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The increasing number of refugees, asylum seekers, and irregular migrants poses a challenge for mental health services in Europe. This review found that these groups are exposed to risk factors for mental disorders before, during, and after migration. The prevalence of psychotic, mood, and substance-use disorders in these groups varies but overall resembles that in the host populations. Refugees and asylum seekers, however, have higher rates of post-traumatic stress disorder. Poor socioeconomic conditions are associated with increased rates of depression five years after resettlement. Refugees, asylum seekers, and irregular migrants encounter barriers to accessing mental health care. Good practice for mental health care includes promoting social integration, developing outreach services, coordinating health care, providing information on entitlements and available services, and training professionals to work with these groups. These actions require resources and organizational flexibility.
Worldwide, more people are on the move now than ever before, yet many refugees and migrants face poorer health outcomes than the host populations. Addressing their health needs is, therefore, a global health priority and integral to the principle of the right to health for all. The key is to strengthen and maintain health systems by ensuring that they are refugee- and migrant-sensitive and inclusive. Health outcomes are influenced by a whole host of determinants. However, refugees and migrants face additional determinants such as precarious legal status; discrimination; social, cultural, linguistic, administrative and financial barriers; lack of information about health entitlements; low health literacy; and fear of detention and deportation. This groundbreaking publication outlines current and future opportunities and challenges and provides several strategies to improve the health and well-being of refugees and migrants. It is an advocacy tool for national and international policy-makers involved in health and migration. Evidence on the health of refugees and migrants remains fragmented – comparable data across countries and over time are urgently needed to track progress towards the health-related United Nations Sustainable Development Goals. With only 8 years until the 2030 target date to transform our world, the time to act is now.
"This book can be read by anyone with an interest in migration and health, whether as an advocate for migrants health, as a student in a health profession, researcher or policy maker. It provides an ample orientation to the field in the European context. Among other important raised issues, it underlines an all too often neglected fact; health is a human right. By involving broad issues and problem areas from a variety of perspectives, the volume illustrates that migration and health is a field that can not be allocated to a single discipline." Carin Bjrngren Cuadra, Senior Lecturer, Malm University, Sweden Migrants make up a growing share of European populations. However, all too often their situation is compounded by problems with accessing health and other basic services. There is a need for tailored health policies, but robust data on the health needs of migrants and how best these needs can be met are scarce. Written by a collaboration of authors from three key international organisations (the European Observatory on Health Systems and Policies, the EUPHA Section on Migrant and Ethnic Minority Health, and the International Organization for Migration), as well as leading researchers from across Europe, the book thoroughly explores the different aspects of migration and health in the EU and how they can be addressed by health systems. Structured into five easy-to-follow sections, the volume includes: Contributions from experts from across Europe Key topics such as: access to human rights and health care; health issues faced by migrants; and the national and European policy response so far Conclusions drawn from the latest available evidence Comprehensive information on different aspects of health and migration and how they can best be addressed by health systems is still not easy to find. This book addresses this shortfall and will be of major value to researchers, students, policy-makers and practitioners concerned with migration and health in an increasingly diverse Europe.
The WHO European Region has faced high rates of external and internal migration in recent years, with concerns that this is contributing to the burden of tuberculosis (TB), multidrug-resistant TB (MDR-TB) and TB/HIV coinfection in some countries. This report examines evidence of effective and efficient service packages for the prevention, diagnosis and treatment of TB to inform strategies to address the TB burden in refugee and migrant populations. Significant regional variations were identified in both migration levels and TB burden in refugees and migrants, as well as in approaches to TB control, with low quality of evidence in many cases. While it is unlikely that a single strategy/package will be effective for all situations, the evidence highlights some common approaches that could guide policy-making and service development. TB elimination targets for the Region will not be met unless inequalities in access to screening and treatment for migrants are addressed, alongside efforts to tackle TB globally.
Refugees and asylum seekers are defined in many ways but can be considered as those who did not make a voluntary choice to leave their country of origin and cannot return home in safety. Outcome data are limited and mostly focused on perinatal and mental health but do suggest significant levels of unmet need. This scoping review considered 72 studies where refugees and asylum seekers formed part or all of the population studied. Access to appropriate health care across the WHO European Region is very varied and is overwhelmingly shaped by legal frameworks and the regulation of the migration process. The need for improved communication with asylum seekers and coordinated action between agencies within and beyond the medical system is widely noted. Improved data to support intersectoral working to address the health care needs of asylum seekers and refugees are imperative.
This book focuses on the closely interlinked areas of refugee migration and health. It discusses the main challenges of the recent unprecedented, extremely diverse and mostly unregulated refugee migration wave for Germany and Europe, and offers a broader view of refugee health from a European perspective. Health issues can lead to several challenges for refugees as well as healthcare providers, and as such the book also examines the requirements for the management of migrant populations in terms of medical care and health system adaptations, and includes theoretical aspects of refugee migration and health as well as various perspectives on the latest developments. Lastly, it describes the healthcare system demands and responses for short- and long-term care of refugees.
The provision of effective health care to linguistically and culturally diverse migrant populations has been identified as a crucial public health issue. This scoping review examines strategies which have been implemented and evaluated to address communication barriers experienced by refugees and migrants in health care settings across the WHO European Region. Four main types of strategy were identified: cultural mediation interpretation translation of health information and guidance and training for health care providers. These have been used to support access to health care management of specific diseases and promotion of health across a wide variety of health care settings. Intersectoral collaboration was seen as important in the development and implementation of strategies. Policy considerations include the development of national policies and the promotion of intersectoral dialogue to augment the knowledge base and resolve the common issues identified such as provision of training and confusion regarding the roles of mediators/interpreters that affect strategy implementation and evaluation.
International migration, particularly to Europe, has increased in the last few decades, making research on aspects of this phenomenon, including numbers, challenges, and successes, particularly vital. This Special Issue highlights this necessary and relevant area of research. It presents 37 articles including studies on diverse topics relating to the health of refugees and migrants. Most articles (28) present studies focusing on European host countries. The focus on Europe is justified if we take into consideration the increased number of refugees and migrants who have come to Europe in recent years. However, there are also articles which present studies from countries in other continents. The topics discussed in the Issue include healthcare utilization, infectious diseases, mother and child health, mental health, and chronic diseases. Finding from the included articles indicate that further development of guidelines and policies at both local and international levels is needed. Priorities must be set by encouraging and funding in-depth research that aims to evaluate the impact of existing policies and interventions. Such research will help us formulate recommendations for the development of strategies and approaches that improve and strengthen the integration of migrants and refugees into the host countries.