Health and social needs of asylum seekers and Ukrainian refugees in Lithuania: A mixed-method protocol

Arab, Rabie Adel El; Urbanavice, Rita; Jakavonytė-Akstinienė, Agnė; Skvarcevskaja, Marija; Austys, Donatas; Mateos, José Tomás; Briones-Vozmediano, Érica; Rubinat, Esther; Fatkulina, Natalja

doi:10.3389/fpubh.2022.1025446

Cited by 5 publications

(6 citation statements)

References 29 publications

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“…Many migrants, asylum seekers and refugees find their final destination is not what they expected. They may spend months or years in conditions frequently fall short of basic humanitarian standards even in the European Union (EU) ( 2 , 3 ). The legal and socio-economic status varies greatly; however, many are at a higher risk of inadequate healthcare due to their unsettled or transitory status ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…Adult and adolescent migrants may not receive the recommended regular vaccinations and are not immediately included in catch-up vaccination efforts in various European countries ( 8 ). The COVID-19 pandemic may increase the vulnerability of refugees and asylum seekers, and the lack of COVID-19 health information strategies for culturally and linguistically diverse groups reduces awareness of prevention measures ( 2 , 3 ). A variety of risk factors and comorbidities associated with COVID-19 have exacerbated health disparities and contributed to the increase of disease burden ( 9 ).…”

Section: Introductionmentioning

confidence: 99%

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Health and well-being of refugees, asylum seekers, undocumented migrants, and internally displaced persons under COVID-19: a scoping review

Arab

Somerville

Abuadas

et al. 2023

Front. Public Health

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ObjectivesThe objective of this scoping review was to identify what is known about the impact of COVID-19 on the physical and mental well-being of refugees, asylum seekers, undocumented migrants, and internally displaced persons. The aim was also to identify barriers influencing access to treatment or prevention.MethodsThe search was conducted using PubMed/Medline, CINAHL, Scopus, and ScienceDirect. A mixed methods appraisal tool was used to assess methodological rigor. The study findings were synthesized using a thematic analysis approach.Results and DiscussionThis review comprised 24 studies and were conducted utilizing a mixed method approach incorporating both quantitative and qualitative methodologies. Two major themes were identified related to the impact of COVID-19 on the health and wellbeing of refugees, asylum seekers, undocumented migrants, and internally displaced persons and the key barriers influencing access to treatment or prevention of COVID-19. They often have barriers to accessing healthcare due to their legal status, language barriers, and limited resources. The pandemic has further strained already limited health resources, making it even more challenging for these populations to receive healthcare. This review reveals that refugees and asylum seekers in receiving facilities face a higher risk of COVID-19 infection than the general population due to their less favorable living conditions. The various health impacts stem from a lack of access to accurate information about the pandemic, misinformation, and the exacerbation of pre-existing mental health issues caused by heightened stress, anxiety, and uncertainty, fear of deportation among undocumented migrants, and overcrowding camps and detention facilities that increase exposure risk. Social distancing measures are difficult to implement in these settings, and inadequate sanitation, hygiene, and a lack of personal protective equipment further compound the problem. Moreover, the pandemic has had significant economic consequences for these populations. Many of them rely on informal or precarious employment, which has been disproportionately affected by the pandemic. Job losses and reduced working hours, and limited access to social protection can lead to increased poverty, and food insecurity. Children faced specific challenges, such as disruptions to education, additionally, interruptions in support services for pregnant women. Some pregnant women have avoided seeking maternity care due to fears of contracting COVID-19, resulting in increased home births and delays in accessing healthcare services. Factors that play a role in vaccination reluctance include uncertainty of undocumented migrants’ inclusion in vaccination programs, furthermore, a growing vaccine hesitancy in the population; skepticism about the safety of vaccines, inadequate knowledge/education, a variety of access barriers such as language barriers, and logistical challenges including remote locations, and inaccurate information.ConclusionThis review highlights that the physical health of refugees, asylum seekers, undocumented migrants, and internally displaced persons has been significantly impacted by various barriers to healthcare access during the pandemic. These barriers include legal and administrative challenges, such as a lack of documentation. Additionally, the shift to digital tools has introduced new obstacles, not only due to language barriers or limited technical knowledge but also because of structural barriers, such as the requirement of a bank ID that is often inaccessible to these groups. Other factors contributing to limited healthcare access include financial constraints, language barriers, and discrimination. Additionally, limited access to accurate information about health services, prevention measures, and available resources may hinder them from seeking care or following public health guidelines. Misinformation and lack of trust in healthcare systems can also contribute to a reluctance to access care or vaccination programs. There is concerning evidence regarding vaccine hesitancy that needs to be addressed to reduce any future pandemic outbreak, in addition there is a need to explore the factors that play a role in vaccination reluctance among children in these populations.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Health and well-being of refugees, asylum seekers, undocumented migrants, and internally displaced persons under COVID-19: a scoping review

Arab

Somerville

Abuadas

et al. 2023

Front. Public Health

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“…The surge of undocumented migrants and asylum seekers from Belarus into Latvia, Lithuania, and Poland has been unfolding since mid-2021 and has brought to the forefront the pressing issue of their health and well-being ( 21 ). The following characteristics have been observed among the undocumented migrants who arrived in Lithuania from June 2021 to December 2023 ( 22 ).…”

Section: Introductionmentioning

confidence: 99%

“We want our freedom back, that’s our only need”: a qualitative study of health and social needs among asylum seekers and undocumented migrants crossing the borders from Belarus to Lithuania

