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Fulltext The nutritional status of children in resettlement villages in Kelantan

Zulkifli A, Khairul Anuar A, Atiya AS

Southeast Asian J. Trop. Med. Public Health, 1999 Mar;30(1):122-8.
PMID: 10695800

A cross-sectional survey of the nutritional status of children aged 1-10 years old from the Kuala Betis resettlement villages was carried out. A total of 620 children were examined, of which 329 were preschool children and 291 were schoolchildren. The age was determined and anthropometric measurements such as weight, height and MUAC were taken. The nutritional status was assessed by looking at the distributions of the z-scores of weight-for-age (WAZ), height-for-age (HAZ) and weight-for-height (WHZ) in relation to the growth charts of the National Center for Health Statistics reference population. It was found that the nutritional status of the Orang Asli children was poor, with a prevalence of 33.7-65.3% underweight, 55.3-74.4% stunting and 4.4-29.7% wasting based on the NCHS reference values. The prevalence of malnutrition among the Malay children was lower, underweight--7.3-34.1%, stunting--9.8-34.1% and wasting--1.7-17.1%. The nutritional status of the Orang Asli children were poorer compared to the Malay children. More preschool Orang Asli children were stunted compared to the Orang Asli schoolchildren. This may be due to the poor economic base of the Orang Asli community during the transformation period after resettlement. A comprehensive primary health care program is essential, especially targeting the preschool Orang Asli children in these resettlement villages.

Matched MeSH terms: Refugees/statistics & numerical data*
Fulltext The need to map existing health care services for refugees in Malaysia

Yunus RM, Azme N, Chen XW, Badlishah-Sham SF, Miptah HN, Azraai AM

J Glob Health, 2021 Jan 30;11:03024.
PMID: 33692879 DOI: 10.7189/jogh.11.03024
Matched MeSH terms: Refugees*
Immunisation coverage and its determinants among Rohingya refugee children in Malaysia

Al-Haroni H, Muthanna A, Nasir Mohd Desa M, Azzani M

Aust J Gen Pract, 2023 Oct;52(10):712-719.
PMID: 37788693 DOI: 10.31128/AJGP-01-23-6676

BACKGROUND AND OBJECTIVES: The displacement of populations due to humanitarian emergencies has an adverse impact on the global elimination of vaccine-preventable diseases. However, the level of immunisation coverage among Rohingya refugee children remains unknown. Therefore, this study investigated immunisation coverage and its determinants among Rohingya refugee children in Malaysia.
METHOD: A cross-sectional study was conducted from September to November 2020 among the guardians of 243 Rohingya refugee children studying under the sponsorship of the King Salman Humanitarian Aid and Relief Center, Malaysia.
RESULTS: Among the 243 children, 90 (37%) were unimmunised, 147 (60.5%) were partially immunised and only 6 (2.5%) were fully immunised. The country of child's birth, the child's age and access to healthcare services were significantly associated with unimmunisation (all P<0.05).
DISCUSSION: This study found low immunisation coverage among Rohingya refugee children in Malaysia. Given the low level of coverage, a public health intervention, such as a vaccination program, for this refugee population is necessary.

Matched MeSH terms: Refugees*
Malaysia: a refugee conundrum

Bemma A

Lancet, 2018 01 13;391(10116):107-108.
PMID: 29353607 DOI: 10.1016/S0140-6736(18)30052-7
Matched MeSH terms: Refugees/statistics & numerical data*
Fulltext Evaluation of Measles-Mumps-Rubella Vaccination Among Newly Arrived Refugees

Lee D, Weinberg M, Benoit S

Am J Public Health, 2017 05;107(5):684-686.
PMID: 28323479 DOI: 10.2105/AJPH.2017.303698

OBJECTIVES: To assess US availability and use of measles-mumps-rubella (MMR) vaccination documentation for refugees vaccinated overseas.
METHODS: We selected 1500 refugee records from 14 states from March 2013 through July 2015 to determine whether overseas vaccination records were available at the US postarrival health assessment and integrated into the Advisory Committee on Immunization Practices schedule. We assessed number of doses, dosing interval, and contraindications.
RESULTS: Twelve of 14 (85.7%) states provided data on 1118 (74.5%) refugees. Overseas records for 972 (86.9%) refugees were available, most from the Centers for Disease Control and Prevention's Electronic Disease Notification system (66.9%). Most refugees (829; 85.3%) were assessed appropriately for MMR vaccination; 37 (3.8%) should have received MMR vaccine but did not; 106 (10.9%) did not need the MMR vaccine but were vaccinated.
CONCLUSIONS: Overseas documentation was available at most clinics, and MMR vaccinations typically were given when needed. Further collaboration between refugee health clinics and state immunization information systems would improve accessibility of vaccination documentation.

