Lessons from the Profile of Kidney Diseases Among Afghan Refugees

Abstract

BackgroundDue to a paucity of research on the profile of kidney diseases among refugee populations, specifically Afghan refugees in Iran, this study aimed to illustrate the pattern of kidney disease among Afghan refugees in Iran and create a database for evaluating the performance of future health services.Material/MethodsThis was a retrospective cross sectional study, in which we collected the demographics and profile of kidney diseases among Afghan refugees between 2005 and 2010 from referrals to the United Nations High Commissioner for Refugees (UNHCR) offices in Iran.ResultsThe total number of referrals in this group of diseases was 3193 out of 23 152 with 41.5% female and 58.5% male. Regarding age distribution, 10.5% were 0–14 years of age, 78% were 15–59, and 11.5% were ≥60. The most common health referral for females and males (0–14) was end-stage renal disease (ESRD), accounting for 34.6%. This was also the main reason of referrals for females and males aged 15–59, accounting for 73.5% and 66.6%, respectively, and in both sexes in the ≥60 age range it was 63.1%.ConclusionsThe pattern of our renal clinic referrals may gradually change to ESRD, which is associated with a huge economic burden. The need to provide health insurance to everyone or reform the health care system to provide coverage for more of the population can be justified and would improve cost effectiveness.

Barriers and facilitators of providing primary health care to Afghan refugees: A qualitative study from the perspective of health care providers

“…Content analysis included 4 main themes of the challenges: ( 1 ) while providing primary health care, ( 2 ) after providing primary health care, ( 3 ) opportunities, and ( 4 ) solutions. Subthemes of challenges while providing health care services included lack of trained and professional personnel, identification and identity records, communication, insurance, past medical and health records, training, interorganizational information exchange, refugee identity, number of children, family members, and vaccination.…”

“…In the case of ambiguity in the participants' statement, ambiguous points were clarified and resolved. For data analysis, the framework analysis method was used in 7 steps: ( 1 ) transcription, ( 2 ) familiarization with the interview, ( 3 ) coding, ( 4 ) developing a working analytical framework, ( 5 ) applying the analytical framework, ( 6 ) charting data into the framework matrix, and ( 7 ) interpreting the data ( 15 ). The researcher identified key concepts and subjects and provided a thematic framework.…”

“…The Afghan migration to the countries of the region, especially Iran, is one of the forms of international migrations that has increased in recent decades ( 1 ). Afghans constitute the largest refugee group worldwide ( 2 ). The largest Afghan refugees reside in Iran.…”

“…The largest Afghan refugees reside in Iran. The 2015 report of UN High Commissioner for Refugees (UNHCR), which was released in December 2014, shows that 982 027 registered refugees live in Iran, and according to the same report, the Islamic Republic of Iran hosts the largest urban refugee population in the world ( 2 , 3 ). Refugees often have multiple and complex health care needs due to inequalities in health determinants, prosecution, torture, or other forms of harm, deprivation and unhealthy environmental conditions, and the lack of access to health care ( 4 ).…”

“…Ensuring primary health care for refugees is a global concern ( 4 ). The primary health care provides access to the health care system for all new needs and problems ( 2 ). The speed and mobility of people at the international level are the results of a change in the global pattern of diseases that may have challenges for immigrants who carry these diseases and a challenge for health care professionals who may not be familiar with these diseases ( 5 ).…”