Publications

Recent years have witnessed the growing emphasis of the Chinese central government to develop community services as a method of building communities and strengthening social solidarity. With the increased involvement of multi‐generation households in China’s internal rural‐to‐urban migration, however, little is known about what community services are available for migrant families. Nor do we know much about how such services can enhance social support for migrants, which is crucial for their psychological well‐being in managing the ongoing challenges that arise from migration and further integration into cities. This article presents a case study conducted in Shanghai where social services are emerging in a few urban villages. We begin with a brief background on China’s rural‐to‐urban migration and the emergence of urban villages, followed by a discussion of community services and social support for Chinese migrant families. We then document existing services in an urban village to explore how they can influence migrant families’ social support. Drawing on the perspective of service providers, we highlight the effects social work interventions can have on improving social support for migrant families. Finally, we propose an intervention framework based on multi‐dimensions of social support, emphasizing an integration of formal and informal social support through community services for migrant populations.

China’s internal rural‐to‐urban migration has impacted the country in economic, social, and cultural terms. Despite the increasing number of families involved in migration, little is known about how migrant families as a unit adapt to new environments from rural to urban settings. Policy making needs to be informed to address migrant families’ needs. This article investigates how Chinese families experience transitions resulting from migration, exploring their use of formal and informal support to achieve adaptation and the process of making evolving choices for their children. We begin with a brief introduction to the literature on family resilience and its relation to Chinese migrant families. Then we provided an analysis of Chinese social policies most central to the experiences of rural‐to‐urban migrant families. After a brief description of methodology, we present our findings starting with a migrant family story to provide an anchor for the following discussion on how current policies can impede or facilitate migrant families’ resilience. Our conclusion is that lack of social support leaves migrant Chinese families vulnerable when coping with enormous social, cultural, and economic transformations. Family constitutes the basis of Chinese society; therefore, a policy framework on social support is important to support these families and foster family resilience.

Research articles about unaccompanied refugee minors (UM) have rarely addressed ethical issues. This is remarkable, given UM’s specific, marginalized and vulnerable position within society, and the growing interest and developments in research ethics in refugee research. This article poses the question whether studies involving UM raise specific ethical issues compared to research on other refugee groups. We formulate personal reflections on ethical issues in a particular research project—a longitudinal study of UM in Belgium—and connect them to the existing body of literature on research ethics in qualitative and refugee research. We conclude that research ethics in studies with UM need to be multilayered because of researchers’ obligation to take ethical responsibility at both the micro and socio-political levels

Depuis plusieurs années la population immigrante est en forte croissance au Québec. L’augmentation de ce segment de la population modifie les caractéristiques de la main-d’œuvre, ce qui peut avoir des répercussions sur la santé et la sécurité du travail (SST). Dans ce contexte de diversité de la main-d’œuvre québécoise, il devient nécessaire de connaître les caractéristiques du travail des immigrants pouvant influencer les risques pour la SST. La présente étude vise à dresser un portrait de la main-d’œuvre immigrante en s’appuyant sur des études dont les analyses reposent sur des données statistiques et à répertorier les enquêtes populationnelles pouvant contribuer à documenter les caractéristiques du travail des immigrants et les risques pour leur santé et leur sécurité. Une meilleure connaissance de la littérature et du potentiel qu’offrent les bases de données issues d’enquêtes populationnelles contribuera à orienter l’exploitation des données statistiques pour le Québec afin d’alimenter les recherches et d’identifier les lacunes informationnelles en matière de SST concernant cette population de travailleurs.

Les résultats de la revue de la littérature ont été divisés en cinq grandes thématiques : le contexte et les caractéristiques de la population immigrante; les immigrants sur le marché du travail; les conditions de travail et d’emploi des immigrants; la santé et la sécurité du travail des immigrants; les résidents temporaires.

L’analyse du contexte de l’immigration et des caractéristiques sociodémographiques de cette population a permis de relever plusieurs différences avec les natifs du Canada. Ils forment, entre autres, une population plus jeune, présentent un rapport de masculinité plus élevé dans le cas des immigrants économiques, comptent une proportion de diplômés universitaires supérieure et affichent un état de santé général plus favorable à leur arrivée.

