Analysis of Policies to Protect the Health of Urban Refugees and Asylum Seekers in Thailand: A Qualitative Study and Delphi Survey

The health of urban refugees and asylum seekers (URAS) in Bangkok has been neglected and health policies for USAR have not materialized. This study aimed to explore the views of stakeholders on policies to protect URAS well-being in Thailand. This study conducted a mixed-methods approach comprising both in-depth interviews and Delphi survey. The interview findings revealed six main themes: (1) the government position on URAS; (2) opinions on Thailand becoming a party of the 1951 Refugee Convention; (3) NGOs on health promotion for URAS; (4) options on health insurance management for URAS; (5) working potential of URAS; and (6) uncertainty of future life plans for URAS. The Delphi survey showed that URAS should have the right to acquire a work permit and be enrolled in the public insurance scheme managed by the Ministry of Public Health. Moreover, the ideology of national security was more influential than the concept of human rights. The ambiguity of the central authorities’ policy direction to take care of URAS creates haphazard legal interpretations. The Delphi survey findings suggested the need for a more inclusive policy for URAS, however actual policy implementation requires further research on policy feasibility and acceptance by the wider public.

Predictors of Access To Sexual And Reproductive Health Services By Urban Refugees In Kampala City, Uganda

Background: The influx of over 1.3 million refugees in Uganda, with over 10% settling in the capital city Kampala, challenges the ability of urban refugees to access Sexual and Reproductive Health services (SRH) and family planning (FP) amidst the multiple uncertainties of a precarious everyday life. Utilization of SRH services remains low among urban refugees despite the fact that these services are essential to those of reproductive age and vulnerable to unwanted pregnancies and its consequences and contracting sexually transmitted infections (STIs) including HIV. Mildmay Uganda conducted a multimethod outreach program to establish the predictors of access to SRH services by urban refugees in Kampala city. This paper reports on social demographic characteristics that influenced the uptake of SRH services by urban refugees.Methods: A participatory, gender based, community-led, empowerment approach known as Gender Action Learning Systems (GALS) was employed to deliver SRH including family planning services to urban refugees in Kampala between March 2018 and September 2019. Urban refugees enrolled in GALS were interviewed at the beginning and end of the GALS intervention, where both qualitative and quantitative data were collected. Univariate, bivariate, and multivariate analyses were conducted to determine social demographic factors influencing the uptake of SRH services by urban refugees.Results: The​ ​study enrolled 867 participants, with 605 remaining to the end. Median age was 29 (IQR:22-36) years with a standard deviation of 10.7, 52% of the participants had never married. Retention in the study of the sexually active age cohort of primary interest (15 -34) was higher than the 35-54 cohort for both men and women. There were significant associations between SRH use and age, religion and education level among the urban refugees. Pentecostal religion (Adjusted OR 7.9; 3.5-18) and education level of primary (Adjusted OR 3.4; 1.1-11) were associated with uptake of SRH and FP. Conclusion: The participatory, peer-led community approach to delivering SRH services to urban refugees in this research project boosted uptake by the refugees and supported its successful completion and ability to address previously unknown predictors. A continuous awareness campaign using tested models such as GALS to promote services to refugees is needed to successfully integrate newcomers into Uganda’s general healthcare services.

Situation of Self-Reported Anxiety and Depression among Urban Refugees and Asylum Seekers in Thailand, 2019

Academic evidence on the health of urban refugees and asylum seekers (URAS) in Thailand is extremely sparse, especially for neglected problems such as mental health disorders. This study aimed to investigate the prevalence of anxiety and depression and factors associated with these problems among URAS in Bangkok. A cross-sectional study was conducted in 2019. The URAS were randomly selected from the roster of the Bangkok Refugee Centre (BRC). A self-administered questionnaire was used and 180 samples were recruited. Descriptive statistics and multivariable logistic regression were used for the analysis. We found a prevalence of 70.0% for anxiety and 39.5% for depression. Compared to Southeast Asia and China, URAS from other regions were 3.4 times (95% CI 1.5–7.5, p < 0.05) and 4.0 times (95% CI 1.1–14.0, p < 0.05) more likely to experience anxiety and depression, respectively. URAS with chronic co-morbidities (OR = 3.4, 95% CI 1.2–9.4, p < 0.05) and being divorced or widowed (OR = 11.1, 95% CI 2.1–57.2, p < 0.05) faced greater odds of depression than those without co-morbidities and being single. Related health authorities should play a proactive role in providing mental healthcare services for URAS, with greater consideration for those of certain nationalities and with chronic diseases.

Barriers to Healthcare Access and Utilization among Urban Syrian Refugees in Turkey

Turkey currently hosts 3.6 million registered Syrian refugees, most of which reside in urban centres. Urban refugees in Turkey face significant challenges in accessing the healthcare to which they are entitled under international and Turkish law. This literature review seeks to provide a holistic overview of the major barriers refugees face in accessing adequate healthcare. Language forms the single greatest obstacle despite efforts to provide services staffed by Arabic speakers. Poverty exacerbated by lack of employment, unhygienic living conditions, and the COVID-19 pandemic also play significant roles. Above all, hostile Turkish public sentiment towards refugees motivates restrictive government policies and discourages aid. Potential means by which this situation may be addressed include prompt address of the financial hardships brought on by COVID-19, permitting NGOs to evaluate the effectiveness of migrant health centres, and the resumption of refugee registration in key provinces.

‘Min Al-Mukhayyam’ (‘From the Camp’)

This article examines the implications of long-term encampment and exile for the meaning of Palestinian identity amongst refugees. It shows how the conditions of Palestinian camps in Jordan function as a key marker of social difference between refugees of the camps and the city. Whereas camp refugees see the hardships of camp life as conditions to be confronted, urban refugees take them as constitutive features of a socially distinct refugee. As I argue, the distinctions between camp and city refugees illustrate how the refugee category and the humanitarian camp exceed the ideology and function of humanitarianism. They demonstrate how, in protracted refugee situations, the refugee label and the historical context of the camp can become socially significant and contested features of identity.

Exploring the relationship between information and communication technology collective behaviors and sense of community: an urban refugee analysis

PurposeHelping others use information and communication technologies (ICTs), such as mobile phones, can be beneficial for individuals and communities. In urban refugee communities, displaced and living far from home, collective behaviors with mobile phones can generate a sense of belonging. The purpose of this paper is to explore the potential for these offline behaviors to generate a sense of community among urban refugees.Design/methodology/approachUsing quantitative evidence, the authors examined the relationship between collective behaviors, such as sharing or helping with a mobile phone, and sense of community. The authors analyzed survey data collected from urban refugees in Rwanda via multiple regression to test hypotheses related to the impact of collective behaviors on sense of community, as well as the mediating role of ICT self-efficacy and gender.FindingsThe findings suggest that collective behaviors with mobile phones have a positive relationship with sense of community, driven primarily by providing assistance as compared to sharing. ICT self-efficacy was positively related to sense of community. However, collective behaviors' impacts differed by gender, suggesting that social dynamics influence this relationship.Originality/valueWhile the extant literature highlights the various roles of mobile phones in refugees' lives, less is known about the social aspects of use and its potential to help overcome isolation by fostering a sense of community. The authors extend this literature to a novel context (urban refugees in the Global South), testing a model that incorporates other factors that may play a role (e.g. self-efficacy and gender). These findings are valuable to urban refugees, due to difficulties in re-building a sense of community and increased ICT access.