Search Results (60)

Tuberculosis (TB) remains a critical public health issue in Johannesburg, South Africa, driven by a complex interplay of individual, social, and structural factors. This study assessed the syndemic relationship between these determinants to understand their collective impact on TB burden and treatment outcomes. A cross-sectional survey was conducted among TB patients attending selected clinics, examining behavioural risks (e.g., smoking, alcohol use, HIV co-infection), social conditions (poverty, overcrowding, stigma), and structural challenges (access to healthcare, migration status). The results revealed a significant co-occurrence of TB and HIV (56.1%), alongside high rates of smoking (33.1%) and alcohol use (45.2%). Unemployment (50.2%), inadequate housing, and limited healthcare access, particularly for undocumented migrants (26.2%), were also prominent. Factor analysis demonstrated a syndemic interaction between behavioural and social determinants, underscoring the compounded vulnerability of affected populations. The findings highlight the necessity of integrating medical interventions with social and structural reforms. Recommendations include TB-HIV co-management, substance abuse programmes, improved housing, and inclusive healthcare access. A multisectoral approach addressing both health and socioeconomic inequalities is critical for comprehensive TB control in urban South African contexts. Full article

The Sustainable Development Goals commit states to Universal Health Coverage (UHC) for all; yet displaced populations—including asylum seekers, refugees, internally displaced persons (IDPs), and undocumented migrants—remain systematically excluded from national health systems across southern and eastern Africa. This paper applies a whole-of-route, rights-based framework to examine how legal status, policy implementation, and structural governance shape healthcare access for displaced populations across South Africa, Kenya, Somalia, and the Democratic Republic of Congo (DRC). Drawing on 70 key informant interviews and policy analysis conducted between 2020 and 2025, the study finds that despite formal commitments to health equity, access remains constrained by restrictive legal regimes, administrative discretion, and fragmented service delivery models. Critical gaps persist in migration-sensitive planning, gender-responsive care, and mental health integration. The findings highlight the limitations of rights-based rhetoric in the absence of legal coherence, intersectoral coordination, and political will. To realise UHC in displacement contexts, health systems must move beyond citizen-centric models and embed migration-aware, inclusive, and sustainable approaches across all stages of displacement. Without such structural reforms, displaced populations will remain at the margins of national health agendas—and the promise of health for all will remain unmet. Full article

Background: Mobile populations, including refugees, asylum seekers, and undocumented migrants, face challenges related to access, continuity, and quality of healthcare, among others, due to the lack of available health records. This study aimed to examine the current landscape of Electronic Personal Health Records (EPHRs) developed for and used by mobile populations. Methods: A rapid systematic review was conducted between September 2024 and January 2025, identifying relevant publications through searches in Embase, PubMed, Scopus, and grey literature. Results: The literature search yielded 2303 articles, with 74 remaining after title and abstract screening. After full-text screening, 10 scientific articles and 9 grey literature records were included in a qualitative data synthesis. Six distinct EPHRs were identified, differing in how they centralize health records, in additional functionalities, and the level of patient autonomy granted. Discussion and Conclusions: Limited evidence exists on EPHRs impact on health outcomes or continuity of care, and user adoption remains a critical challenge. Key elements in the development and implementation of EPHRs include ensuring a high level of data security and co-designing easy-to-use EPHRs. The review indicates a need for future research on user experiences of EPHRs and their impact on the health outcomes of mobile populations. Full article

For the United States, detailed estimates of the number of resident migrants and the rates of migrant arrival are valuable for understanding population dynamics and for determining the impact of economic and political changes that influence migration. The goal of this analysis was to derive estimates of the U.S. foreign-born population and how this population has changed in recent years, as well as estimates of recent and historical immigration volumes. Using data from large population surveys (the 2000 U.S. decennial census and 2001–2019 American Community Survey (ACS)), a Bayesian evidence synthesis was conducted to pool survey data across years while accounting for various biases and logical constraints that apply to these data. This analysis produced highly disaggregated estimates of the foreign-born population residing in the United States over the period 2000–2019, as well as estimates of immigration volume for 1950–2019. These population estimates demonstrated high in- and out-of-sample predictive performance, with substantially greater precision than that for raw survey estimates. Estimated immigration flows tracked other available time series, although with higher precision and with the potential to include undocumented immigration not represented in other immigration data. This study documents immigration from 100 countries of origin into the United States and demonstrates how the results of repeated cross-sectional population surveys can be used to infer migration dynamics that are difficult to measure directly. Full article

