Undocumented migrant women in Denmark have inadequate access to pregnancy screening and have a higher prevalence Hepatitis B virus infection compared to documented migrants in Denmark: a prevalence study

Wendland, Annika; Ehmsen, Boje Kvorning; Lenskjold, Vibeke; Astrup, Birgitte Schmidt; Mohr, Marlene; Williams, Christine B.; Cowan, Susan

doi:10.1186/s12889-016-3096-8

Cited by 24 publications

(49 citation statements)

References 17 publications

(16 reference statements)

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“…One major reported obstacle is the pre-donation screening guidelines resulting in a temporal or permanent deferral for a substantive number of potentially rare donors; This result is in line with those of other international studies which report that lower donor eligibility and higher deferral rates are problematic [4,23]. Although the incidence of transmittable diseases is higher among certain migrant groups, especially among people from Sub-Saharan African descent [24,25] excluding potentially rare donors during the preliminary screening steps, the Donor Health Questionnaire and the consultation with the donor physicians, before giving blood samples precludes the identification of persons with rare antigen combinations [26]. In the Netherlands, those with a Sub-Saharan African partner cannot donate immediately, but a survey among various national blood bank organisations had revealed that almost 30% even permanently ban people from Sub-Saharan countries [5].…”

Section: Discussionsupporting

confidence: 65%

The supply chain of migrant blood donors: an organisational interview study

et al. 2019

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Background and ObjectivesMigrant blood donors are underrepresented worldwide resulting in shortages of compatible blood products. Prior studies focused on individual barriers and motivators of potential blood donors, but no studies addressed organisational factors of the blood supply chain. This study explored the perceptions and experiences in recruitment and retention of migrant – and potentially rare‐blood donors among staff members within the blood supply chain and identified obstacles and solutions in this chain.Materials and MethodsThe study was conducted at Sanquin, the national blood supply organisation of the Netherlands. Qualitative in‐depth interviews were done among key staff members (N = 17). Expert validity was assessed in three feedback meetings.ResultsSeven staff members believed there is a shortage of migrant blood donors, while five believed there is not. However, there was a consensus that it may become a problem in the future due to demographic changes. The perceived obstacles to recruit and retain migrant donors were difficulties in determining how many migrant donors are needed and recruiting them, excluding potentially rare donors prior to donation, limited use of extended phenotyping and high blood typing and frozen storage costs. The possible solutions to increase blood pool diversity lay in registering donor ethnicity, specialised information provision for donors, reconsidering eligibility criteria and optimising blood typing strategies.ConclusionWhilst recruitment of migrant blood donors is perceived by staff as difficult, various organisational policies and guidelines seem to hinder retention. Improvements in the blood supply chain may be achieved by addressing logistics, current procedures and registration of ethnicity.

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Section: Discussionsupporting

confidence: 65%

The supply chain of migrant blood donors: an organisational interview study

et al. 2019

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“…Although this number could be an overestimation of the actual prevalence, the data included only first-time asylum applicants and did not include undocumented and illegal immigration, which could have an additional effect on the total HBV prevalence in host countries. 47,48 Programmes and strategies HBV vaccination strategies are generally still a controversial issue in the European public health system. Even though the cost-effectiveness of universal infant…”

Section: Panel: Data Analysismentioning

confidence: 99%

Mass migration to Europe: an opportunity for elimination of hepatitis B virus?

Thijssen

Lemey

Amini-Bavil-Olyaee

et al. 2019

The Lancet Gastroenterology & Hepatology

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People from low-to-middle income countries have been migrating to western Europe on a large scale in recent years. Data indicate that the number of first-time asylum applications by non-EU members increased from 290 000 in 2011 to more than 1•3 million in 2015. During the peak period of migration, The Global Health Sector Strategy on Viral Hepatitis was adopted by WHO. Viral hepatitis, and particularly hepatitis B virus (HBV), is an important disease because of its high prevalence and associated mortality. In some cases, HBV can be carried by refugees arriving from regions of high and intermediate prevalence. Refugees with HBV might not show clinical symptoms and not be diagnosed in destination countries with a low prevalence, where screening is not regularly done. Although transmission to the host population is low, dedicated surveillance and tailored public health policies are required. It is important to note that some of the countries that receive many migrants do not have a universal HBV vaccination programme. In this Viewpoint, we argue that the current large-scale movement from regions with high or intermediate HBV prevalence should be taken as an opportunity to achieve viral hepatitis elimination targets, by establishing a well prepared infrastructure for HBV screening, vaccination, and treatment.