Matched MeSH terms: Refugees*
Fulltext Seroprevalence of varicella-zoster virus in five US-bound refugee populations

Leung J, Lopez A, Mitchell T, Weinberg M, Lee D, Thieme M, et al.

J Immigr Minor Health, 2015 Feb;17(1):310-3.
PMID: 24271111 DOI: 10.1007/s10903-013-9946-x

Little is known about varicella-zoster virus (VZV) susceptibility in US-bound refugee populations, although published data suggest that VZV seroprevalence in these refugee populations may be lower than US populations. We describe VZV seroprevalence in five US-bound refugee groups: (1) Bhutanese in Nepal, (2) Burmese on the Thailand-Burma (Myanmar) border, (3) Burmese in Malaysia, (4) Iraqi in Jordan, and (5) Somali in Kenya. Sera were tested for presence of VZV IgG antibodies among adults aged 18-45 years. Overall VZV seroprevalence was 97% across all refugee groups. VZV seroprevalence was also high across all age groups, with seroprevalence ranging from 92-100% for 18-26 year-olds depending on refugee group and 93-100% for 27-45 year-olds. VZV seroprevalence was unexpectedly high in these five US-bound refugee groups, though may not reflect seroprevalence in other refugee groups. Additional studies are needed to better understand VZV seroprevalence in refugee populations over time and by region.

Matched MeSH terms: Refugees
Incidence and Prevention of Invasive Meningococcal Disease in Global Mass Gathering Events

Muttalif AR, Presa JV, Haridy H, Gamil A, Serra LC, Cané A

Infect Dis Ther, 2019 Dec;8(4):569-579.
PMID: 31471813 DOI: 10.1007/s40121-019-00262-9

INTRODUCTION: Mass gathering events involve close contact among large numbers of people in a specific location at the same time, an environment conducive to transmission of respiratory tract illnesses including invasive meningococcal disease (IMD). This report describes IMD incidence at mass gatherings over the past 10 years and discusses strategies to prevent IMD at such events.
METHODS: A PubMed search was conducted in December 2018 using a search string intended to identify articles describing IMD at mass gatherings, including religious pilgrimages, sports events, jamborees, and refugee camps. The search was limited to articles in English published from 2008 to 2018. Articles were included if they described IMD incidence at a mass gathering event.
RESULTS: A total of 127 articles were retrieved, of which 7 reported on IMD incidence at mass gatherings in the past 10 years. Specifically, in Saudi Arabia between 2002 and 2011, IMD occurred in 16 Hajj pilgrims and 1 Umrah pilgrim; serotypes involved were not reported. At a youth sports festival in Spain in 2008, 1 case of serogroup B IMD was reported among 1500 attendees. At the 2015 World Scout Jamboree in Japan, an outbreak of serogroup W IMD was identified in five scouts and one parent. At a refugee camp in Turkey, one case of serogroup B IMD was reported in a Syrian girl; four cases of serogroup X IMD occurred in an Italian refugee camp among refugees from Africa and Bangladesh. In 2017, a funeral in Liberia resulted in 13 identified cases of serogroup C IMD. Requiring meningococcal vaccination for mass gathering attendees and vaccinating refugees might have prevented these IMD cases.
CONCLUSIONS: Mass gathering events increase IMD risk among attendees and their close contacts. Vaccines preventing IMD caused by serogroups ACWY and B are available and should be recommended for mass gathering attendees.
FUNDING: Pfizer.