Oakland, California has been identified as a Black city since the early days of the Great Migration. Migrants from the South brought their labor, families, and most importantly, a vision for the future of Black communities. Alongside the influx of domestic Black folks moving into the city has been a steady stream of Black immigrants who help to push the boundaries for how Blackness is understood in Oakland. Increased anti-immigrant sentiments have added to this violence, putting undocumented immigrants at risk of suffering the abuses of landlords. In this article, I uplift the voices of Oakland community members that demonstrate the tragedies of dispossession as they tell their own geographic stories. These collective stories demonstrate the markers of dispossession on different levels as the sociospatial dynamics of Oakland are being (re)imagined. Oakland has now become one more example of the threat to Black spaces in the U.S. and gives us a roadmap for how these spaces will be reimagined under asymmetrical violence. Full article

Background: Obesity is continually growing not only in medium- and high-income countries but also in low-income countries, from where increasing numbers of migrants arrive in Western countries. We aimed to investigate the frequency and characteristics of obesity in a sample of undocumented migrants, a population for which official health data are not available. Methods: We collected demographic and socio-economic data and information on medical diagnoses and pharmacologic treatments for 341 undocumented migrants consecutively attending the outpatient clinic of a big non-governmental organisation in Milan, Italy, from March to July 2023. To measure obesity, we used both body mass index (BMI) and waist circumference (WC). We used multivariate robust Poisson regression models to calculate prevalence ratios (PRs) and 95% Confidence Intervals (CIs) of overweight or obesity according to socio-demographic conditions and other risk factors. Results: Using BMI, the proportion of migrants with obesity was 28.7% (95% CI 24.0–33.0%) and those with overweight represented 32.3% (95% CI 27.3–37.5%). Obesity was more frequent among Asians (53.9%, 95% CI 37.2–69.9%), followed by Latinos (38.7%, 95% CI 29.6–48.5%) and Eastern Europeans (38.2%, 95% CI 25.4–52.3%). Using WC, 68.3% (95% CI 63.1–73.2%) of migrants had values suggestive of overweight or obesity. In the multivariate analyses, overweight and obesity were more frequent in migrants with older age, with a stable employment, and who had been present in Italy for a long time, as well as in those with CV diseases. Moreover, individuals with obesity needed more medications for the cardiovascular system and for the alimentary tract and metabolism. Conclusions: In our sample of undocumented migrants, overweight and obesity were frequent, representing an important public health issue, considering the difficulty experienced by such individuals in finding access to both prevention and healthcare services. Full article

The Trump administration’s attacks on immigrant communities, especially undocumented people, produced major policy reversals on temporary humanitarian relief programs, such as the termination of Deferred Enforced Departure (DED). While these policies have had wide-reaching impacts across communities of color, within the broader immigration debate, the experiences of Black migrants have often been overlooked. This paper asks the following questions: How did extremist policies impact Black migrants under the Trump administration? What vulnerabilities did these policies produce or exacerbate? What do these efforts tell us about the “turn” toward authoritarianism in U.S. politics? Applying antiblackness as a theoretical framework, this paper conducts a content analysis of media outlets to examine the impact of extremist policies on Liberian DED beneficiaries. The ramifications of these policies intensified pre-existing antiblack dynamics of belonging and exclusion within the state by reinforcing racial hierarchies, producing social exclusion and vulnerability to state violence, and maintaining constrained access to citizenship. In assessing the many ways that antiblack racism manifests for citizens and non-citizens alike, we can extend our understanding of migrant justice, racial justice, and anti-imperialism as interdependent struggles in the face of rising authoritarianism. Full article