En ce qui concerne la situation des immigrants sur le marché du travail, les études constatent qu’ils ont une plus grande difficulté d’intégration sur le marché du travail que la population née au Canada. En plus de méconnaître le marché du travail canadien, leur expérience de travail, leurs titres de compétence ou leurs diplômes sont rarement reconnus. À ces facteurs pouvant expliquer les difficultés qu’éprouvent les immigrants, s’ajoutent aussi les barrières linguistiques et culturelles.

L’analyse des conditions de travail et d’emploi des immigrants a permis de relever que, pour certaines variables (formation, cumul d’emplois, taille d’entreprise, etc.), il existe peu ou pas de différences entre les immigrants et les personnes nées au Canada. Toutefois, les résultats peuvent fluctuer selon les variables considérées (durée de résidence, profession, secteur d’activité, etc.), la méthodologie choisie et la source de données utilisée.

Bien que les immigrants soient nombreux sur le marché du travail, peu d’études quantitatives se sont intéressées aux risques spécifiques auxquels ils doivent faire face. Ceci s’explique, entre autres, par le fait que les enquêtes nationales incluent rarement de l’information sur les lésions professionnelles et les conditions de travail et, lorsque c’est le cas, la taille de l’échantillon limite les analyses. La recherche bibliographique a tout de même permis de recenser quelques études sur le sujet. L’une d’elles (Smith et Mustard, 2010) montre que les immigrants sont davantage exposés aux risques pour la SST comparativement aux canadiens de naissance.
Par ailleurs, même en tenant compte dans les analyses du secteur d’activité économique, les relations se confirment.

La revue de la littérature portait également sur les immigrants temporaires. Bien que cette population soit difficile à estimer, les études indiquent une augmentation des effectifs depuis 2008. Parmi les études sélectionnées, aucune ne présentait de statistiques sur les immigrants temporaires et la SST. Toutefois, l’étude de Preibisch et Hennebry (2001) souligne que l’augmentation du nombre de travailleurs étrangers temporaires, en particulier ceux qui occupent des emplois peu spécialisés, pose certains défis au regard de la santé et la sécurité du travail.

L’inventaire des sources de données statistiques issues d’enquêtes populationnelles a permis d’évaluer leur potentiel d’analyse pour la population immigrante et les risques pour la SST. Au total, 12 bases de données ont été analysées au moyen de deux outils, soit la grille « travailleur, emploi et atteintes à la santé » et des fiches descriptives. Dans l’ensemble, les variables qui permettent de caractériser le travailleur sont très présentes dans les enquêtes. Par contre, si les variables liées à l’organisation du travail y figurent, elles portent davantage sur le temps de travail que sur les aspects psychosociaux. L’absence de données probantes sur la formation qu’ils reçoivent ou sur l’information en matière de prévention qu’on leur communique en milieu de travail constitue une limite de ces enquêtes. De plus, on constate d’importantes lacunes informationnelles pour les variables liées aux situations de travail. La littérature et les bases de données permettent de documenter les atteintes à la santé et leurs conséquences, mais la thématique plus pointue des atteintes liées au travail est souvent négligée.

Il ressort de la revue de littérature qu’il existe peu d’études statistiques qui ont exploité des données sur la santé et la sécurité des travailleurs immigrants. Par ailleurs, certaines variables clés comme la durée de résidence, la profession ou le secteur d’activité économique peuvent s’avérer utiles pour l’identification des groupes vulnérables. D’autre part, l’inventaire des sources de données statistiques montre clairement qu’aucune d’entre elles ne permet de brosser un portait complet des travailleurs immigrants et de la SST au Québec. Tenant compte des limites des bases de données, l’inventaire a fait ressortir la pertinence de certaines sources qui pourraient permettre de connaître ou de suivre la situation des immigrants sur le marché du travail, en lien avec certains aspects de la SST, ou de comparer celle-ci avec celle des natifs du Canada. Ainsi, le recours à plusieurs sources de données ou encore aux méthodes mixtes (qualitatives, quantitatives) pourrait servir à répondre à certaines questions de recherche sur cette thématique. Certaines recommandations sont d’ailleurs adressées aux organismes responsables de la collecte des données puisqu’ils déterminent le type et la disponibilité des informations concernant les immigrants et la SST.

