Nepalese migrants in Japan: What is holding them back in getting access to healthcare?

Shakya, Prakash; Tanaka, Masako; Shibanuma, Akira; Jimba, Masamine

doi:10.1371/journal.pone.0203645

Cited by 27 publications

(36 citation statements)

References 34 publications

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“…Two studies enrolled non-pregnant migrants41 42 and eight exclusively analysed mothers 43–50. The remaining nine studies were of general migrant populations of a single (n=5) or various (n=4) nationalities 51–59. There were 10 studies specifically examining Brazilians of Japanese descent, making them the most studied nation-specific migrant subgrouping in terms of mental well-being 60–70…”

Section: Resultsmentioning

confidence: 99%

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Mental well-being of international migrants to Japan: a systematic review

et al. 2019

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BackgroundMigration is a stressful process of resettlement and acculturation that can often negatively impact the mental health of migrants. International migration to Japan, a country with dominant ethnic homogeneity, is growing steadily amid an ageing domestic population and severe labour shortages.ObjectivesTo identify the contemporary barriers to, and facilitators of, mental well-being among the migrant population in Japan.DesignSystematic reviewData sourcesPubMed, ProQuest, Web of Science, Ichushi and J-StageEligibility criteriaResearch articles examining the mental well-being of international migrants in Japan that were published in English or Japanese between January 2000 and September 2018 were included.Data extraction and synthesisFull texts of relevant articles were screened and references of the included studies were hand-searched for further admissible articles. Study characteristics, mental well-being facilitators and barriers, as well as policy recommendations were synthesised into categorical observations and were then thematically analysed.ResultsFifty-five studies (23 published in English), surveying a total of 8649 migrants, were identified. The most commonly studied migrant nationalities were Brazilian (36%), followed by Chinese (27%) and Filipino (8%). Thematic analysis of barriers to mental well-being among migrants chiefly identified ‘language difficulties’, ‘being female’ and ‘lack of social support’, whereas the primary facilitators were ‘social networks’ followed by ‘cultural identity’. Policy recommendations for authorities generally described more migrant support services and cross-cultural awareness among the Japanese public.ConclusionAccess to social support networks of various types appears to be an influential factor affecting the mental well-being of international migrants in Japan. More research is necessary on how to promote such connections to foster a more inclusive and multicultural Japanese society amid rapid demographic change.PROSPERO registration numberCRD42018108421.

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Section: Resultsmentioning

confidence: 99%

“…The number of subjects per study ranged from 3 to 1,252, with a median size of 119. Importantly, a small number of migrants (<75) were explicitly not enrolled in a health insurance plan; the only studies that listed this variable were those of Nepalese51 or Brazilians migrants 60–70…”

Section: Resultsmentioning

confidence: 99%

Mental well-being of international migrants to Japan: a systematic review

et al. 2019

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“…The total possible scores ranged from zero to 21. This questionnaire has been previously used in another study of migrants in Japan [ 23 , 25 ]. The Cronbach's alpha coefficient was 0.84 for this study.…”

Section: Methodsmentioning

confidence: 99%

“…A higher incidence of tuberculosis has been reported among migrants than among the Japanese population due to delayed access to treatment [22]. A study among Nepalese migrants in Japan showed that around 32% of them did not visit the doctor or health worker when needed, which was mostly due to language and health insurance related barriers [23]. Such barriers may also limit migrants' utilization of HIV testing in Japan.…”

Section: Introductionmentioning

confidence: 99%

Factors associated with access to HIV testing among international students in Japanese language schools in Tokyo

