Vaccinating refugees, migrants and asylum seekers
Immunization benefits all people, not only by improving health and life expectancy, but also reducing economic and social costs both locally and globally. At a global level, joint strategies to reduce diseases, preventable by vaccines, not only help saving lives, also improving global health and security (WHO, 2005).
The social condition, the cultural shock which characterize each migration, even if it is for short period, the language barrier are the main elements of differences between migrants and the local population in the health context. The specific problems related to the vaccination itself (e.g collateral effects, hesitancy), are the same of the local population, and they have been treated in the previous and further modules.
Introduction
Ethical issues to consider
If ethics is a reflection between good and bad in the daily decision making, the management of care problems related to this specific population, requests to the health professional consciousness and cultural competence. This latter competence has been described as a “process in which the health care provider continuously strives to achieve the ability to effectively work within the cultural context of a client” (Campinha-Bacote, 1999). To answer this competence, and work in an ethical way, a professional should start from e real knowledge and comprehension of the person in charge, which include, health and social condition, but even specific laws, characteristics of the migrant path, culture or cultures of reference. Starting from this knowledge, the real encounter with the other, is possible only if the prejudices are aware and left aside (Gradellini, 2020).
Campinha-Bacote, J. (1999). A model and instrument for addressing cultural competence in health care. Journal of Nursing education, 1999, 38.5: 203-207.
Gradellini, C. (2020). Talking about Prejudice. A project for the nursing courses. Health and Primary Care, 4: 1-5. https://oatext.com/pdf/HPC-4-196.pdf.
Epidemiological data
Many childhood infection diseases are preventable by immunization. However, in many countries of migrants origin, vaccination campaigns are not so developed, and the individual data/reports are not easy to be found. A lower immunization rate in children with different nationality from UE is confirmed, and it becomes a risk factor for the overall coverage (European Observatory on Health System and policies Series, 2011).European Observatory on Health System and policies Series. (2011). Migration andHealth in the European Union. New York: McGraw Hill.Screen for vaccination and controlling diseases
Screen is important in adult migrants because different factors may increase vulnerability to infectious diseases and; because due to the low coverage in many countries of origin many may be susceptible to preventable diseases with vaccination (Pottie K. et al., 2011). Migrants adolescents and children are more likely than their parents to have received vaccines that are part of the World Health Organization Extended Programme on Immunization, however, many may not have received all the vaccines (Nglazi MD, 2013).PottieK, Greenaway C, FeightnerJ, Welch V, SwinkelsH, Rashid M, et al. (2011). Evidence-based clinical guidelines for immigrants and refugees. The Canadian Medical Association Journal (CMAJ) September, 183,12.Nglazi, M.D., Bekker, L.G., Wood, R., Hussey, G.D., Wiysonge, C.S. (2013). Mobile phone text messaging for promoting adherence to antituberculosis treatment: a systematic review. BMC Infectious Diseases, 13 (1), 566.
Self-tests and assignments
To reflect on the care approach to people from other cultures, it is important to introduce a few theorist who study about this specific context. Some of them are from the nursing field, but the way the talk about the care approach could be useful for all the health professionals.
Further reading
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