CONTEXT: Migration is one of the most politically pressing issues of the 21st century but migrant health remains an under‐researched area. The International Collaboration for Participatory Health Research (ICPHR) working group on migration developed this position statement to address opportunities and challenges in relation to migrant health. It aims to contribute to a shift from a deficit model that sees migrants as passively affected by policies to their reconceptualization as citizens who are engaged in the co‐creation of solutions. METHODS: This paper examines the opportunities and challenges posed by the use of PHR with migrants. It draws on a broad literature to provide examples of successful PHR with migrants and highlights critical issues for consideration. FINDINGS: Successful initiatives illustrate the value of engaging migrants in the definition of the research agenda, the design and implementation of health interventions, the identification of health‐protective factors and the operationalization and validation of indicators to monitor progress. Within increasingly super diverse contexts, fragmented community landscapes that are not necessarily constructed along ethnicity traits, inadequate structures of representation, local tensions and operational barriers can hamper meaningful PHR with migrants. CONCLUSION: For each research context, it is essential to gauge the 'optimal' level and type of participation that is more likely to leverage migrants' empowerment. The development of Monitoring and Evaluation tools and methodological strategies to manage inter‐stakeholder discrepancies and knowledge translation gaps are steps in this direction. PATIENT OR PUBLIC CONTRIBUTION: This paper draws from contributions of migrant populations and other stakeholders to policymaking.
peer-reviewed ; Context: Migration is one of the most politically pressing issues of the 21st century but migrant health remains an under-researched area. The International Collaboration for Participatory Health Research (ICPHR) working group on migration developed this position statement to address opportunities and challenges in relation to migrant health. It aims to contribute to a shift from a deficit model that sees migrants as pas sively affected by policies to their reconceptualization as citizens who are engaged in the co-creation of solutions. Methods: This paper examines the opportunities and challenges posed by the use of PHR with migrants. It draws on a broad literature to provide examples of successful PHR with migrants and highlights critical issues for consideration. Findings: Successful initiatives illustrate the value of engaging migrants in the defini tion of the research agenda, the design and implementation of health interventions, the identification of health-protective factors and the operationalization and vali dation of indicators to monitor progress. Within increasingly super diverse contexts, fragmented community landscapes that are not necessarily constructed along eth nicity traits, inadequate structures of representation, local tensions and operational barriers can hamper meaningful PHR with migrants. Conclusion: For each research context, it is essential to gauge the 'optimal' level and type of participation that is more likely to leverage migrants' empowerment. The development of Monitoring and Evaluation tools and methodological strategies to manage inter-stakeholder discrepancies and knowledge translation gaps are steps in this direction. Patient or public contribution: This paper draws from contributions of migrant popu lations and other stakeholders to policymaking.
RESUMO Objetivo: compreender como se dá a inserção do enfermeiro nos Bancos de Tecidos Oculares Humanos e identificar as dificuldades relatadas pelos enfermeiros dos serviços para a sua atuação. Método: estudo exploratório e descritivo, com abordagem qualitativa. Os dados foram produzidos por meio de entrevista semiestruturada, entre os meses abril e outubro de 2012, com sete enfermeiros e analisados com a Técnica de Análise de Conteúdo. