This commentary focuses on female workers in construction sites in India, and the impact of mothers’ work on the health and nutrition of their children. The sector provides good opportunities for work, but it also affects children’s health outcomes.
“A study of 131 migrant children living at various construction sites in Ahmedabad showed that half of the children surveyed were underweight (low weight for age), 41% were stunted (low height for age) and 22% were wasted (low weight for height). According to the National Family Health Survey (2015-’16), 35.5% of children under the age of five in the country are underweight, 38.4% are stunted, 21% are wasted.”
The article highlights various reasons why children are in this condition. Mothers do not have time or comfortable environments to breastfeed exclusively, and can also have difficulty finding the time to wean at the proper age. Mothers don’t have access to affordable, healthy food, so older children eat a lot of packaged food. The water in construction sites is often contaminated and not potable. Utilizing health services means taking time off work, which results in a loss of wages.
The author argues that NGO’s can be one way to help alleviate the situation, but they can be difficult to access as well. Dr Ravindranath’s main recommendation is that “it is also critical to view the role of parental work environment and migration as factors contributing to undernutrition. Policies and interventions designed to address undernutrition must consider these as key factors without which such children would continue to be denied a chance of improved nutrition and better health.”
Current research on Nepali migrant workers in India neglects work, lifestyle, and health care access in favor of focusing on sexual health. This article aims to gain a broader sense of migrant workers’ health by conducting focus groups and interviews. The researchers analyzed their data and determined five different themes:
Lifestyle, networking, and risk-taking behaviours
Support from local organisations
Health service utilisation
This qualitative study demonstrates that health risks for Nepali migrant workers’ emerge because of a wide range of factors. The authors recommend a larger quantitative study to gain more insight.
This research provides necessary information on the mental health (specifically major depressive disorder or MDD) of refugees from Syria, as this information has not been collected or analyzed thoroughly as of yet. The researchers surveyed 135 Syrian refugees in a camp in Greece, specifically screening for MDD. The authors found that 44% of participants had symptoms of major depression. They found that women had an increased likelihood of MDD, and that time spent in the camp had a trend towards increased risk of depression.
“The development of depression during the asylum process is likely to undermine individual and societal functioning, which are essential for the survival and eventual resettlement of forced migrants. Depression is also likely to lead to adverse acculturation outcomes.”
Like our other recent highlighted articles, this one again focuses on Alberta, Canada. This research was an exploratory study into the health and wellbeing of temporary foreign workers (TFWs) in the province.
They asked two primary research questions:
“What are the perspectives of stakeholders on the health and well-being of TFWs and their families in Alberta?”
“What do they see as potential threats to child and family health in this population?”
The authors found that stakeholders perceive TFWs as experiencing several different types of specific health challenges: mental health, family health, and occupational health. They also found that workers confront barriers in accessing mental health services as well as the fact that income and social status are social determinants of health.
If you wish to read the rest of the article, click here. Institutional access restrictions apply.
In this article, authors interviewed immigrant service providers in Alberta, Canada, to discuss how their clients experience belonging on a day-to-day basis. The research showed that there are two different groups within which migrants experience belonging; their specific ethnocultural group, and the mainstream society of Canada. The researchers saw that migrants feel more belonging in an ethnic group before becoming comfortable with people who live near them. The authors argue that lack of ethnocultural diversity in local organizations adds to this distance from Canadian society.
If you wish to read the rest of the article, click here. Institutional access restrictions apply.
This article focuses on the parental disciplinary practices of African migrants in Alberta, Canada. The authors themselves are members of the immigrant community and so were better able to research these practices in a supportive and reflexive manner.
“We found that African immigrant parents used corporal discipline, persuasive discipline, and a hybrid of the two, as well as emerging practices involving transnational fostering and emotional isolation of children who persistently misbehaved. These practices, in their totality, appeared to be influenced by the transnational experiences of parents and precepts that are traceable to Canada’s legal and educational systems.”
Child discipline is a controversial subject, and these authors nuance the topic of discipline in African immigrant households by examining how parents negotiate new environments and expectations by adjusting practices as needed.
Read the full article here. (Note that institutional restrictions on access apply).
This paper focuses on migrant services for mental health in Alberta, Canada. The authors argue that health providers perceive several challenges to access and utilization of services, including stigma, language barriers, and cultural ideas about mental health. Service providers adopt different strategies to better provide for their patients in response to these different barriers. Read the full paper here
Divya Ravindranath, Jean-Francois Trani, and Lora Iannoti
International Journal for Equity in Health, doi: 10.1186/s12939-019-1034-y (Published 17 September 2019)
In this paper, the authors determine the causes of undernutrition in children of migrant construction workers in Ahmedabad, India. The work builds on a UNICEF framework of undernutrition (shown in featured image), focusing specifically on the middle level of underlying causes. Read the full paper here
Guest Editor Prof. Kevin PottieWebsiteE-Mail (1) C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa ON K1R 6M1, Canada; (2) Department of Family Medicine, School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, ON K1N 6N5, Canada Interests: health inequities for vulnerable populations; primary care access and guidelines for immigrants and refugees; community based research; infectious diseases and NCD in migrant populations
Guest Editor Dr. Olivia MagwoodWebsiteE-Mail Research Associate, C.T. Lamont Primary Health Care Research Centre, Bruyère Research Institute, Ottawa ON，Canada Interests: Refugee and migrant health, Community participation in health, Maternal and child health, Mental health, Primary health care, Public health
Guest Editor Dr. Azaad KassamWebsiteE-Mail Psychiatrist, Queensway Carleton Hospital, 3045 Baseline Road, Nepean, ON, K2H 8P4, Canada
Special Issue Information
Global health prioritizes the science of the burden of disease; its driving philosophy is equity, i.e., justice and fairness in the distribution of health in society, and its scope is global. Global mental health is the application of these principles to the domain of mental illness and suffering. Although most migrants are remarkably resilient, forced migration is associated with trauma, physical violence, and lack of basic resources. Exposure to stressors after resettlement, such as poverty and limited social support, also impacts on mental illness. Common mental health disorders such as anxiety, depression and post-traumatic stress disorder are often more prevalent among refugee populations of all ages compared to the general population.