El Arab,

Urbanavice,

Jakavonyte-Akstiniene

et al. 2024

Front. Public Health

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BackgroundThe influx of undocumented migrants and asylum seekers into Lithuania, particularly during the COVID-19 pandemic, presents unique public health challenges. This study employs the Social Determinants of Health framework to explore the healthcare and social needs of this vulnerable population.MethodsIn May 2022, we carried out a qualitative study through semi-structured interviews with asylum seekers across four centers in Lithuania. Employing both purposive and snowball sampling techniques, we selected participants for our investigation. The study comprised 21 interviews—19 conducted in Arabic and 2 in English—with durations ranging between 20 and 40 min each. We audio-recorded all interviews, transcribed them verbatim, and subsequently performed a thematic analysis using Atlas.ti software. This process of design and analysis strictly followed the principles of thematic analysis as outlined by Braun and Clarke, guaranteeing methodological precision and rigor.Findings21 interviews revealed critical insights into the healthcare access challenges, mental health issues, and social integration barriers faced by the participants. Key themes included ‘Healthcare Needs and the Impact of the COVID-19 Pandemic ‘and ‘Social needs and Aspirations Amidst Pandemic-Induced Uncertainty ‘. The findings highlight the multifaceted healthcare and social needs of asylum seekers, juxtaposed against significant barriers they face. Access to medical services is hindered by long waiting times and financial constraints, especially for specialized care such as dental services. Communication issues during medical appointments due to language barriers and the lack of gender-specific healthcare, such as access to gynecological services, further exacerbate the challenges. Additionally, the COVID-19 pandemic introduces hurdles such as limited testing, isolation measures, language-specific information barriers, and insufficient social distancing practices. Mental health has emerged as a critical concern, with asylum seekers reporting significant stress and emotional exhaustion due to uncertainty and restrictive living conditions. Social needs extend to delayed asylum application processes, inconsistent language education opportunities, inadequate clothing, and nutrition that lacks cultural sensitivity, and living conditions characterized by overcrowding and insufficient facilities. The restricted freedom of movement within asylum seeking centres severely impacts their psychological well-being, underscoring a deep longing for autonomy and a better life despite the myriad of challenges faced.DiscussionThe study illustrates the complex interplay between migration, health, and social factors in the context of a global pandemic. It highlights the need for culturally sensitive healthcare services, mental health support, and structured language education programs. Offering educational avenues alongside language courses for children and adults is essential for fostering social inclusion and securing economic prosperity. Addressing the challenge of language barriers is of utmost importance, as these barriers significantly impede undocumented migrants’ and asylum seekers employment opportunities and their access to crucial services. The findings emphasized immigration as a health determinant and underscored the importance of inclusive health policies and advocacy for undocumented migrants and asylum seekers’ rights and needs.ConclusionThere is an urgent need for comprehensive policies and practices that are grounded in the principles of equity, compassion, and human rights. Additionally, advocating for practice adaptations that are culturally sensitive, linguistically inclusive, and responsive to the unique challenges faced by undocumented migrants and asylum seekers. As global migration continues to rise, these findings are crucial for informing public health strategies and social services that cater to the diverse needs of this vulnerable population.

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“…Previous studies have attributed socioeconomic and/or social needs and mental health factors to life satisfaction among immigrants. Social needs in the context of immigrants refer to complex, multifaceted necessary needs that an immigrant requires to survive or have healthy and productive lives in their host country ( Artiga & Pham, 2019 ; El Arab et al, 2023 ; Hacker & Houry, 2022 ). These needs, including food security, employment, and healthcare utilization, significantly impact the life satisfaction of individuals, including immigrants ( Chen & Hou, 2019 ; Chilton & Booth, 2007 ; Hacker & Houry, 2022 ; Kaiser et al, 2007 ; Pinard et al, 2015 ; Pourmotabbed et al, 2020 ; Salahodjaev & Mirziyoyeva, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

“…These needs, including food security, employment, and healthcare utilization, significantly impact the life satisfaction of individuals, including immigrants ( Chen & Hou, 2019 ; Chilton & Booth, 2007 ; Hacker & Houry, 2022 ; Kaiser et al, 2007 ; Pinard et al, 2015 ; Pourmotabbed et al, 2020 ; Salahodjaev & Mirziyoyeva, 2021 ). These social needs are important particularly for immigrants to survive or maintain their health and well-being in their host country because immigrants need food to survive, jobs to afford services, or medical care to improve their health ( Artiga & Pham, 2019 ; El Arab et al, 2023 ; Hacker & Houry, 2022 ). Populations with higher food security or employment have higher life satisfaction ( Chen & Hou, 2019 ; Salahodjaev & Mirziyoyeva, 2021 ).…”

Section: Introductionmentioning

confidence: 99%

Mediation analysis of mental health characteristics linking social needs to life satisfaction among immigrants

Adzrago,

Williams

2023

SSM - Population Health

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Health and social needs of asylum seekers and Ukrainian refugees in Lithuania: A mixed-method protocol

Cited by 5 publications

References 29 publications

Health and well-being of refugees, asylum seekers, undocumented migrants, and internally displaced persons under COVID-19: a scoping review

Health and well-being of refugees, asylum seekers, undocumented migrants, and internally displaced persons under COVID-19: a scoping review

“We want our freedom back, that’s our only need”: a qualitative study of health and social needs among asylum seekers and undocumented migrants crossing the borders from Belarus to Lithuania

Mediation analysis of mental health characteristics linking social needs to life satisfaction among immigrants

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