Matched MeSH terms: Refugees
Fulltext Measles outbreak associated with an arriving refugee - Los Angeles County, California, August-September 2011

Centers for Disease Control and Prevention (CDC)

MMWR Morb Mortal Wkly Rep, 2012 Jun 1;61(21):385-9.
PMID: 22647743

Measles is a highly communicable, acute viral illness with potential for severe complications, including death. Although endemic measles was eliminated in the United States in 2000 as a result of widespread vaccination, sporadic measles outbreaks still occur, largely associated with international travel from measles-endemic countries and pockets of unvaccinated persons. On August 26, 2011, the Los Angeles County Department of Public Health (LACDPH) was notified of suspected measles in a refugee from Burma who had arrived in Los Angeles, California, on August 24, after a flight from Kuala Lumpur, Malaysia. Passengers on the flight included 31 other refugees who then traveled to seven other states, widening the measles investigation and response activities. In California alone, 50 staff members from LACDPH and the California Department of Public Health (CDPH) interviewed and reinterviewed 298 contacts. Measles was diagnosed in three contacts of the index patient (patient A). The three contacts with measles were two passengers on the same flight as patient A and a customs worker; no secondary cases were identified. Delayed diagnosis of measles in patient A and delayed notification of health officials precluded use of measles-mumps-rubella (MMR) vaccine as an outbreak intervention. This outbreak emphasizes the importance of maintaining a high level of vaccination coverage and continued high vigilance for measles in the United States, particularly among incoming international travelers; clinicians should immediately isolate persons with suspected measles and promptly report them to health authorities.

Matched MeSH terms: Refugees*
Fulltext Measles among U.S.-bound refugees from Malaysia--California, Maryland, North Carolina, and Wisconsin, August-September 2011

Centers for Disease Control and Prevention (CDC)

MMWR Morb Mortal Wkly Rep, 2011 Sep 23;60(37):1281-2.
PMID: 21937975

On August 26, 2011, California public health officials notified CDC of a suspected measles case in an unvaccinated male refugee aged 15 years from Burma (the index patient), who had lived in an urban area of Kuala Lumpur, Malaysia, which is experiencing ongoing measles outbreaks. Currently, approximately 92,000 such refugees are living in urban communities in Malaysia. Resettlement programs in the United States and other countries are ongoing. The health and vaccination status of urban refugees are largely unknown.

Matched MeSH terms: Refugees*
The Proportion of Infectious Disease Cases, Its Associated Factors, and the Appropriateness of Antimicrobial Prescription Among Rohingya Refugee Pediatric Patients in IMARET Mobile Clinics

Tahir ARM, Ee XW, Rashid AA, Yahaya AYB, Devaraj NK

J Immigr Minor Health, 2021 Dec;23(6):1159-1169.
PMID: 33543426 DOI: 10.1007/s10903-021-01150-6

The Rohingyas fled from their home to escape ethnic persecution. Due to their status as refugees they have difficulties in accessing healthcare leading to avoidable mortality and morbidity. Infectious diseases are reported to be among the causes. To ease access to healthcare, IMAM Response and Relief Team (IMARET) provides a free monthly clinic for them. The objective of this study is to determine the proportion of infectious diseases and appropriateness of antimicrobial usage among its pediatrics patients. It was conducted in 2017, through universal sampling. Information retrieved were via interviews and medical records. The majority diagnosis were infectious diseases (57.1%), which include respiratory infections (77.3%), skin (13.6%), gastrointestinal (4.5%), eye and ear infection (both 1%). Albendazole (40.7%) was the most prescribed. Only 7.4% were appropriately prescribed antimicrobials. Age (p = 0.005) and BMI (p = 0.006) were significantly associated with infections.

Matched MeSH terms: Refugees*
Muslim refugees in Southeast Asia, the Malaysian response