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, Protocolo nº 010/2012. Resultados: compreende-se, ao analisar os resultados obtidos, que os conflitos no exercício do trabalho do enfermeiro apareceram sob diferentes manifestações e envolvem muitas vezes relações hierárquicas conflituosas. Os discursos mostram que os enfermeiros se consideram membros responsáveis pelo serviço de enfermagem e pela integração da equipe, mas se sentem tolhidos diante das estruturas políticas presentes. Descritores: Bancos de Olhos; Enfermagem; Córnea. ABSTRACT Objective: understanding the process of inclusion of nurses in the Human Ocular Tissue Banks and the difficulties reported by the nurses of the services for its operations. Method: an exploratory and descriptive study with a qualitative approach. Data were generated through semi-structured interviews conducted between April and October 2012, with seven nurses and analyzed with the technique of content analysis. The research project was approved by the Research Ethics Committee, Protocol 010/2012. Results: it is understood by analyzing the results obtained, that the conflicts in the exercise of the nurse's work appeared under different manifestations and often involve conflicting reporting relationships. The speeches show that nurses consider themselves members responsible for nursing services and integration team, but feel constrained, given the present political structures. Descriptors: Eye Banks; Nursing; Cornea. RESUMEN Objetivo: comprender cómo se da la inserción de las enfermeras en los Bancos de Tejido Ocular Humano e identificar las dificultades reportadas por las enfermeras de los servicios para su funcionamiento. Método: estudio descriptivo y exploratorio con un enfoque cualitativo. Los datos fueron producidos a través de entrevistas semi-estructuradas, entre abril y octubre de 2012, con siete enfermeras y analizados con la técnica de análisis de contenido. El proyecto de investigación ha sido aprobado por el Comité de ética en la investigación, Protocolo nº 010/2012. Resultados: se comprende, al analizar los resultados obtenidos, que los conflictos en el trabajo de las enfermeras aparecieron bajo diferentes manifestaciones e involucran a menudo relaciones jerárquicas conflictivas. Los discursos muestran que las enfermeras se consideran miembros responsables por el servicio de enfermería y por la integración del equipo, pero sientan restringidas dada las actuales estructuras políticas. Descriptores: Bancos de Ojos; Enfermería; Córnea. ; ABSTRACT Objective: understanding the process of inclusion of nurses in the Human Ocular Tissue Banks and the difficulties reported by the nurses of the services for its operations. Method: an exploratory and descriptive study with a qualitative approach. Data were generated through semi-structured interviews conducted between April and October 2012, with seven nurses and analyzed with the technique of content analysis. The research project was approved by the Research Ethics Committee, Protocol 010/2012. Results: it is understood by analyzing the results obtained, that the conflicts in the exercise of the nurse's work appeared under different manifestations and often involve conflicting reporting relationships. The speeches show that nurses consider themselves members responsible for nursing services and integration team, but feel constrained, given the present political structures. Descriptors: Eye Banks; Nursing; Cornea. RESUMO Objetivo: compreender como se dá a inserção do enfermeiro nos Bancos de Tecidos Oculares Humanos e identificar as dificuldades relatadas pelos enfermeiros dos serviços para a sua atuação. Método: estudo exploratório e descritivo, com abordagem qualitativa. Os dados foram produzidos por meio de entrevista semiestruturada, entre os meses abril e outubro de 2012, com sete enfermeiros e analisados com a Técnica de Análise de Conteúdo. O projeto de pesquisa foi aprovado pelo Comitê de Ética em Pesquisa, Protocolo nº 010/2012. Resultados: compreende-se, ao analisar os resultados obtidos, que os conflitos no exercício do trabalho do enfermeiro apareceram sob diferentes manifestações e envolvem muitas vezes relações hierárquicas conflituosas. Os discursos mostram que os enfermeiros se consideram membros responsáveis pelo serviço de enfermagem e pela integração da equipe, mas se sentem tolhidos diante das estruturas políticas presentes. Descritores: Bancos de Olhos; Enfermagem; Córnea. RESUMEN Objetivo: comprender cómo se da la inserción de las enfermeras en los Bancos de Tejido Ocular Humano e identificar las dificultades reportadas por las enfermeras de los servicios para su funcionamiento. Método: estudio descriptivo y exploratorio con un enfoque cualitativo. Los datos fueron producidos a través de entrevistas semi-estructuradas, entre abril y octubre de 2012, con siete enfermeras y analizados con la técnica de análisis de contenido. El proyecto de investigación ha sido aprobado por el Comité de ética en la investigación, Protocolo nº 010/2012. Resultados: se comprende, al analizar los resultados obtenidos, que los conflictos en el trabajo de las enfermeras aparecieron bajo diferentes manifestaciones e involucran a menudo relaciones jerárquicas conflictivas. Los discursos muestran que las enfermeras se consideran miembros responsables por el servicio de enfermería y por la integración del equipo, pero sientan restringidas dada las actuales estructuras políticas. Descriptores: Bancos de Ojos; Enfermería; Córnea.
