health problems are prevalent among the refugee population in Egypt that are compounded by the difficult post-migration socio-economic situation. Multisectoral attention towards refugees’ mental health is urgently needed.

The Role of University-Ngo Cooperation in Increasing the Entrepreneurial Skills of Youth: An Evaluation Specific to Refugee Youth

As widely recognized, Turkey is hosting the world's highest number of registered refugees since 2011. Notably, 20% of this refugee population comprises young individuals aged 18-29, highlighting significant youth. Gaziantep, second to Istanbul in refugee concentration, accommodates over 440,000 refugees. This study delves into the necessity of forging a new symbiotic relationship between residents and migrants. Such a partnership can positively affect industry, productivity and human resource diversity. Notably, research indicates that a majority (80%) of refugees do not foresee a return to Syria, underscoring the significance of maximizing the productivity and efficiency of these individuals in their adopted regions. Consequently, the study investigates the interplay between young migrants and the city's entrepreneurship ecosystem, drawing upon data from 14 collaborative projects, focusing on enhancing local and refugee youth's capacity and entrepreneurial skills, between Gaziantep University and NGOs. The findings underscore the outcomes stemming from the alliance between young refugees and their local counterparts, which fosters innovation and productivity through collaboration. This study illuminates the potential for new ecosystems to drive entrepreneurial effectiveness and efficiency, culminating in innovation-driven accomplishments facilitated by the collaboration between refugee and local youth.

"Nobody does checkups back there": A qualitative study of refugees' healthcare needs in the United States from stakeholders' perspectives.

The number of refugees globally grew to 35.3 million in 2022, and many refugees are exposed to various health risks along their migration journey. As a result, they may arrive in host communities with numerous health issues, including communicable diseases and chronic and mental health conditions. Navigating the healthcare system in a host country proves to be a significant challenge for them, leading to delayed care. This qualitative study explored the convolute healthcare needs of refugees in the United States by soliciting insights from stakeholders involved in refugee resettlement and healthcare. In-depth interviews were conducted with fifteen stakeholders who work closely with refugees, including healthcare providers, cultural/clinical health navigators supporting refugees, staff from refugee resettlement agencies and governmental entities, and researchers studying refugee health. Following informed consent, interviews were audio-recorded, transcribed verbatim, and imported into MAXQDA 2022 (VERBI Software) for thematic analysis. The results revealed key themes, including the heterogeneity of refugee populations, limited awareness of preventive healthcare, high prevalence and suboptimal management of chronic conditions, complexity of the healthcare system, lack of follow-up, and language barriers. Further research is warranted concerning the long-term health of refugee populations in the United States. Additionally, more tailored programs involving peer educators are recommended to support refugee communities in navigating the complex healthcare system in the host country.

Improving rates of immunisation in refugee populations in Australia.

Despite an established humanitarian program running for many years, the health needs of refugees resettled in Australia, particularly immunisation, have not been met adequately. Under-immunisation is one of the top health issues for this population. While there is no population-level immunisation coverage data, seroprevalence studies based on small cohorts of refugees show suboptimal immunity to various vaccine-preventable diseases and lower vaccine coverage for this group than the general population. This is compounded by gaps in immunisation policy and service delivery that further perpetuate access issues and may contribute to under-immunisation. This is particularly pertinent against the backdrop of the coronavirus disease 2019 (COVID-19) pandemic, where there have been significant disruptions in the delivery of routine and catch-up immunisations. This paper briefly analyses the status quo and draws on the key policy considerations for enhancing the equitable provision of immunisation for refugees as recommended by the 2019 World Health Organisation technical guidance report to provide a clear, overarching direction for empirical work on immunisation service delivery for refugees in Australia.

Evaluation of a Ready4LifeProgram for US Refugee and Immigrant Youth

program on 4 outcome measures: (1) communication skills; (2) conflict resolution/conflict management, and problem-solving skills; (3) healthy relationship and marriage skills; and (4) progress towards greater economic stability. Methods. Refugee and immigrant youth (N = 341) were randomly assigned to either an intervention group or a comparison group. Intervention participants received a 16-hour relationship enhancement (RE) program developed for refugee populations. In addition to the RE program, intervention participants also received case management. Participants in the comparison group only received case management. All participants, intervention and control, completed self-report questionnaires prior to the beginning of the program. Intervention youth participated in the RE program. All participants completed a posttest questionnaire at the end of the program, and again 6 months after the end of the program. Results. Intervention participants made statistically significant improvements from pretest to 6-month follow-up (p &lt; .05) compared to control participants for 3 of the 4 outcome variables. Conclusion. These results indicate the positive impact of an RE program on refugee and immigrant youth. Future researchers should consider including specific health programming as part of the intervention and also examine health behavior and other direct health outcomes.

Integrating Syrian refugees into Lebanon’s healthcare system 2011–2022: a mixed-method study