Dorall RF

Asian Migr, 1988 May-Jun;1(3):88-93.
PMID: 12281348

This article surveys the arrivals of Muslim refugees from countries in Southeast Asia who have not only come to Malaysia for political refuge, but who have also stayed on, in many instances integrating into the local Muslim community. The author concludes that Burmese, Thai, and Filipino Muslim refugee-cum-migrants, and the estimated 500,000 illegal Indonesian migrant workers in East and Peninsular Malaysia make the presence of economic migrants in Malaysia's towns and rural sectors a far more pressing concern to Malaysians than that posed by the arrival of genuine political refugees. Only the Indonesians present in Malaysia are consistently termed by all parties as illegal migrants and some of them have been subjected to well-publicized deportation by the Malaysian immigration authorities. Sympathy for fellow-Muslims in distress explains Malaysia's open-door policy to Muslim refugees. The Koran specifically enjoins Muslims to assist Muslim refugees who have been persecuted by others. However, the necessity to maintain regional political and military alliances, principally as a bulwark against Communism, and the Malay--Non-Malay, Muslim--Non-Muslim dichotomy in Malaysia which almost evenly divides Malaysia's 16 million population into mutually antagonistic halves, results in any overt public policy in favor of Malays and Muslims to be immediately denounced by the other half of the population as a move against the Non-Malays and Non-Muslims. Without political and media attention, the refugees live wherever they can find work, as do hundreds of thousands of mainly Indonesian illegal migrant workers. They surreptitiously get their children admitted to public schools, and through bribery, can even get Malaysian identification papers. Malaysia is a relatively tranquil haven for Malaysia's Muslim refugees compared to their homelands, but their continued stay remains dependent on the ever-present struggle for more equitable sharing of political and economic power between the different ethnic groups in Malaysia. At present, it is deemed inopportune to discuss publicly the issue of Muslim refugees in Malaysia. To do so would be to invite strong emotional responses from Malaysian Muslim groups objecting to refugee repatriation to what they see as continued persecution in Southeast Asia's non-Muslim countries, and from non-Muslim Malaysians who see in their continued presence a possible long-term demographic threat. Furthermore, the presence of Muslim evacuees granted refugee status brings painful memories as to why non-Muslim refugees principally from Indochina were denied such a similar privilege.

Matched MeSH terms: Refugees*
Fulltext The United Nations (UN) Card, Identity, and Negotiations of Health among Rohingya Refugees

Rahman MM, Dutta MJ

Int J Environ Res Public Health, 2023 Feb 15;20(4).
PMID: 36834082 DOI: 10.3390/ijerph20043385

Being persecuted and expelled from Myanmar, Rohingya refugees are now distributed throughout the world. The Southeast Asian nation of Malaysia has been a preferred destination for Rohingyas fleeing Myanmar's state-sponsored genocide and more recently in a bid to change their fates from the refugee camps in Bangladesh. Refugees are one of the most vulnerable groups in Malaysia and often face dire circumstances, in which their health and wellbeing are compromised. Amidst a plethora of structural challenges, Rohingya refugees try to claim some of their rights with the aid of the UN card (UNHCR ID cards) in Malaysia. Guided by the culture-centered approach (CCA), this study examined the perspectives and experiences of healthcare among Rohingya refugees while living in Malaysia, now resettled in Aotearoa, New Zealand. The participants' narratives showed that the UN card not only materialized their refugee status in Malaysia but also offered them a way of living in a world where documents anchor the materiality of health.

Matched MeSH terms: Refugees*
Resilience in adolescent refugees living in Malaysia: The association with religiosity and religious coping

Chow MISP, Hashim AH, Guan NC

Int J Soc Psychiatry, 2021 Jun;67(4):376-385.
PMID: 32924726 DOI: 10.1177/0020764020957362

BACKGROUND: Until now, there is scarcity of information regarding resilience, religiosity and religious coping among adolescent refugees. Currently, most researches emphasize on the physical, psychological and social distresses experienced by refugees while overlooking these crucial aspects, that is, resilience and coping.
AIM: The study aimed to examine resilience and its association with religiosity and religious coping among adolescent refugees living in Malaysia.
METHODS: This is a cross-sectional study conducted in five community-based learning centres in Malaysia from July 2019 till December 2019. A total of 152 refugees, aged 13 to 19-years-old, were recruited. The study gauged resilience using the 14-Item Resilience Scale (RS-14), the Duke University Religion Index (DUREL) for religiosity and the Brief Religious Coping Scale (Brief RCOPE) for religious coping.
RESULTS: The majority of adolescent refugees portrayed moderate levels of resilience (43.5%). The study highlighted the interconnectedness between resilience and intrinsic religiosity (IR) (p

Matched MeSH terms: Refugees*
[The first monkey malaria in Turkey: a case of Plasmodium knowlesi]

