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Migrant children and young people’s voice in healthcare

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Abstract

This chapter addresses the issue of children and young people’s participation and ‘voice’ in healthcare provision, in the wider context of their inclusion in social and political life and with a focus on young people who have migrated to the UK with their families. While children and young people’s participation in decisions that affect their lives is stipulated as a right through the United Nations Convention on the Rights of the Child (1989), public services still vary in their commitment and established mechanisms for including children and young people’s views in improving provision. The chapter draws on research with Eastern European migrant children newly arrived in the UK in relation to experiences of healthcare provision post-migration. The main focus is on their views of health service provision, the barriers they face in relation to health service use and the strategies migrant families adopt to overcome perceived shortcomings in provision, including adopting a transnational use of health services.

Chapter 22: Migrant children and young people’s ‘voice’ in healthcare
    !" #$ %&$' %()*+' Handbook of Migration and Health, &,-& .-
 .$
!"/-0- 0&"&"1
Introduction
- 1&-0 -.-,.!!!.0.
&  -/"&.&!2.$ -
 !-2.0.3/,&. --
!&.-& -&-.!!$ "-- - /
 -& - &-.  !  45  &03 - -   2.  -
6-& -/,, !- !& -/$-%())**78'
-.&  &-3/ && 0 / -,
 4-   - , -. 3 & -.0 6-   ,-&   - , ,0$
&.&3 -/!-  -  &-&0. -
-- ,-&-."&0.3.-.
2,&.&&.-&$
 &-3&6- &!" &.  -0 - -
/,--,0//. !-&&" /-.0-.&
0-- &0!2-2% ())('$ *797&/
  .    &%'-0-! &-&0.3-. 
&:&-& /."   . &-&   & -.   
&&-&  /&-! -/$ ! 
&. &-& 0. &2. -/, 0 .&
-"  !-  -. & !" &-/ /&0 
-  -. --&$
  -6"!-2,&.  &-&0.!0
6-  "  &  - -/ .0&,0 &$
      -.   &  -& -   &- & 0. "
--/ -/-"&.0" 0".."-
-$&03.&,-&" /-&--!",0
/,0"  &-3  !& ,. &--&/- "
 &!.-$ 6,   --. ---&
&& ,0,   0- . 0 - ,   0
/$
 &-&0.3  &,..0- -/-0&0
/"- - ,   0/$ 6".
0.3/,-/  -20"-  -&-!&
 &0   . --/ !.  &$ !- 
- /- -&" - .- - !- 20  &&
&$ ;.  -&0 6&& -     - -0  0" -
6!" /.6-!/-0"!.-" &0&-!
 "-0.&$!0-"-.-
&6.-/"-. -/!. --&" 
0!2-"-.-.!.-%<0,-()*)'$
  -&-,-- , --!.- &-,0--/& 
1-6-  --/!.-$ . &-&.
-3/,  --/20-!.0  -&!-"
 /,!.-.-"&--  &-&0."---0
6-&$ -&-&&- ."   -6!-  ,&-6  
 0&!  !.- &-&&" &-! 
 !.-  &-3  ! &    -   &  
 --/!.-$  ! &-&0.3/,
  -/ -/"  --- 0 -   -/ & 
-.!.-!&/-!-/& -!.-/"&.
&.-  -/$
 6!.-"0.36-  --.
-/!. &&! -&" 0!06-&
----!& :0 -6-$-&0!&" &-
&0.  - &  - -. "&/ &  
&/&  -   -.  - !$    - . .    !- - 
!.-3/--  -/", .-- &-
&0.--2--&"&& --  0
&-&/-0 &2 &&6&/-$
Seeking the views of children and young people
  -"--!.- &-&0. , ,--
-0& -& --0,  -!0" -. &- - 
-& !.-$&&-. &0!2. &-"  -&-
2,&.&!-!6"& 20!--!- -!.--0
& .%1 ())+'$ /-  ,&&"-- ,  &-
&0. . -! ,-- --/ &-
& -0- -- -"0-- -"
-- --&-- -%1())='$  &&! 
 4! &3%-0.-'"& .&- &-&
0. 30-6-  -/" -&  -
-/ & --/ --/.0%<!&-*77>?
<!$*779? *779?- ())='$  4, .0 & &3! --!
/,  & & 6-&" && &&&-   
/ &-&0.--$
@  &-3-. - / -& &/
 .   &%'*797"0-0  &-3&0.
3 /, /  2,&.&  /&   - , -. $  -  , 
6 -- ,&- &-3-. -/..
  !"&.!0.-&--/&, &
 -/  0$ -%())* *78'-.&  2.   &-3 /
 &!---042:60&-/
