In terms of the number of respondents, Survey on Well-Being among Foreign Born Population (FinMonik) is so far the most extensive survey carried out among the population with foreign background in Finland. It comprises a wide range of self-reported data, including information on the respondent’s health, well-being and access to care, which can be widely utilized in planning and assessing integration, health and welfare policies. A mixed-method approach (an electronic questionnaire, a paper questionnaire and phone interviews) was used in collecting the data which consists of responses by 6836 respondents aged 18–64 years. All response types included, the response rate was 53.1% (n = 6836). This study describes in detail the methods used in the FinMonik survey. In addition, we describe the demographics of the respondents partaking in each response format. The aim of the study is to promote the development of mixed-method survey as a way of collecting reliable data that can be used to enhance foreign-born people’s health, well-being and access to health care. The survey responses will be used as a baseline in observing the respondents’ well-being through the register-based data available in several national registers on health, medicine use and access to care as well as the data collected in the study Impact of Coronavirus Epidemic on Well-Being among Foreign Born Population Study (MigCOVID). Furthermore, the FinMonik study protocol will be repeated every four years.
BackgroundSince reproductive health is often considered a highly sensitive topic, underreporting in surveys and under coverage of register data occurs frequently. This may lead to inaccurate information about the reproductive health. This study compares the proportion of women having births and induced abortions among migrant women of Russian, Somali and Kurdish origin in Finland to women in the general Finnish population and examines the agreement between survey- and register-based data.MethodsThe survey data from the Migrant Health and Wellbeing Study conducted in 2010–2012 and data from the Health 2011 Survey with corresponding information on women in the general population were used in this study. The respondents were women aged 18–64: 341 Russian, 176 Somali and 228 Kurdish origin women and 630 women in the general population. The survey data were linked to the Finnish Medical Birth Register and the Register of Induced Abortions.ResultsIn the combined (survey and register) data, migrant groups aged 30–64 had a higher proportion (89–96%) compared to the general population (69%) of women with at least one birth. Under-coverage of registered births was observed in all study groups. Among women aged 18–64, 36% of the Russian group and 24% of the Kurdish group reported more births in the survey than in the register data. In the combined data, the proportions of Russian origin (69%) and Kurdish origin (38%) women who have had at least one induced abortion in their lifetime are higher than in the general population (21%). Under-reporting of induced abortions in survey was observed among Somali origin women aged 18–29 (1% vs. 18%). The level of agreement between survey and register data was the lowest for induced abortions among the Somali and Russian groups (− 0.01 and 0.27).ConclusionBoth survey- and register-based information are needed in studies on reproductive health, especially when comparing women with foreign origin with women in the general population. Culturally sensitive survey protocols need to be developed to reduce reporting bias.
Suomen ulkomaalaistaustaisen väestön määrän kasvaessa on entistä tärkeämpää saada luotettavaa tietoa tämän väestöryhmän hyvinvoinnista, terveydestä, elinoloista, osallisuudesta, toimintakyvystä ja palveluiden käytöstä. Tiedon saantiin liittyy haasteita, joihin on etsitty ratkaisuja muun muassa kehittämällä tutkittavien tavoittamista ja haastattelujen toteutusta sekä hakemalla toimivia käytäntöjä viranomaisten ja tutkimuslaitosten väliseen yhteistyöhön. Tässä artikkelissa kuvataan kahdessa ulkomaalaistaustaisiin kohdennetussa väestötutkimuksessatoimineen monikulttuurisen kenttätutkimushenkilöstön kokemuksia tiedonkeruusta. Empiirisenä aineistona on Maahanmuuttajien terveys- ja hyvinvointitutkimuksen (Maamu) ja Ulkomaista syntyperää olevien työ ja hyvinvointi Suomessa (UTH) -tutkimuksen ulkomaalaistaustaisen kenttähenkilöstön puolistrukturoidut teemahaastattelut. Kenttätutkimushenkilöstön kokemusten karttuminen ja varmuuden kasvaminen auttoivat tutkittavien suostuttelussa. Tutkittavien epäluuloisuus viranomaisia kohtaan laski halukkuutta osallistua tutkimukseen. Kenttätutkimushenkilöstön ja tutkittavien yhteinen kulttuuritausta toisaalta edisti mutta toisaalta myös hankaloitti tutkittavien tavoittamista. Lisäksi työnantajan kenttähenkilöstölle tarjoama tuki koettiin tärkeänä. Kohdennetussa väestötutkimuksessa tutkittavien tavoittelemiseen on varattava riittävästi aikaa ja resursseja. Resursseja tarvitaan erityisesti kaikista heikoimmassa asemassa olevien tavoittamiseen. Tutkittavien tavoittamiseen ja kenttähenkilöstön kouluttamiseen liittyviä käytäntöjä on hyödyllistä kehittää viranomaisyhteistyönä. Myös kohdeväestö on tärkeä ottaa mukaan tutkimuksen suunnitteluun, toteutukseen ja raportoimiseen.
IntroductionEarlier researches have established that migrants with refugee background have increased risk for variety of mental health problems due to often traumatic reasons for leaving their home country, hazardous journey and post-migration adversity. The challenge is that mental health work with refugees is not systematically organized in Finland. PALOMA (developing National mental health policies for refugees 2016-2018) project was launched to answer these challenges. The project is carried out through the combined effort of National institute for health and welfare, The Finnish association for mental health, Helsinki and Kuopio university hospitals, and the municipality of Hämeenlinna. PALOMA Project is founded by the Asylum, migration and integration fund (AMIF).ObjectivesPALOMA project focuses on exploring existing good practices and weaknesses in mental health services in use for refugees. The objectives of the project are to develop a national model for effective mental health services for refugees and implement it nationwide in Finland.AimsThe aim of PALOMA Project is to develop a national model for effective mental health services for refugees in Finland.MethodsPALOMA Project includes three phases: data collection (interviews, literature review, seminars), building the model in expert groups and implementing the model.ResultsAs a result of PALOMA Project, there will be guidelines for professionals working in different levels of administration with refugees in Finland.ConclusionRefugees’ mental health and wellbeing will be improved as a result of better prevention, recognition and appropriate care of mental health problems.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Background Prior studies suggest that people with foreign background (PFB) often face problems in access to health care, although access to care may vary between the different PFB groups. This study explores 1) the potential differences in perceived access to care between different PFB groups and the general population, and 2) if marital status, education, employment, self-perceived health, long-term illness, length of stay, age moved to Finland or language skills are associated with access to care among PFB. Methods The data were gathered from the cross-sectional survey on well-being among the PFB (FinMONIK), conducted in Finland 2018. Its random sample consisted of 12 877 persons, aged 18-64 years and the response rate was 53%. Three items were used to assess perceived access to care: I was able to contact the place of care smoothly, I was able to make an appointment without undue delay and I was examined without undue delay (e.g. laboratory tests, X-ray, ultrasound). Logistic regression was used to test which factors were associated with accesses to care, adjusted for age, sex and region. Results After controlling for age, sex and region, the results showed significant differences in access to care among different migrant groups and the general population (p < 0.001). Of those of Estonian background 37% felt that access to care was smooth while only 17% of those coming from Middle-East, and 26% of the general population. Employed persons, persons who had good self-perceived health, and people with no long-term illness, and those who had lived in Finland less than five years, had better access to health care. Marital status, education, language skills and age moved to Finland, were not associated with access to care. Conclusions Large inequities in access to care were identified among people with foreign background. Access to services seems to be better for employed persons and those who have good self-perceived health. Key messages Special attention should be given to improve access to care among non-employed migrants. Migrants should not be considered as a uniform group when planning services.
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