Background: Preventive health services (PHSs) form part of primary healthcare with the aim of screening to prevent disease. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with the native populations. This can have a significant impact on migrants' access to health systems and participation in prevention programmes. Even in countries with widely accessible healthcare systems, migrants' access to PHSs may be difficult. The aim of the study was to compare access to preventive health services between migrants and native populations in five European Union (EU) countries. Methods: Information from Health Interview Surveys of Belgium, Italy, Malta, Portugal and Spain were used to analyse access to mammography, Pap smear tests, colorectal cancer screening and flu vaccination among migrants. The comparative risk of not accessing PHSs was calculated using a mixed-effects multilevel model, adjusting for potential confounding factors (sex, education and the presence of disability). Migrant status was defined according to citizenship, with a distinction made between EU and non-EU countries. Results: Migrants, in particular those from non-EU countries, were found to have poorer access to PHSs. The overall risk of not reporting a screening test or a flu vaccination ranged from a minimum of 1.8 times (colorectal cancer screening), to a high of 4.4 times (flu vaccination) for migrants. The comparison among the five EU countries included in the study showed similarities, with particularly limited access recorded in Italy and in Belgium for non-EU migrants. Conclusions: The findings of this study are in accordance with evidence from the scientific literature. Poor organization of health services, in Italy, and lack of targeted health policies in Belgium may explain these findings. PHSs should be responsive to patient diversity, probably more so than other health services. There is a need for diversity-oriented, migrant-sensitive prevention. Policies oriented to removing impediments to migrants' access to preventive interventions are crucial, to encourage more positive action for those facing the risk of intersectional discrimination. ; peer-reviewed
Background: Preventive health services (PHSs) form part of primary healthcare with the aim of screening to prevent disease. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with the native populations. This can have a significant impact on migrants' access to health systems and participation in prevention programmes. Even in countries with widely accessible healthcare systems, migrants' access to PHSs may be difficult. The aim of the study was to compare access to preventive health services between migrants and native populations in five European Union (EU) countries. Methods: Information from Health Interview Surveys of Belgium, Italy, Malta, Portugal and Spain were used to analyse access to mammography, Pap smear tests, colorectal cancer screening and flu vaccination among migrants. The comparative risk of not accessing PHSs was calculated using a mixed-effects multilevel model, adjusting for potential confounding factors (sex, education and the presence of disability). Migrant status was defined according to citizenship, with a distinction made between EU and non-EU countries. Results: Migrants, in particular those from non-EU countries, were found to have poorer access to PHSs. The overall risk of not reporting a screening test or a flu vaccination ranged from a minimum of 1.8 times (colorectal cancer screening), to a high of 4.4 times (flu vaccination) for migrants. The comparison among the five EU countries included in the study showed similarities, with particularly limited access recorded in Italy and in Belgium for non- EU migrants. Conclusions: The findings of this study are in accordance with evidence from the scientific literature. Poor organization of health services, in Italy, and lack of targeted health policies in Belgium may explain these findings. PHSs should be responsive to patient diversity, probably more so than other health services. There is a need for diversity-oriented, migrant-sensitive prevention. Policies oriented to removing impediments to migrants' access to preventive interventions are crucial, to encourage more positive action for those facing the risk of intersectional discrimination.
Background: Preventive health services (PHSs) form part of primary healthcare with the aim of screening to prevent disease. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with the native populations. This can have a significant impact on migrants' access to health systems and participation in prevention programmes. Even in countries with widely accessible healthcare systems, migrants' access to PHSs may be difficult. The aim of the study was to compare access to preventive health services between migrants and native populations in five European Union (EU) countries. Methods: Information from Health Interview Surveys of Belgium, Italy, Malta, Portugal and Spain were used to analyse access to mammography, Pap smear tests, colorectal cancer screening and flu vaccination among migrants. The comparative risk of not accessing PHSs was calculated using a mixed-effects multilevel model, adjusting for potential confounding factors (sex, education and the presence of disability). Migrant status was defined according to citizenship, with a distinction made between EU and non-EU countries. Results: Migrants, in particular those from non-EU countries, were found to have poorer access to PHSs. The overall risk of not reporting a screening test or a flu vaccination ranged from a minimum of 1.8 times (colorectal cancer screening), to a high of 4.4 times (flu vaccination) for migrants. The comparison among the five EU countries included in the study showed similarities, with particularly limited access recorded in Italy and in Belgium for non- EU migrants. Conclusions: The findings of this study are in accordance with evidence from the scientific literature. Poor organization of health services, in Italy, and lack of targeted health policies in Belgium may explain these findings. PHSs should be responsive to patient diversity, probably more so than other health services. There is a need for diversity-oriented, migrant-sensitive prevention. Policies oriented to removing impediments to migrants' access to preventive interventions are crucial, to encourage more positive action for those facing the risk of intersectional discrimination.