Özbilgin A, Çavuş İ, Yıldırım A, Gündüz C

Mikrobiyol Bul, 2016 Jul;50(3):484-90.
PMID: 27525405

Plasmodium knowlesi is now added to the known four Plasmodium species (P.vivax, P.falciparum, P.malariae, P.ovale) as a cause of malaria in humans because of the recent increasing rate of cases reported from countries of southeastern Asia. P.knowlesi which infects macaque monkeys (Macaca fascicularis and M.nemestrina) is transmitted to humans especially by Anopheles leucosphyrus and An.hackeri mosquitos. First human cases of P.knowlesi malaria have been detected in Malaysia which have reached high numbers in recent years and also have been reported from countries of Southeast Asia such as Thailand, Philippines, Myanmar, Singapore and Vietnam. However the number of cases reported from western countries are rare and limited only within voyagers. This report is the first presentation of an imported case of P.knowlesi malaria in Turkey and aims to draw attention to the point that it could also be detected in future. A 33-year-old male patient from Myanmar who has migrated to Turkey as a refugee, was admitted to a health center with the complaints of fever with a periodicity of 24 hours, headache, fatigue, cough, sore throat, anorexia, myalgia and arthralgia. He was prediagnosed as upper respiratory tract infection, however because of his periodical fever and background in Myanmar, thick and thin blood films were prepared and sent to our laboratory for further examinations. Microscopic examination of the thin blood films revealed erythrocytic stages compatible with P.knowlesi (three large early trophozoites in an erythrocyte, three late trophozoites with compact view, and three late band-form trophozoites). Upon this, both real-time polymerase chain reaction (Rt-PCR) targeting the small subunit ribosomal RNA (SSU-rRNA) genes of Plasmodium genus and DNA sequence analysis targeting P.knowlesi rRNA gene were performed. As a result, the suspected identification of P.knowlesi by microscopy was confirmed by Rt-PCR and DNA sequencing. The patient was treated with chloroquine and primaquine combination and in the follow-up on the seventh day after the treatment, his parasitemia and symptoms had ceased. Although there were some previous reports concerning about imported patients infected with different Plasmodium species in our country, no cases of P.knowlesi have been reported. This first case presented here emphasizes the occurence of P.knowlesi malaria in Turkey hereinafter due to the increasing number of refugees.

Matched MeSH terms: Refugees
Trauma, mental health, and everyday functioning among Rohingya refugee people living in short- and long-term resettlements

Khan S, Haque S

Soc Psychiatry Psychiatr Epidemiol, 2021 Mar;56(3):497-512.
PMID: 33015727 DOI: 10.1007/s00127-020-01962-1

PURPOSE: This study investigated if Rohingya refugee people resettled in camps in rural Bangladesh and urban locations in Malaysia had different levels of trauma, mental health and everyday functioning. The study also examined if direct and indirect exposure to traumatic events could predict PTSD, depression, generalized anxiety, and everyday functioning in the two groups separately. An attempt was also made to see if the relations between trauma and mental health were different across the two settings.
METHODS: This was a cross-sectional study, for which we conveniently recruited 100 adult Rohingyas, 50 from each country; the majority was males. Rohingyas in Bangladesh fled Myanmar's Rakhine State following a major military crackdown in 2017, whereas Rohingyas in Malaysia fled Rakhine gradually over the last three decades because of recurrent violence and military operations. We assessed trauma (cumulative trauma, direct trauma, and indirect trauma), PTSD, depression, generalized anxiety, and everyday functioning of the participants using traumatic event questionnaire, PTSD-8, PHQ-9, GAD-7, and WHODAS-2.0.
RESULTS: The Bangladeshi cohort experienced more types of traumatic events (i.e., cumulative trauma) than did the Malaysian cohort (d = 0.58). Although the two cohorts did not differ in terms of indirect exposure to traumatic incidents (i.e., indirect trauma), the Malaysian cohort had direct exposure to traumatic events (i.e., direct trauma) more frequently than did the Bangladeshi cohort (d = 1.22). The Bangladeshi cohort showed higher PTSD (d = 1.67), depression (d = 0.81), generalized anxiety (d = 1.49), and functional impairment (d = 2.51) than those in Malaysia. Hierarchical linear regression analyses showed that after controlling for demographic variables, both direct and indirect trauma significantly predicted PTSD, depression, and functional impairment among Rohingyas in Bangladesh, with direct trauma being the stronger predictor. However, similar analyses showed that only indirect trauma predicted PTSD among Rohingyas in Malaysia, while all other effects were nonsignificant. The results also showed that the predictive relationship between direct trauma and PTSD was different across the two countries. With the same level of direct trauma, a participant from Malaysia would score 0.256 points lower in PTSD than a participant from Bangladesh.
CONCLUSION: The recently experienced direct and indirect trauma have impaired mental health and everyday functioning among the Bangladeshi cohort. However, only indirect trauma was active to cause PTSD in the Malaysian cohort as direct trauma was weakening due to the time elapsed since migration. We discuss the results in the context of the current theories of trauma and mental health and suggest therapeutic interventions for the refugee population.

