ABSTRACT
Purpose: The reproductive health outcomes of international migrant women differ in comparison with receiving-country-born women, depending on country of birth and immigrant status. Effective interventions to support the reproductive health of international migrant women are not well known. Methods: We conducted a systematic review and meta-analysis of studies between 2010 and 2017 evaluating interventions directly or indirectly affecting the reproductive health (as defined by the World Health Organization) of international migrant women in Western-receiving countries. Results: Sixteen studies representing 5080 migrants were identified. Interventions consisted of linguistically (e.g., translated brochures) or culturally adapted (e.g., cultural narratives) routine care or new interventions. Meta-analysis showed that interventions increased rates of preventive reproductive health activities, including mammography, condom use, and Pap test completion, by almost 18% (95% confidence interval 7.61-28.3) compared with usual care or interventions not adapted to migrant women. Conclusion: Culturally and linguistically adapted care practices congruent with target populations of international migrant women are effective in improving their reproductive health outcomes, particularly their participation in preventative reproductive health activities.
ABSTRACT
Background: In 2015, over 850 000 refugees, asylum seekers and migrants arrived in Greece. In response to an overwhelming need for access to healthcare for them, Doctors of the World established the Refugee Ferry Project, which comprised of a clinic providing primary health care, and integrated mental health and psychosocial support on board a commercial ferry. Methods: Of the 1405 service users, 87.5% (1229/1405) originated from Syria, Afghanistan and Iraq. The majority were women 801/1405 (57%) and children 511/1405 (36%), including 50 pregnant women and 19 unaccompanied minors. Results: The most common diagnoses were respiratory tract infections, dehydration, nausea and vomiting, and musculoskeletal pain with 39.4% of the disease burden being classified as non-communicable. Exposure to violence was associated with an increased risk of developing mental health issues. Conclusions: Humanitarian actors face huge challenges trying to respond to the needs of transiting populations. It is only by continuous reassessment and having the capacity to mobilize and adapt to an ever-evolving situation that we can try to meet these needs. Having an integrated, flexible and multidisciplinary approach remains crucial, despite the shift from a transit to static population. With over 62 000 refugees stranded in Greece, the need to develop innovative ways to respond to their needs is greater than ever.
Subject(s)
Health Services Needs and Demand , Refugees , Ships , Greece , HumansABSTRACT
BACKGROUND: Globalisation is having profound impacts on health and healthcare. We solicited the views of a wide range of stakeholders in order to develop core global health competencies for postgraduate doctors. METHODS: Published literature and existing curricula informed writing of seven global health competencies for consultation. A modified policy Delphi involved an online survey and face-to-face and telephone interviews over three rounds. RESULTS: Over 250 stakeholders participated, including doctors, other health professionals, policymakers and members of the public from all continents of the world. Participants indicated that global health competence is essential for postgraduate doctors and other health professionals. Concerns were expressed about overburdening curricula and identifying what is 'essential' for whom. Conflicting perspectives emerged about the importance and relevance of different global health topics. Five core competencies were developed: (1) diversity, human rights and ethics; (2) environmental, social and economic determinants of health; (3) global epidemiology; (4) global health governance; and (5) health systems and health professionals. CONCLUSIONS: Global health can bring important perspectives to postgraduate curricula, enhancing the ability of doctors to provide quality care. These global health competencies require tailoring to meet different trainees' needs and facilitate their incorporation into curricula. Healthcare and global health are ever-changing; therefore, the competencies will need to be regularly reviewed and updated.
