ABSTRACT
Uptake of preventive measures to reduce transmission of viruses such as SARS-CoV-2, is crucial in the control of pandemics. To ensure equitable uptake we explored contextual factors that shaped uptake of COVID-19 preventive measures amongst smaller, albeit substantial, migrant populations in the Netherlands. 39 persons of Eritrean, Ghanaian, Indonesian and Filipino origin, with diverse legal status and length of stay in the Netherlands, participated in five online focus group discussions. Thematic analysis of data was informed by concepts from the Precaution Adoption Process Model and Protection Motivation Theory. Awareness and knowledge of preventive measures was shaped by limited Dutch proficiency, access to understandable information and interference of misinformation. Engagement by preventive measures was subject to COVID-19 threat appraisal and the ease with which complex behavioural messages could be translated to individual situations. Perceived vulnerability of undocumented migrants in particular, motivated information-seeking. A strong social norm to keep with cultural and religious practices, and limited opportunity for preventive behaviour in work and home context hindered uptake of preventive behaviour. Preventive measures brought about job, food, and housing insecurity, and increased barriers in access to healthcare for undocumented migrants. Migration-related, sociocultural, and socioeconomic factors shape uptake of preventive measures. Preventive measures negatively impact work, housing and access to healthcare of undocumented migrants. Our results suggest importance of multilingual information tailored to literacy needs;education and modelling of behaviour;and, regulations to ensure continued access to financial and material resources to minimise negative spill-over effects. Results were incorporated in two policy briefs advising local and national government. Collaboration with municipal health services lead to multilingual public health information. Key messages • Migration-related, sociocultural, and socioeconomic factors shape uptake of preventive measures. • Preventive measures negatively impact work, housing and access to healthcare of undocumented migrants.
ABSTRACT
This article describes the impact of coronavirus disease 2019 (COVID-19) preventive measures on the undocumented migrant domestic workers in the Netherlands. Undocumented migrants (UDMs) are likely to experience inequalities due to the COVID-19 pandemic. They rely on the informal market for work and housing and are usually not entitled to a healthcare insurance. However, they are not represented in the COVID-19 registrations or surveys. In order to advise the policymakers and healthcare professionals on how to tailor the preventive activities in handling a pandemic, including vaccination strategy, to the needs of this group, an insight into their experiences is needed. In our qualitative study, two focus group discussions were held with 14 UDMs, recruited through a snowball technique. The UDMs perceived the COVID-19 as a threat. Their precarious position affected their perceived vulnerability, which motivated them to seek information on and comply with preventive measures and testing. However, structural barriers decreased their self-efficacy and opportunity to comply. The COVID-19 measures impacted the lives of UDMs on essential domains, resulting in job, food, and housing insecurity, and increased barriers in access to healthcare. An intersectoral approach addressing health communication, access to healthcare, and social support, as well as legal rights for safe employment, is needed to alleviate the impact of the measures on UDMs. Copyright © 2022 van den Muijsenbergh, Torensma, Skowronek, de Lange and Stronks.