IntroductionThe Lebanese government estimates the number of Syrian refugees to be 1.5 million, representing 25% of the population. Refugee healthcare services have been integrated into the existing Lebanese health system. This study aims to describe the integration of Syrian refugee health services into the Lebanese national health system from 2011 to 2022, amid an ongoing economic crisis since 2019 and the COVID-19 pandemic.MethodsThis paper employs a mixed-methods approach drawing upon different data sources including: 1- document review (policies, legislation, laws, etc.); 2- semi-structured interviews with policymakers, stakeholders, and health workers; 3- focus group discussions with patients from both host and refugee populations; and 4- health systems and care seeking indicators.ResultsAlthough the demand for primary health care increased due to the Syrian refugee crisis, the provision of primary health care services was maintained. The infusion of international funding over time allowed primary health care centers to expand their resources to accommodate increased demand. The oversupply of physicians in Lebanon allowed the system to maintain a relatively high density of physicians even after the massive influx of refugees. The highly privatized, fragmented and expensive healthcare system has impeded Syrian refugees’ access to secondary and tertiary healthcare services. The economic crisis further exacerbated limits on access for both the host and refugee populations and caused tension between the two populations. Our findings showed that the funds are not channeled through the government, fragmentation across multiple financing sources and reliance on international funding. Common medications and vaccines were available in the public system for both refugee and host communities and were reported to be affordable. The economic crisis hindered both communities’ access to medications due to shortages and dramatic price increases.ConclusionIntegrating refugees in national health systems is essential to achieve sustainable development goals, in particular universal health coverage. Although it can strengthen the capacity of national health systems, the integration of refugees in low-resource settings can be challenging due to existing health system arrangements (e.g., heavily privatized care, curative-oriented, high out-of-pocket, fragmentation across multiple financing sources, and system vulnerability to economic shocks).

Assessing contact-induced change in Palestinian Arabic: Evidence from Beirut

AbstractWe investigate whether Palestinian Arabic (PA), as spoken by the local Palestinian refugee population in Beirut, is converging with Lebanese Arabic (LA), the majority variety. Using a sociolinguistic framework, we target three variables considered to be susceptible to convergent change. We find evidence of contact-induced change in PA in the variable raising of word-medial /a:/ to [e:], as well as in the attrition of socially marked exponents of verbal negation. By contrast, in the case of the third variable, the future temporal reference system, the evidence for convergence is less compelling on account of key differences between the contact varieties, including the vertiginous rise of the proclitic future marker ħa- in PA. We implicate the respective social salience of the targeted variables in their differential susceptibility to convergence. Our results afford new insights into dialect contact and elucidate under-studied patterns of grammatical variation and change in Levantine Arabic.

Mapping the evidence on factors related to postpartum contraception among sub-Saharan African immigrant and refugee women in the United States of America: A scoping review protocol.

Postpartum contraception is essential to sexual and reproductive health (SRH) care because it encourages healthy spacing between births, helps women avoid unwanted pregnancies, and lessens the risks of health problems for mothers and babies. Sub-Saharan African immigrant and refugee populations are rapidly increasing in the United States, and they come from a wide range of cultural, linguistic, religious, and social origins, which may pose challenges in timely access to culturally acceptable SRH care, for preventing mistimed or unwanted childbearing. The objective of this scoping review is to assess the extent of the available literature on postpartum contraception among sub-Saharan African immigrant and refugee women living in the United States. We developed preliminary search terms with the help of an expert librarian, consisting of keywords including birth intervals, birth spacing, contraception, postpartum contraception or family planning, and USA or America, and sub-Saharan African immigrants, or emigrants. The study will include the following electronic databases: PubMed/MEDLINE, PsycINFO, CINAHL, EMBASE, and the Global Health Database. The sources will include studies on postpartum care and contraceptive access and utilization among sub-Saharan African immigrants living in the US. Citations, abstracts, and full texts will be independently screened by two reviewers. We will use narrative synthesis to analyze the data using quantitative and qualitative methods. Factors associated with postpartum contraception will be organized using the domains and constructs of the PEN-3 Model as a guiding framework. This scoping review will map the research on postpartum contraception among sub-Saharan African immigrant and refugee women living in the US. We expect to identify knowledge gaps, and barriers and facilitators of postpartum contraception in this population. Based on the findings of the review, recommendations will be made for advocacy and program and policy development toward optimizing interpregnancy intervals in sub-Saharan African immigrants living in the US. Review registration Open Science Framework: https://osf.io/s385j.

Influence of Youth Unemployment on Youth Involvement in Crime in Kakuma Refugee Camp

Youth, constituting an estimated 70% of the total population, play pivotal roles in society due to their energy and dynamism. Conversely, a significant portion of the refugee population comprises young individuals who, despite being provided with various capacity-building programs, sometimes find themselves involved in criminal activities. The study sought to assess the influence of youth unemployment on youth involvement in Crime in Kakuma Refugee Camp. Employing a descriptive research design, the study was guided by Strain theory. The target population included refugees, host community members operating businesses within the study area, government officials, and officials from humanitarian agencies implementing projects in refugee settlements. Stratified random sampling was utilized to select South Sudanese sub-clans, while purposive sampling was employed to select security officers and stakeholders from various departments. Data collection involved the use of questionnaires and interviews, gathering responses from 125 and 20 respondents, respectively. Primary data was obtained through questionnaires and interviews with government officers working in the camp, such as those from the Department of Refugee Services (DRS), law enforcement officers, Non-Governmental Organizations (NGOs), community peace and protection teams (CPPTs), and national and county government administrators overseeing the refugee camp's jurisdiction. Secondary data was sourced from scholarly journals, books, the internet, reports, newspapers, and treaties on refugees, aiding in achieving the study objectives. Data analysis employed descriptive statistics for quantitative data and content analysis for qualitative data, utilizing SPSS and NVIVO software, respectively. Results were presented through tables, charts, and figures. The study found that poverty was a significant factor contributing to youth involvement in crime. Additionally, societal treatment, characterized by suspicion, victimization, lack of recognition, and disharmony influenced youth criminal behaviour. To address these issues, the study recommends that humanitarian organizations and governments provide income-generating activities for youth, intensify initiatives to alleviate community involvement in crime, foster positive societal attitudes towards youth, and provide proper guidance on avoiding negative peer influence, thereby deterring youth from joining criminal groups.