Methods:

This two-year longitudinal prospective cohort study recruited patients with first-episode psychosis who were entering early intervention services in Montreal, Canada (N=223). Data on sociodemographic characteristics, symptoms, and social functioning were collected annually.

Results:

At two years, immigrants had more than three times the odds of attrition than nonimmigrants after the analysis controlled for potential confounding factors (first-generation immigrants: odds ratio [OR]=3.11, 95% confidence interval [CI]=1.01–9.57, p=.049); second-generation immigrants: OR=3.65, CI=1.07–12.50, p=.039). Medication adherence was similar among those who remained in the programs.

Conclusions:

During the two years after entering a program for first-episode psychosis, immigrants were more likely than nonimmigrants to disengage from treatment. Further research is warranted to understand this phenomenon and to improve the ability of services to engage immigrants with first-episode psychosis.

This article describes the development of a dynamic culturally constructed clinical practice model for HIV/STI prevention, the Narrative Intervention Model (NIM), and illustrates its application in practice, within the context of a 6-year transdisciplinary research program in Mumbai, India. Theory and research from anthropology, psychology, and public health, and mixed-method ethnographic research with practitioners, patients, and community members, contributed to the articulation of the NIM for HIV/STI risk reduction and prevention among married men living in low-income communities. The NIM involves a process of negotiation of patient narratives regarding their sexual health problems and related risk factors to facilitate risk reduction. The goal of the NIM is to facilitate cognitive-behavioral change through a three-stage process of co-construction (eliciting patient narrative), deconstruction (articulating discrepancies between current and desired narrative), and reconstruction (proposing alternative narratives that facilitate risk reduction). The NIM process extends the traditional clinical approach through the integration of biological, psychological, interpersonal, and cultural factors as depicted in the patient narrative. Our work demonstrates the use of a recursive integration of research and practice to address limitations of current evidence-based intervention approaches that fail to address the diversity of cultural constructions across populations and contexts.

While anthropologists have reflected on ethics and power since the late 1960s, the specific dilemmas that arise in research conducted with children and youth have scarcely been addressed. Nevertheless, critical anthropology’s reflections on power relations and reflexivity can valuably contribute to the interdisciplinary debate in the field of childhood studies, by complexifying categories of voice, dependency and agency, which are often taken for granted in the ethical conversation. Drawing on ethnographic fieldwork with undocumented youth in Montreal, this article argues for the importance of a critical understanding of childhood within a wider context of interdependence, and consequently, for a redefinition of ethics as a reflexive and relational space of intersubjectivity.

OBJECTIVES: Study results on child maltreatment based on general population samples cannot be extrapolated with confidence to vulnerable immigrant or
refugee families because of the specific characteristics and needs of these families. The aims of this paper are 1) to conduct an evidence review of the
prevalence, risk factors and protective factors for child maltreatment in immigrant and refugee populations, and 2) to integrate the evidence in an analytical
ecosystemic framework that would guide future research.
METHODS: We used a 14-step process based on guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Canadian
Collaboration for Immigrant and Refugee Health. We searched major databases from “the oldest date available to July 2014”. The eligibility criteria for paper
selection included qualitative or quantitative methodologies; papers written in English or French; papers that describe, assess or review prevalence, risk and
protection factors for child maltreatment; and a studied population of immigrants or refugees.
SYNTHESIS: Twenty-four articles met the criteria for eligibility. The results do not provide evidence that immigrant or refugee children are at higher risk of
child maltreatment. However, recently settled immigrants and refugees experience specific risk factors related to their immigration status and to the
challenges of settlement in a new country, which may result in high risk of maltreatment.
CONCLUSION: Future research must incorporate more immigrant and refugee samples as well as examine, within an ecosystemic framework, the interaction
between migratory and cultural factors with regard to the prevalence, consequences and treatment of child maltreatment for the targeted groups.

