Public health nursing education viewed through the lens of superdiversity: a resource for global health.

BACKGROUND: Nurses are increasingly confronted with the challenge of globalization and the acceleration of migratory flows. This reality affects the notion of culture and its influence on health-related behaviors. The state of health of the population in the Canton of Geneva, where there is a wide diversity of origins, is characterized by significant differences. The term "superdiversity" is used to describe the increasing complexity in ethnic diversity due to migration and social stratification. Nursing education in Geneva, influenced by the Bologna Process, appears appropriate for superdiverse contexts of care, with the development of dedicated competencies. AIM: This discussion paper aims to examine the academic curricula implemented in Geneva in the light of the concept of superdiversity. MAIN TEXT: In Geneva, nursing education and curricula in public health are based on a competence framework for nursing care divided into 7 roles and educational tracks. Bachelor's-level nurses know how to assess a care problem quickly and solve it effectively by setting relevant priorities, and do so based on evidence. The curricula aim to teach nurses to design population and individual interventions in their superdiverse context. DISCUSSION: Education should enable students to develop their role as health promoters for the well-being of patients and communities, taking into account cultural complexity. CONCLUSIONS: Superdiverse contexts highlight the role of nurse educators in preparing future generations of public health nurses.

Health of undocumented migrants in primary care in Switzerland.

BACKGROUND: Undocumented migrants endure adverse living conditions while facing barriers to access healthcare. Evidence is lacking regarding their healthcare needs, notably in regards to chronic diseases. Our goal was to investigate health conditions in undocumented migrants attended in primary care setting. METHODS: This study was conducted at the primary care outpatient clinic, Geneva University Hospitals, Switzerland. We retrospectively recorded and coded all medical conditions of a random sample of 731 undocumented migrants using the International Classification of Primary Care, 2nd version (ICPC-2). We dichotomized conditions as chronic or non-chronic and considered multimorbidity in the presence of three or more chronic conditions. RESULTS: Participants originated from 72 countries and were mainly female (65.5%) with a mean age of 42.4 (standard deviation [SD]: 11.4) years. They presented a mean of 2.9 (SD: 2.1; range: 1-17) health conditions. In multivariable analysis, the number of conditions was associated with female gender (p = 0.011) and older age (p <0.001), but not with origin (p = 0.373). The body systems most frequently affected were endocrine, metabolic and nutritional (n = 386; 18.4%), musculoskeletal (n = 308, 14.7%) and digestive (n = 266, 12.8%). Hypertension (17.9%; 95% CI: 15.2%, 29.9%), obesity or overweight (16%; 95% CI: 13.4%, 18.9%) and gastric problems (14.1%; 95% CI: 11.6%, 16.8%) were most prevalent. Overall, 71.8% (95% CI: 68.5%, 75%) participants had at least one chronic condition while 20% (95% CI: 17.2%, 23.1%) had three or more. In multivariable analysis, age (p <0.001) was the only predictor of presenting at least one or three or more chronic conditions. CONCLUSIONS: Undocumented migrants present multiple health problems in primary care settings and bear an important burden of chronic diseases. The extent of multimorbidity highlights the need to provide and facilitate the access to comprehensive and long-term primary healthcare services.