Matched MeSH terms: Refugees*
Autobiographical memory impairment among Rohingya refugee people: roles of direct and indirect trauma exposures and PTSD symptom severity

Khan S, Haque S

Cogn Emot, 2021 12;35(8):1573-1587.
PMID: 34644246 DOI: 10.1080/02699931.2021.1990018

Literature indicates that trauma exposure leads to autobiographical memory (AM) impairment, but the differential effects of direct and indirect trauma on memory remain unclear. We investigated AMs of 100 Rohingya refugees (Meanage = 35.79; SDage = 15.36) recruited from camps in Bangladesh and communities in Malaysia. Each participant retrieved ten memories to word cues and rated to what extent those memories were self-defining on a 5-point scale. They also completed the PTSD-8 scale and a trauma checklist reporting the types of traumatic events they experienced. Results showed that participants with frequent exposure to direct and indirect trauma recalled more traumatic memories. Surprisingly, more direct-trauma memories appeared to be specific than indirect trauma and non-trauma memories. As expected, individuals who scored higher on the PTSD-8 scale recalled more non-specific AMs. Rohingyas in Bangladesh who migrated months before data collection, thus retaining recent trauma experiences , retrieved more non-specific memories than those in Malaysia who migrated years ago. The direct trauma memories of the Malaysian cohort were more self-defining than their counterparts. The participant's ability to recall more direct trauma memories with specificity could be attributed to the repeated recall of those memories to the relevant authorities of the host countries to justify their refugee status.

Matched MeSH terms: Refugees*
A group mental health randomized controlled trial for female refugees in Malaysia

Shaw SA, Ward KP, Pillai V, Hinton DE

Am J Orthopsychiatry, 2019;89(6):665-674.
PMID: 30035560 DOI: 10.1037/ort0000346

Forcibly displaced persons confront multiple stressors while awaiting permanent asylum or resettlement and often experience high levels of emotional distress. This study assessed an 8-week somatic-focused culturally adapted cognitive-behavioral therapy (CBT) group intervention with 39 female refugees from Afghanistan living in Kuala Lumpur, Malaysia. Twenty-nine participants were randomly assigned to treatment conditions, resulting in 20 participants in two separate treatment groups and 9 in a waitlist control group. An additional 10 participants were not randomly assigned and therefore were treated as an additional treatment group and analyzed separately. A three-group piecewise linear growth model was specified in Mplus using Bayesian estimation. Dependent variables included emotional distress, anxiety, depression, posttraumatic stress, and social support. From baseline to posttreatment assessments, initial intervention participants experienced significant declines in emotional distress (b = -16.90, p < .001), anxiety (b = -.80, p < .001), depression (b = -.59, p < .001), and posttraumatic stress (b = -.24, p < .05). Gains were maintained three months posttreatment, with similar trends observed among nonrandomized participants. Subsequent to receiving treatment, the waitlist control participants also showed significant declines in emotional distress (b = -20.88, p < .001), anxiety (b = -1.10, p < .001), depression (b = -.79, p < .001), and posttraumatic stress scores (b = -.82, p < .001). Comparing the treatment groups to the waitlist control group revealed large effect sizes: Cohen's d was 2.14 for emotional distress, 2.31 for anxiety, 2.42 for depression, and 2.07 for posttraumatic stress. Relevant public health findings include low drop out, group format, and facilitation by a trained community member. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Matched MeSH terms: Refugees/psychology*
Fulltext Southeast Asian health system challenges and responses to the 'Andaman Sea refugee crisis': A qualitative study of health-sector perspectives from Indonesia, Malaysia, Myanmar, and Thailand