Most EU member states fail to provide essential sexual and reproductive health services to undocumented migrants, a vulnerable population facing limited access, utilization, and worse health-related outcomes. This study systematically reviewed the literature on access to and use of these services, as well as related health, economic, and migratory outcomes for undocumented migrants in the EU-EFTA region. The systematic review is reported based on the PRISMA 2020 checklist and includes 37 studies published between 2017 and 2024. Included studies were based upon original quantitative, qualitative, or mixed-methods data; conducted in one or more European countries; and published in one or more of the following languages: English, Spanish, French, Portuguese, or Romanian. A quality assessment was conducted using the CASP checklist for qualitative studies and the NHLBI Study Quality Assessment Tools for quantitative studies. The findings revealed numerous access barriers, including refusal of care, lack of knowledge about national healthcare schemes, bureaucratic hurdles, and affordability issues. Even when care was available, stigma, fear of deportation, socio-economic precarity, and abuse further hindered utilization. These barriers contributed to generally worse reproductive health outcomes for undocumented migrants in Europe, though the findings may not generalize to all EU-EFTA countries. Full article

Based on ethnographic fieldwork, this article is concerned with how undocumented refugees and migrants use invisibility strategies to navigate a hostile host environment in Western Tanzania. This article explores how the shifts in Tanzania’s refugee policy have affected different generations of refugees differently, and how older cohorts assist newer cohorts. This article argues that the challenges of migration are productive of ‘affective circuits’ and of generating new forms of kinship. It argues that it can be productive to bring together the different understandings of generations, as it was found that generations as cohorts can transform into generations as kin in situations of rupture and adversity. Full article

The Eiffel Tower is an enduring symbol, and people from around the world dream of travelling to Paris to gaze at it. Walking amongst the millions of tourists who visit the famous site each year are an enterprising group of African souvenir vendors whose livelihoods rely on the sales of miniature versions of the structure. As visibly omnipresent as these sellers are at the tower, their experience as undocumented migrants working unofficially makes them invisible. For the Paris authorities, the mere presence of Africans offering cheap keepsakes at the Eiffel Tower is considered an illegal nuisance that must be eradicated. No matter, recurrent police interventions have failed to cease the unauthorised souvenir market. Because these independent entrepreneurs are neither wanted nor welcomed, Africans selling trinkets at the iconic Parisian site face daily challenges. Until now, no one has ever investigated or profoundly surveyed their experience working at one of the most-visited places in the world. This study aims to demystify this unique group of Africans in Paris after observing and informally engaging with them directly concerning various topics. Despite the demur realities confronting them as undocumented migrants living clandestinely in a country that does not want them, these migrants remain hopeful for the future. Full article

Spain has grown economically due to the recent boosts in the industrial sector, the agricultural sector, construction and services. Those who carry out agricultural tasks are mainly undocumented immigrants living in marginal neighborhoods. Objectives: to know the perception of undocumented Moroccan migrants living in marginal neighborhoods regarding access to the Public Health System. Methods: A qualitative method with a phenomenological approach was used to get closer to the experience of the participants in the study. In this work, 24 semi-structured interviews were conducted following a guide with a set of open questions to facilitate an in-depth discussion of the topics of interest. The participants were given an informed consent form, which guaranteed anonymity and confidentiality regarding the information obtained. For this, codes were used to identify them. The data were stored, managed, classified, and organized with the ATLAS-ti 9 software. Results: access and use of health services by the immigrants in the study was difficult due to communication problems related to language and culture, the discriminatory attitude and lack of cultural competence of health personnel, and the location of the neighborhoods (which were marginal far from urban centers), as well as the lack of transportation to health centers. Conclusions: it is an ethical imperative of the Health System to offer greater attention to the population in situations of extreme vulnerability, implement intercultural mediators and train health professionals in cultural competence. Full article