Background: Preventive health services (PHSs) form part of primary healthcare with the aim of screening to prevent disease. Migrants show significant differences in lifestyle, health beliefs and risk factors compared with the native populations. This can have a significant impact on migrants' access to health systems and participation in prevention programmes. Even in countries with widely accessible healthcare systems, migrants' access to PHSs may be difficult. The aim of the study was to compare access to preventive health services between migrants and native populations in five European Union (EU) countries. Methods: Information from Health Interview Surveys of Belgium, Italy, Malta, Portugal and Spain were used to analyse access to mammography, Pap smear tests, colorectal cancer screening and flu vaccination among migrants. The comparative risk of not accessing PHSs was calculated using a mixed-effects multilevel model, adjusting for potential confounding factors (sex, education and the presence of disability). Migrant status was defined according to citizenship, with a distinction made between EU and non-EU countries. Results: Migrants, in particular those from non-EU countries, were found to have poorer access to PHSs. The overall risk of not reporting a screening test or a flu vaccination ranged from a minimum of 1.8 times (colorectal cancer screening), to a high of 4.4 times (flu vaccination) for migrants. The comparison among the five EU countries included in the study showed similarities, with particularly limited access recorded in Italy and in Belgium for non-EU migrants. Conclusions: The findings of this study are in accordance with evidence from the scientific literature. Poor organization of health services, in Italy, and lack of targeted health policies in Belgium may explain these findings. PHSs should be responsive to patient diversity, probably more so than other health services. There is a need for diversity-oriented, migrant-sensitive prevention. Policies oriented to removing impediments to migrants' access to preventive interventions are crucial, to encourage more positive action for those facing the risk of intersectional discrimination. ; publishersversion ; published
Ferreira-Borges, C., Endal, D., Babor, T., Dias, S., Kachiwiya, M., & Zakeyu, N. (2014). Alcohol policy process in Malawi: Making it happen. The International Journal Of Alcohol And Drug Research, 3(3), 187 – 192. doi:http://dx.doi.org/10.7895/ijadr.v3i3.156Aims: This paper presents the recent history of alcohol-policy development in Malawi, describing changes in the policy process, initiatives to expand the involvement of relevant stakeholders, and efforts to limit the role and influence of vested commercial interests. We also note the challenges that remain for alcohol-policy formulation in Malawi.Design: We used a holistic, single case-study design to illustrate the process, using information generated from a combination of direct and indirect observations, document reviews, media analysis, and in-depth and semi-structured interviews.Findings: Alcohol policy development in Malawi reflects a complex combination of political and social processes, fraught with numerous stakeholder conflicts and political power plays. Despite the influence of the alcohol industry in the agenda-setting and consultative process, when adequately resourced and supported, civil society organizations can play an important and productive role in steering policy developments in a sound public-interest direction.Conclusions: Documenting this type of practical "natural experiment" provides an important opportunity for learning. The Malawi case study reinforces the need for more regular policy analysis of similar initiatives—in particular, in low-income developing countries—and for additional study of the alcohol-policy development process and policy implementation.