et al. 2020

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Japan has been recognized for its excellent universal health coverage system. However, the migrant population faces many barriers in accessing health services in Japan. Japan hosts around 260,000 international students, mostly from developing countries. Among them, language school students tripled from 2011 to 2017, against the backdrop of labor shortage in Japan. Most of these students are also engaged as cheap laborers and are vulnerable populations with poor access to health services. Several socioeconomic and behavioral factors may increase their vulnerability to HIV and prevent them from accessing HIV testing in Japan. We examined the factors associated with access to HIV testing among international students in language schools in Tokyo. We conducted a cross-sectional study among international students studying in Japanese language schools in Tokyo. We collected data from 769 Chinese, Vietnamese, and Nepalese students using a self-administered questionnaire. We measured their access to HIV testing through questions on their knowledge of where to receive HIV testing and utilization of HIV testing. Bivariate and multivariable logistic regression models were used to analyze the data. Nepalese students were less likely to know where to receive HIV testing in Japan than Chinese students (AOR = 0.12, 95% CI 0.01-0.96). Students who did not need Japanese language interpreters during visits to health facilities were more likely to know where to receive HIV testing (AOR = 1.93, 95% CI 1.14-3.25). Students who did not have knowledge of free and anonymous HIV testing in Japan were also less likely to know where to receive HIV testing in Japan (AOR = 0.18, 95% CI 0.08-0.42). Students who did not have knowledge of free and anonymous HIV testing (OR = 0.05, 95% CI 0.02-0.10) and who had not utilized HIV testing in their home country (OR = 0.12, 95% CI 0.06-0.27) were less likely to utilize HIV testing in Japan. Factors associated with access to HIV testing among Japanese language school students in Tokyo are nationality, need for Japanese language interpreters, perceived access to doctors/health workers, utilization of HIV testing in the home country, and knowledge of free and anonymous HIV testing. These findings may help to design interventions for improving access to HIV testing among international students in Japan.

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“…As there are numerous insurance schemes in Japan, it is di cult to obtain exact gures regarding coverage among foreign residents. According to reports from some local governments and NGOs, however, it has been estimated that approximately 80% of foreign residents are covered by a Japanese public insurance scheme (7,8,22). This shows a dramatic improvement in coverage in recent decades, as in 2004 a survey conducted by a local government reported that this gure was 64.4% (27).…”

Section: Discussionmentioning

confidence: 99%

Associated factors of access to health care among foreign residents living in Aichi Prefecture, Japan: Secondary data analysis of informal free consultations organized by a non-governmental organization

Higuchi

Endo

Ito

2020

Preprint

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Background In Japan, foreign residents, and particularly new arrivals in the country, experience barriers to health care and show poorer health outcomes when compared to Japanese nationals. The health-care-related situation for foreign residents in Japan has been characterized by drastic changes over time; thus, there is difficulty identifying individuals who are “left behind” by the system. In this study, we aimed to identify, among foreign residents who attended informal free medical consultations, factors associated with “being advised to visit a medical facility” and “being referred to a medical facility,” which represented hypothetical proxy indicators of barriers to health care. Methods Secondary data analyses were conducted using the activity records of a non-governmental organization that provides free consultations targeting foreign residents in various locations in Aichi Prefecture, Japan. Participant characteristics, including insurance coverage, were determined. Bivariable and multi-variable analyses were performed to identify factors associated with having barriers to health care. Results Among 608 extracted cases, 81.7% were covered by Japanese public insurance, and insurance coverage was associated with sex and region of origin. During the consultations, 164 (27.5%) cases were advised to visit a medical facility, and 72 (11.8%) were referred to a medical facility. Those who were not covered by public insurance showed a 1.56-times (95% confidence interval [CI]: 1.19–2.05) higher prevalence of being advised to visit a medical facility when compared to those who were covered by public insurance. Unemployed people and students were more likely to be referred to a medical facility than were professional workers; the prevalence ratios were 3.28 (95% CI: 1.64–6.57) and 2.77 (95% CI: 1.18–6.46), respectively. Conclusions Information from the non-governmental organization revealed the diversity of foreign residents who require informal health-care-related consultations. Although the majority were insured, almost 30% were advised to visit a medical facility, which implied that they had had limited access to the formal health-care system before availing of the free consultations. The findings highlight specific groups who may be vulnerable, and it is important to provide these groups with the necessary support, based on updated evidence, to ensure that no one is “left behind.”

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Nepalese migrants in Japan: What is holding them back in getting access to healthcare?

Cited by 27 publications

References 34 publications

Mental well-being of international migrants to Japan: a systematic review

Mental well-being of international migrants to Japan: a systematic review

Factors associated with access to HIV testing among international students in Japanese language schools in Tokyo

Associated factors of access to health care among foreign residents living in Aichi Prefecture, Japan: Secondary data analysis of informal free consultations organized by a non-governmental organization

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