Legido-Quigley H, Leh Hoon Chuah F, Howard N

PLoS Med, 2020 11;17(11):e1003143.
PMID: 33170834 DOI: 10.1371/journal.pmed.1003143

BACKGROUND: Southeast Asian countries host signficant numbers of forcibly displaced people. This study was conducted to examine how health systems in Southeast Asia have responded to the health system challenges of forced migration and refugee-related health including the health needs of populations affected by forced displacement; the health systems-level barriers and facilitators in addressing these needs; and the implications of existing health policies relating to forcibly displaced and refugee populations. This study aims to fill in the gap in knowledge by analysing how health systems are organised in Southeast Asia to address the health needs of forcibly displaced people.
METHODS AND FINDINGS: We conducted 30 semistructured interviews with health policy-makers, health service providers, and other experts working in the United Nations (n = 6), ministries and public health (n = 5), international (n = 9) and national civil society (n = 7), and academia (n = 3) based in Indonesia (n = 6), Malaysia (n = 10), Myanmar (n = 6), and Thailand (n = 8). Data were analysed thematically using deductive and inductive coding. Interviewees described the cumulative nature of health risks at each migratory phase. Perceived barriers to addressing migrants' cumulative health needs were primarily financial, juridico-political, and sociocultural, whereas key facilitators were many health workers' humanitarian stance and positive national commitment to pursuing universal health coverage (UHC). Across all countries, financial constraints were identified as the main challenges in addressing the comprehensive health needs of refugees and asylum seekers. Participants recommended regional and multisectoral approaches led by national governments, recognising refugee and asylum-seeker contributions, and promoting inclusion and livelihoods. Main study limitations included that we were not able to include migrant voices or those professionals not already interested in migrants.
CONCLUSIONS: To our knowledge, this is one of the first qualitative studies to investigate the health concerns and barriers to access among migrants experiencing forced displacement, particularly refugees and asylum seekers, in Southeast Asia. Findings provide practical new insights with implications for informing policy and practice. Overall, sociopolitical inclusion of forcibly displaced populations remains difficult in these four countries despite their significant contributions to host-country economies.

Matched MeSH terms: Refugees
Coronavirus Vaccination for Rohingya Refugees: A Call to Action

Rabby MII, Hossain F, Akhi IJ, Huda SN

Asia Pac J Public Health, 2022 01;34(1):148.
PMID: 34550014 DOI: 10.1177/10105395211048327
Matched MeSH terms: Refugees*
Fulltext Development and Testing of a Community-Based Intervention to Address Intimate Partner Violence among Rohingya and Syrian Refugees: A Social Norms-Based Mental Health-Integrated Approach

James LE, Welton-Mitchell C, Michael S, Santoadi F, Shakirah S, Hussin H, et al.

Int J Environ Res Public Health, 2021 11 07;18(21).
PMID: 34770188 DOI: 10.3390/ijerph182111674

Intimate partner violence (IPV) is the leading form of gender-based violence globally and increases during times of conflict and displacement. To reduce IPV and encourage help-seeking, a two-phase community-based intervention was co-designed with Rohingya in Malaysia and Syrians in Lebanon. Three day workshops, utilizing a social norms-based mental health-integrated approach, were implemented for women and men in each country (n = 148). Pre- to post-measures indicated reductions in beliefs about acceptability of violence and rigid gender norms, and improvements in mental health, functioning, coping, and self-efficacy for women and men following workshop participation. Workshop participation was also associated with increased help-seeking intent, for both mental health and IPV (victims and perpetrators). Workshops included community design of poster campaigns to address IPV, which were then tested in each setting using a randomized controlled trial in Malaysia (n = 240) and a matched cluster comparison in Lebanon (n = 260). Women in both settings found IPV less acceptable in the poster condition. Help-seeking preferences were also influenced by the poster for women and men in both countries. This participatory intervention research can provide a roadmap for use in other settings, emphasizing the value of community-generated solutions to IPV among displaced populations.

Matched MeSH terms: Refugees*

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