This panel discussion session explores some of the central dimensions of the Crisis in the Anthropocene that constitute global social challenges in the context of development studies. The conference theme highlighted the profound human impact on our blue-green-brown planet, that is already breaching planetary boundaries and pushing us beyond the roughly 1.5°C tipping point. This threatens liveability and sustainability in many localities and regions and may well rapidly be 'off the scale' of imaginability and survivability. Inevitably, as mounting empirical evidence and increasingly clear projections by the IPCC and other authoritative bodies show, these impacts are unevenly spread, both socially and spatially, both now and over the coming decades. The urgency of appropriate action is undeniable and we already know many dimensions of the required adaptations and transformations. Yet progress mostly remains too slow. These challenges are vital to the development studies community – heterogenous as it is – with our concerns for tackling poverty, inequality, deprivation and environmental degradation globally and locally. Hence this symposium asks what the crisis means for development theory, policy and practice and what development studies can and should be contributing to – and, indeed, whether it is capable of – addressing some key dimensions that warrant greater attention.
Background: Cervical cancer claims 311,000 lives annually, and 90% of these deaths occur in low- and middle-income countries. Cervical cancer is a highly preventable and treatable disease, if detected through screening at an early stage. Governments have a responsibility to screen women for precancerous cervical lesions. Yet, national screening programmes overlook many poor women and those marginalised in society. Under-screened women (called hard-to-reach) experience a higher incidence of cervical cancer and elevated mortality rates compared to regularly-screened women. Such inequalities deprive hard-to-reach women of the full enjoyment of their right to sexual and reproductive health, as laid out in Article 12 of the International Covenant on Economic, Social and Cultural Rights and General Comment No. 22. Discussion: This article argues first for tailored and innovative national cervical cancer screening programmes (NCSP) grounded in human rights law, to close the disparity between women who are afforded screening and those who are not. Second, acknowledging socioeconomic disparities requires governments to adopt and refine universal cancer control through NCSPs aligned with human rights duties, including to reach all eligible women. Commonly reported- and chronically under-addressed- screening disparities relate to the availability of sufficient health facilities and human resources (example from Kenya), the physical accessibility of health services for rural and remote populations (example from Brazil), and the accessibility of information sensitive to cultural, ethnic, and linguistic barriers (example from Ecuador). Third, governments can adopt new technologies to overcome individual and structural barriers to cervical cancer screening. National cervical cancer screening programmes should tailor screening methods to under-screened women, bearing in mind that eliminating systemic discrimination may require committing greater resources to traditionally neglected groups. Conclusion: Governments have human rights obligations to refocus screening policies and programmes on women who are disproportionately affected by discrimination that impairs their full enjoyment of the right to sexual and reproductive health. National cervical cancer screening programmes that keep the right to health principles (above) central will be able to expand screening among low-income, isolated and other marginalised populations, but also women in general, who, for a variety of reasons, do not visit healthcare providers for regular screenings. ; publishersversion ; published
Background: European Member States are facing a challenge to provide accessible and effective health care services for immigrants. It remains unclear how best to achieve this and what characterises good practice in increasingly multicultural societies across Europe. This study assessed the views and values of professionals working in different health care contexts and in different European countries as to what constitutes good practice in health care for immigrants. Methods: A total of 134 experts in 16 EU Member States participated in a three-round Delphi process. The experts represented four different fields: academia, Non-Governmental Organisations, policy-making and health care practice. For each country, the process aimed to produce a national consensus list of the most important factors characterising good practice in health care for migrants. Results: The scoring procedures resulted in 10 to 16 factors being identified as the most important for each participating country. All 186 factors were aggregated into 9 themes: (1) easy and equal access to health care, (2) empowerment of migrants, (3) culturally sensitive health care services, (4) quality of care, (5) patient/health care provider communication, (6) respect towards migrants, (7) networking in and outside health services, (8) targeted outreach activities, and (9) availability of data about specificities in migrant health care and prevention. Although local political debate, level of immigration and the nature of local health care systems influenced the selection and rating of factors within each country, there was a broad European consensus on most factors. Yet, discordance remained both within countries, e. g. on the need for prioritising cultural differences, and between countries, e. g. on the need for more consistent governance of health care services for immigrants. Conclusions: Experts across Europe asserted the right to culturally sensitive health care for all immigrants. There is a broad consensus among experts about the major principles of good practice that need to be implemented across Europe. However, there also is some disagreement both within and between countries on specific issues that require further research and debate.