There is a critical need for more research on timely community-based mental health services for refugees and other migrants. Community-based programs are often more acceptable and accessible to migrant families. These services provide interdisciplinary care that may extend into primary health care. What are the best approaches to deliver community-based services for migrants? How can primary care collaborate with mental health specialists and community-based support systems? What form of training programs and supervision are warranted? How can trans-national influences on mental health, such as migration, conflict, and disasters, be integrated into community-based care?
This Special Issue seeks papers providing insights into how global and community mental health can be enhanced for refugees and other migrants, in both clinical and non-clinical settings. We welcome papers that examine naturally occurring processes or utilize experimental approaches, as well as high-quality theoretical or systematic reviews. We hope that this Special Issue will present a collection of findings useful to improve community-based mental health care for refugees and other migrants.
Prof. Kevin Pottie Dr. Olivia Magwood Dr. Azaad Kassam Guest Editors
Manuscript Submission Information
Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.
Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.
MHADRI member Dr Roomi Aziz reflects on her participation in a week’s worth of migration and health events, co-hosted by MHADRI, that took place at the University of the Witwatersrand, Johannesburg at the end of July 2019. This post was originally published here.
Just got some time to review and recap the last week of July 2019, which was everything Gender and Migration and South Africa, beginning with a research workshop, having the privilege of being on an all-female panel on decolonizing global migration and health research, weaving a high level policy dialogue, closing with the UCL-Lancet Commission Launch of report on Migration and Health, and a symposium on gender, migration, health and public policy at the dynamic University of the Witwatersrand and the African Centre for Migration & Society.
We also went through some existential questions, of what does it even mean to be a migrant? What does health access imply? Especially since health often gets short-handed for the biomedical healthcare system, and this understanding is one of the many structural determinants leading to health inequities. For example, health insurance is not universal health coverage, but one of the many factors contributing to it. At the end of it, what stayed with me was the birth-right of a human, to live a meaningful life, and create a home.
Just want to record my five key Points-to-Ponder from the week, one for each day:
P1 | CHANGE THE PERSPECTIVE: It is important to step outside the box we live and operate in, to understand and grasp a broader, ‘helicopter’ vantage point of the situation and the context. Unlearn. Couldn’t be more truer for migration and health, and their bidirectional journey. There was a lot of discussion on the need to look at both systems response and global governance, and be conscious of the rhetoric of migrants’ health. Current public health policies do not engage with migration or mobility of populations, which raised some pertinent questions, on whether the local conversations are reflective of global realities? And about the drivers of policy-making? Is it fear or rights-based approach? Then again, as long as health is discussed in humanitarian paradigm where migration is discussed in securitization paradigm, challenges will continue to grow. We must remember Ellis Island. Exceptionalism in policy frameworks can further hurt a cause. #Mobility is the new normal. It is time that we accept it. We also need to know what we do not know, to truly understand and learn. It is important that we acknowledge the lack of evidence, rather than pretending that we have all the answers/ solutions. We need more data, better data to feed into politics and decisions, and understand the issue enough to take action.
P2 | WHO HOLDS THE POWER: Are we aware of what the rights-based arguments may drive away, and what are the most effective ways to make our case on policy tables? We have limited orientation as to who holds the power in the global discourse. Who has the loudest voice and who is determining the global or the national agenda? While we are continuously dealing with complexities, we must find levers of change within the system that are on our side, and learn to influence them. We must also not forget the key role of national treasury, which can make or break our comprehensive action plans. We religiously talk of evidence-informed decision making, when we also need to remember that sometimes this evidence is not politically correct, and sometimes lack of evidence is desirable for scape-goat-ing. More importantly, how do we make sure that the research generated is responding to the evidence need and who needs it. In either case, we need to be cognizant of our complicity and role in this system of control, and our responsibility towards challenging the global narrative.
P3 | AFFILIATIONS AND IMPLICATIONS: We are very trigger-happy when it comes to the use of adjectives like ‘vulnerable’ and ‘marginalized’, but are we aware of the implications that assignment of such adjectives has? We speak of biometrics and blockchain, without realizing the cost to personal security and implications for non-nationals as well as nationals. These discussions are critical today, when we are still grappling with the idea of profiling people on the basis of their looks, professions, languages, socio-economic status, beliefs and nationalities.
P4 | STAYING AWARE: By virtue of things beyond our control, like the country we were born in, the family we were born into, the skin color we inherited, we hold unequal power and privilege. It is critical that we do not centralize our agenda or usurp the central stage and remember the ‘invisible’. That is the crux of the bone of contention we have with Eurocentric understanding of migration and health and inequalities vis-à-vis Global South being reinstated. This goes back to the ‘changing the perspective’ point, where we must endeavor to visibilize the invisible, profile them to understand what can be done for them, since they cannot be passive actors in the society, lest they are left behind. We must remain acutely aware of the danger of propagating a single narrative, recognize the associated complexities and contestations associated with it.
P5 | CREATE OPPORTUNITIES: Not always there is a demand and supply match. Sometimes one must push and manipulate situations and strategize for interest. There are important advocacy windows all around us. There is a need to identify these strategic windows, the sticking points, and realize the power of our personal networks, to push forward our agendas. There is no time to wait for tailor-made opportunities.