In this article, we argue that Direct Provision in Ireland is a state approved form of gendered carcerality which creates and exacerbates conditions of gendered violence. Direct Provision is a system of processing asylum seekers in Ireland where they are temporarily provided accommodation while they wait for a decision on their refugee status claim. This article shows how carceral practices are layered and gendered, making some spaces and bodies more carceral than others. These carceralities increase the institutional burden which agglomerates in human bodies and makes the lives of an already precarious population unliveable. Through a review of the strategies adopted by the government in relation to migrants, undocumented workers and asylum seekers, this article shows how the gendered experiences of certain asylum seekers like mothers and sexual violence survivors become the political site where state approved carceral practices and gendered violence merge. Full article

The advent of the COVID-19 vaccine signified a historic milestone in the field of vaccinology, showcasing remarkable scientific collaboration and global solidarity. However, the most prominent hurdle in maximizing the global public health impact of vaccines remains the absence of comprehensive and inclusive health systems in both high- and low-resource settings. Our discussion centers around the major contributing factors that played a key role in formulating the rapid and efficacious COVID-19 vaccines. Simultaneously, we illuminate the disparities that have marred the vaccine delivery process throughout the pandemic. In particular, we highlight the case scenarios of two minority and vulnerable communities from the Global South and North—the undocumented migrants in Thailand and the Roma community in Europe—who continue to experience inequitable vaccine access regardless of their location. We note that a crucial programmatic solution that is rooted in inclusive and equitable global public health policy, characterized by empathy and trust and bolstered by digital innovation, is lacking. These examples underscore the significance of establishing a comprehensive and integrated health system at multiple levels across countries and the entire world. Furthermore, we highlight the need for both local and global actors to collaboratively engage in vaccine distribution efforts. By gaining a concise grasp of these intricacies, the global community will be better poised to effectively combat future pandemics and emerging health challenges. Full article

Migrants are at increased risk of developing tuberculosis (TB) and have poor treatment outcomes. The National TB program (NTP) of the Kyrgyz Republic recognizes two types of migrants: internal (intra-country) and external (inter-country) migrants. This cohort study compared the characteristics, timeliness of diagnosis and treatment initiation, and treatment outcomes of TB patients (internal migrant vs. external migrant vs. non-migrant) identified during treatment in the country in 2021. The TB treatment register and treatment cards of 5114 patients (156 internal, 430 external, and 4528 non-migrants) were reviewed. Risk factors (unemployment, smoking, alcohol use, and homelessness) were higher (p-value < 0.001) in internal (84%) than in external migrants (66%) and non-migrants (43%). The median delay in seeking care post-symptom onset was longer (p-value= 0.03) in external (30 days) than in internal migrants (21 days) and non-migrants (25 days). Successful treatment outcomes for drug-sensitive TB were higher in internal (89%, p-value = 0.012) and external migrants (86%, p-value = 0.001) than in non-migrants (78%). Internal and external migrants should be separately considered with respect to TB care and monitoring under the NTP. Success rates seem to be high in migrants, but our findings may be biased, as migrants with poor healthcare access may remain undetected and untreated and have undocumented poor outcomes. Full article

Underserved populations have a wide heterogeneity on healthcare provision and use. They also represent the key populations according to WHO 2030 goals for HCV micro-elimination. Our review evaluated the available literature on HCV diagnosis, staging, and treatment among underserved populations, such as incarcerated people, patients with psychiatric disorders, and migrants. A narrative review of literature was performed using key electronic databases (Scopus, Pubmed—MEDLINE) and search engines (Google Scholar). Peer-reviewed publications, grey literature on HCV, and recent models proposed for micro-elimination in underserved populations were included. An insight into the COVID-19 pandemic and its influence on HCV micro-elimination pathways will be also provided. Regarding prison settings, a progressive reduction in HCV epidemiology among incarcerated people in the last years was found (one-third of the level it had been before). People suffering from psychiatric disorders have a high anti-HCV prevalence, but there is a lack of data on active infections. A bidirectional relationship between HCV and psychiatric disorders was found. Migrants showed a very inconsistent assessment of HCV. Furthermore, available studies recorded data from populations with high heterogeneity of anti-HCV prevalence, Therefore, the reported results need caution in their evaluation. Full article