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“…Moreover, these risks appear aggravated amongst migrant women who do not receive antenatal care during pregnancy [ 32 ]. Increased presence of hepatitis B [ 33 ], human immunodeficiency virus (HIV), diabetes, sexually transmitted infections, hypertonia, headache, and acute stress have also been observed amongst this cohort, when compared to the general population of pregnant women [ 34 ]. An elevated presence of psychopathology has also been observed amongst this group, with post-traumatic stress disorder (PTSD), depression, and anxiety disorders, as well as suicidal ideation and attempts being prevalent [ 34 ].…”

Section: Introductionmentioning

confidence: 99%

The need for trust and safety inducing encounters: a qualitative exploration of women’s experiences of seeking perinatal care when living as undocumented migrants in Sweden

Barkensjö

Greenbrook

Rosenlundh

et al. 2018

BMC Pregnancy Childbirth

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BackgroundStudies from around the world have shown that women living as undocumented migrants have limited and deficient access to perinatal care, increasing their risks of both physical and psychological complications during pregnancy and childbirth. Failures to provide equal access to healthcare have been criticized extensively by the United Nations. In 2013, undocumented migrants’ rights to healthcare in Sweden were expanded to include full access to perinatal care. Research surrounding clinical encounters involving women living as undocumented migrants remains largely lacking. The present study aimed to provide a composite description of women’s experiences of clinical encounters throughout pregnancy and childbirth, when living as undocumented migrants in Sweden.MethodsTaking an inductive approach, qualitative content analysis was implemented. Thirteen women from ten different countries were interviewed. Meaning-units were extracted from the data collected in order to identify emergent overarching themes.ResultsIn clinical encounters where healthcare professionals displayed empathic concern and listening behaviours, women felt empowered, acknowledged, and encouraged, leading them to trust clinicians, diminishing fears relating to seeking healthcare services. Conversely, when neglectful behaviour on part of healthcare professionals was perceived in encounters, anxiousness and fear intensified. Vulnerability and distress induced by the women’s uncertain living circumstances were apparent across themes, and appeared exacerbated by traumatic memories, difficulties in coping with motherhood, and fears of deportation.ConclusionThe present study contributes unique and important knowledge surrounding women’s experience of being pregnant and giving birth when living as undocumented migrants. The overarching findings indicated that the needs of undocumented migrant women were largely similar to those of all expectant mothers, but that due to vulnerabilities relating to their circumstances, flexible and informed care provision is essential. Being knowledgeable on undocumented migrants’ rights to healthcare is vital, as clinical encounters appeared highly consequential to the women’s well-being and help-seeking behaviours. Negative encounters inflicted emotional distress and fear. Contrastingly, positive encounters promoted trust in clinicians, personal empowerment, and relief. Positive clinical encounters could provide rare opportunities to assist an otherwise elusive population at increased risk for both physical and psychological complications, highlighting the crucial need for adherence to ethical principles in clinical practice.

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Undocumented migrant women in Denmark have inadequate access to pregnancy screening and have a higher prevalence Hepatitis B virus infection compared to documented migrants in Denmark: a prevalence study

Cited by 24 publications

References 17 publications

The supply chain of migrant blood donors: an organisational interview study

The supply chain of migrant blood donors: an organisational interview study

Mass migration to Europe: an opportunity for elimination of hepatitis B virus?

The need for trust and safety inducing encounters: a qualitative exploration of women’s experiences of seeking perinatal care when living as undocumented migrants in Sweden

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