World Refugee Day 2024: Highlights from the BMC Series

World Refugee Day is an international day designated by the United Nations to honour refugees around the globe. It falls each year on 20 June and celebrates the strength and courage of people who have been forced to flee their home country to escape conflict or persecution. World Refugee Day shines a light on the rights, needs and dreams of refugees, helping to mobilize political will and resources so refugees can not only survive but also thrive. In this blog, we are raising awareness by showcasing the impactful research contributions across the BMC Series.

Photo by Michael Starkie on Unsplash

BMC Pregnancy and Childbirth Refugee women’s and providers’ perceptions of person-centered maternity care: a qualitative study in two refugee camps in Chad

Women often experience acts of obstetric violence or mistreatment during labor and delivery. Conflicts and crises add new challenges to vulnerable health systems, disrupting emergency as well as maternal health services. These occurrences may further deteriorate maternal care, thereby contributing to increased mortality and morbidity. Person-centered maternity care (PCMC), defined as care that is respectful and responsive to women’s needs and preferences on clinical decisions is increasingly regarded as an essential component of healthcare during childbirth at the global level and a vital factor in reducing maternal mortality.

PCMC becomes vital in humanitarian settings, where conflict and displacement pose additional challenges to delivering respectful and responsive maternity care. However, evidence of its implementation and effectiveness in refugee camps remains scarce.

The authors of this study explored Sudanese refugee women’s experiences of PCMC in Chad’s refugee camps, offering valuable insights into the practices that support or hinder respectful maternity care in these challenging environments. With facility assessments and additional interviews with trained and assistant midwives as well as birth attendants, the researchers aimed to align the providers’ and patients’ perspectives on PCMC and determine the capacity of the maternities serving refugee camps to provide PCMC. Whilst many women reported positive experiences with maternity care providers, challenges such as insufficient staffing, language barriers, and physical constraints of the health facilities occasionally led to feelings of neglect or disrespect. Overall, these findings indicate that PCMC can be effectively provided in refugee settings but targeted action needs to be implemented to ensure all women receive high-quality care. This study contributes to our understanding of PCMC in refugee settings and demonstrates the need for systemic changes to address resource shortages, improve training for healthcare providers on PCMC and ensure respectful and supportive care.

© Kotchakorn /

BMC Primary Care Barriers and facilitators to self-measured blood pressure monitoring among US-resettled Arab refugees with hypertension: a qualitative study

Hypertension is a main preventable risk factor for all-cause mortality and one of the most important modifiable risk factors for coronary heart disease and stroke.

Self-measured blood pressure monitoring (SMBP or home blood pressure monitoring) has been shown to improve hypertension control.

In addition to facing well-known disparities in hypertension management as other minorities and medically underserved communities, resettled Iraqi and Syrian refugees have been listed by the Centers for Disease Control and Prevention as a high-risk population for hypertension. This qualitative investigation aimed to enhance our understanding of SMBP monitoring among Arab American refugees and inform future interventions targeting hypertension control within these communities.

By interviewing a large sample of refugees, these researchers identified key barriers and facilitators to SMBP, such as the lack of access to home blood pressure monitors or the hesitancy in using public devices, as well as the pivotal, positive role of family support.

Interestingly, factors such as poor hypertension literacy, cultural stigma of illness, and anxiety about poor health significantly influenced SMBP practices within this community, thereby underscoring the need for tailored interventions that address both socioeconomic and cultural determinants. Based on these findings, improving patient education and supporting self-management of hypertension become imperative objectives of any hypertension intervention for this refugee community.

Lessons from this study are transferable to other minoritized communities and highlight the importance of understanding the culture of minoritized communities to improve healthcare delivery and clinical practice.

*** © Marijan Murat / picture alliance / dpa

BMC Medical Research MethodologyOvercoming denominator problems in refugee settings with fragmented electronic records for health and immigration data: a prediction-based approach

Reliable health monitoring and determination of disease estimates in refugee centers are hindered by missing data to capture the population at risk, an issue generally known in health services research as the “denominator problem”. The detrimental effects of the denominator problem are particularly evident in refugee settings epidemiology due to the high mobility and fluctuating dynamics of populations residing there, leading to potential bias in measures of illness and health care utilization.

This study proposes an empirical approach to estimate disease frequency in refugee camps with fragmented health and occupancy data. The researchers utilized individual-level patient data from primary care surveillance systems and matched these with aggregated occupancy data from German refugee centers. This innovative method enabled the analysis of relationships between occupancy, patient numbers, and disease incidence, which, in turn, could be used to predict the ratio between patients and total occupancy and disease incidence when only occupancy information was available.

In conclusion, this research offers a potential solution to the denominator problem in refugee health research and presents significant implications for health needs assessment, health service planning, and surveillance in refugee settings.

By enabling more accurate prediction models and estimates of disease frequency, this method can improve health systems’ ability to quantify needs, plan services and detect infectious disease transmission among highly mobile populations.

Image by FETHI BOUHAOUCHINE from Pixabay

BMC Health Services Research Reimagining mental health care for newcomer children and families: a qualitative framework analysis of service provider perspectives

Arabic-speaking refugees or immigrants resettled in Canada report poorer mental health compared to refugees or immigrants from other regions e.g. Latin America or US.

Particular emphasis needs to be given to the mental health of refugee or immigrant children and adolescents, as migration stressors mark a critical period in their development and are known to be related to depression, anxiety, and elevated symptoms of post-traumatic stress. Remarkably, however, evidence shows that newcomer children and youth consistently underuse mental health services compared to Canadian-born peers with comparable mental health status.

This qualitative analysis of the perspectives of providers identifies barriers and examines opportunities to improve mental health care for Arabic-speaking newcomer children and families.

Lack of resources, cultural misunderstandings, staff shortages, lack of mental health knowledge or cultural competency contribute to mental health services inadequacy. At the individual or family level, mental health literacy, prioritized settlement needs, stigma, and fear of repercussions for disclosing a mental health concern are found to be major impediments to help-seeking, ultimately, leading to underutilization of mental health services among newcomer families. While barriers at the level of systems, providers, individuals, and families create disparities in access and quality of mental health care for children and families of newcomers, service providers have advocated for a shift to culturally competent, integrated, collaborative, and community-based models of care to increase accessibility, reduce stigma and mistrust, and promote the well-being and resilience of new Canadians.

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