Children and parents seeking asylum are regularly detained in Canada, however little is known about the experiences of detained families. International literature suggests that the detention of children is associated with significant morbidity. Our study aims to understand the experiences of detained children and families who have sought asylum in Canada by using a qualitative methodology that includes semistructured interviews and ethnographic participant observation. Detention appears to be a frightening experience of deprivation that leaves children feeling criminalized and helpless. Family separation further shatters children’s sense of well-being. Children’s emotional and behavioral responses to separation and to detention suggest that the experience is acutely stressful and, in some cases, traumatic–even when detention is brief. Distress and impairment may persist months after release. Given the burden of psychological suffering and the harmful consequences of separating families, children should not be detained for immigration reasons and parents should not be detained without children.

From 2011 until 2012, members of the Canadian parliament debated three iterations of legislation relating to the detention of asylum seekers. The final bill, unlike its predecessors, exempted children under the age of 16 from mandatory year-long detention, opening the door to children’s prolonged separation from parents or invisible detention as guests alongside mandatorily detained parents. Using a critical discourse analysis approach, we examine parliamentary debates and seek to determine how speech acts within the Canadian parliament construct a (detained) migrant child. Our results suggest that parliamentarians invoke logics of human rights and humanitarianism and that a reconfiguration of these paradigms places the state rather than the refugee in need of protection, thus introducing a hierarchy of compassion. Within this discourse, children are rendered so vulnerable as to be voiceless, enforcing the corollary image of the threatening adult refugee, which ultimately allows detention of children to be framed as a protective measure. We hypothesize mechanisms that make such constructions possible and discuss the implications for advocacy efforts.

The issue of irregular migration is experiencing heightened attention in political, social and legal arenas. While deterrence and crime-control discourse and practices dominate current approaches to irregular migration, this article seeks to focus on the problematic neglect of the treatment of irregular migrants in destination countries, in relation to their ability to access fundamental rights and basic public services. This article will put forth an argument for the establishment of firewalls – a separation between immigration enforcement activities and public service provision. This article will canvass existing trends and practices that have both contributed to the erosion of firewall protections, and have built and maintained meaningful firewalls between immigration and public service provision.

At the end of 2011, 34 million people worldwide were living with HIV/AIDS (PLWHA), 68% of these in Sub-Saharan Africa (UNAIDS, 2012). HIV and AIDS remain a major public health challenge that continues to affect the lives of millions of people globally. Gender inequality has been recognised as a key factor to understand the dynamic and impact of the epidemic, particularly in Sub-Saharan Africa (Niëns & Lowery, 2009; Steinitz & Ashton, 2007; UNAIDS, 2012).

Background and Purpose

Migrant-sensitive care provision has been identified as a priority in the World Health Assembly Resolution, ‘Health of Migrants’. Little research has been done on the extent to which migrant-sensitive (‘friendly’) maternity care (MFMC) is currently being provided, factors that support or inhibit provision of such care, and whether specific components of MFMC may be more important than others. We sought to determine: (1) to what extent recommended components of MFMC are being provided to recently-arrived international migrant women giving birth in an urban Canadian city; and (2) what contextual factors support the implementation of MFMC.

Methodology

We conducted a mixed quantitative-qualitative study of 2400 women recently giving birth, speaking any language, in Canada <8 years, and from non-Western countries; and 63 health professionals. Medical records and unit documents were reviewed. The Migrant Friendly Maternity Care Questionnaire was administered and open-ended interviews were completed.

Results

Women from over 97 countries, speaking any of 79 languages reported on their perceptions of how the health system responded to their needs including communication facilitation, promotion of social support, education for healthy weight, treatment of pre-pregnancy/perinatal/maternal illnesses, early access to prenatal care, and responsiveness to preferences for care, among other indicators of MFMC. A range of professionals reported on challenges to care provision and how these were met.

Conclusions and Discussion

Empirical data on migrant-sensitive maternity care, contextual factors supportive of that care, and associated reproductive health outcomes offer baseline data for programming and to permit benchmarking nationally and internationally.

Key messages

• Empirical data on migrant-sensitive maternity care offer baseline data for health programming

• Migrant-friendly maternity care data allow for benchmarking for the future