,-&-/-/&&0.3..!, 20
  3$
-*(& *8  60&&- -.   &- -!&"
//&&&&  -/" .  -. -6-&
, /- /" ,  /  -& -   &  0  -
!! % ())9? 0- ()**'$ #- 6!" - *( !   -.  
-   &- ,  - 4  -!.  - , /,3" .  
-0&&&&/& &-30$ .0&
:-& ,0 & &&0, !-&.
& ,-" 0!2 5&.!$ . -*( 
  &  2 -0 - &.  &-3 /,"  ./ /-0 
.&  ,   !.    /&$ !-0" - 8" ,  & 
-  &20--00!-//. &-"! &
&-- &-3-&,.$/- " !-
-. -,-& -"&&-! !&0 &-, 
!.  /- &&-  ,0 ,  & -.   -"
-&/-0--&-!".-&-%.
())8'$ /" /-/&--!,-2&! !
-!,-. &--- &   & && ! &
0   ,&-     &-3/  ./- /-
/$ 1"-6!"-   &-&#!()*8 
.&%()*8'" &    &-&;.  %&'()*8 %
-! ()*8'!  !-./. &-&0./
-& - -/A-6!" -. -.!-/!
  -/ A &  -0  -/  - - -
$
The impact of migration on the health of Eastern European migrants
B.--0- 1 /. ./- ,&&"
-!!.-3-0-."--!.-&!-%
& B- ()*8'$  -!    1   &   !-  
>$=C!"-*(- 1",---&%()*8'",
 !!!-- .&"&&2$@  6
 -%' &&"-.!--!.- 
1,!-! - & - -$2  " ,  !0 &
!.-&" .!- -0--/&-!.- /!.-&
. -,  -!"!0,  & &-&0.$2
--/.-! -"!.- /!  - 
1"   (9  !!-  /  - 0 -& - -.& /-
 -$()**"&-/  - -!-,!!-
 &    & . :0--&-  - - - D
%- ()**'$ E,/-"&-  -"!-/0
2,!.-3  &,./-& -6-.
 --/!.-$
 - !--0--/&!.- &&!.-3
! !0" 20-&!&--/&"!--&0"
  !.-  -/& &0  -/.-
%;//()**'$--&!!.-- -/
-/%-()**'$@ !! -&!.- &--
-/ 1 6 %  !!0  ())>'" - /
-&-!.-3,2  -%&B())7?
$()*)'", !-& ... - , -& -!!.-
/-&&,.!- ----.&%F
$()*='$ .-0 -/&  - !.--!00.&  0"
,   !06 -,-/$  4  0!.-3 !0 &
"!.--20&- -  -&&.!/-&$
E,/-"---  , -,  4  0!.-3 
-0.!.--0,/"!.- / . --2&--.  /-!
 -.  &4  -3% &D!())G'",  -
&&0!-/! -!&$$%()*)'
. . & !0 --- !.-/-!
-!- - -/-20  -" 
  &  " 0 &, /   0 /0" &! 
-$ -&-&60-..-&0  6-!.-. /
2& . --2&/.!!&"  -
&"&-&60%()*)'$-&-!.  
!?-6!" -. -..!-&!  ",  
&/-0 !  0 . & !  & &  2. -
- $  !5- - -- .   !.- &/&3
 !  &!.-3  --"!0!.-
-  !..-&-0 - &!!.- - --&&
0,   -/-&$
@ &   &!.-- !&/-" &     
!.- &- 1-!6$, -"&!.- &-
/ --&    :    -   - -& -2  --
 0&!  $ .,   0!2 --!-0
 -  . . &  .  ,  0 &    , -0" ,
0.-  &- -. -  -!   & & ! % . &
B- ()*8'$ - , !!.- &  -  --&   -
&-.  0 &!  " & " , .0
. --0 .&-&0 .-!%& &
BD()*8'$ 2  --" 0.-- !.-!0-/ !
 &&,--0 .!.-"&/&
   0--&-2 !!&  &-"
60&&&-!.-.-%()*)'$-$
%*779' /&& /- :  !0 -  ! 
!.-0 $ &&.!0-?&-&
& ..?&--& ,!,  -!.  -
-36-/-! - !&$!!.- &-
6--! &. - &%/())7'",  !0--
!&,- &.!-.$
 &-!   -! &/&  -- %  ." 6 &
 -'"   & !!0 ,-2 & ! &
/-!&% &" .",-2.&'020-
6.   -&!-!.-.-% .-&@  &
*77*'$ B.-36---&&   "0
5!.- ..& / !-!&
,0   .  -  ! %0 ()**'$ #- !.-  ,2& 5"
./-!!-! --,-2&-/--.-
&./-!.-.0- -&&/.
& - --0 & 0  -  !$ #-  
&-6&--   / ,
   -& &!2. &  /-  !.- -! ,& -. 
!2.-&%-$())>?()*8? !()*)'$B.-3 
  &0 -. "&! - &3 
-!.-   && 0-  -&0&& 0 6.
!&&-!  %!()*G'$
Conducting research with young migrants
 !!.-  &- & 0.3  &,.", 
 - /,   -    - -/ & 6-   -/
-/0,-- - - 6$&-  !
-- -- -  &  :   -- !-  -.  
-&&&!&&"--/--&!-
!0.$ !%())9' & &/.&.--0&
/-- ,  &-", ! !2!- --
-$0-.. &-3& -.-. &&&-.
 &, -/," &-./& ! 
-- &!$ --0 & / -!--    /
! & -  , ,0 --/& 0. !.-" --0 , - 0   
..     !0 $- - & &-  -
--"-! ."  0 &"& ,  ,-
-  -&""&"0&
&!%!())9'$
 &-&":/--  -&/../.!.- &-/
-!--0"-&&.!.-&5$E,/-"
-- -&!&!.- &-3,  -!&0
/-$  - -  &.& 0 -& - %! ()*='$ 
!"&!0 , -  &-3 ---&  
!-!-, &-/-!0- "-&
-"-&!0,2  - &-$
  -"&-,&&, =>-- &-".&/*+"
,  &/&&-  -0- ! &0$ 0,-
.&-%8* .- &(+ 0'&-! -. !2.-& &  
!5-0%G9',- " !!.--0.- 1())G$F/ &-
&0.3&/-!&--"-.-- ! &&
 :,-&- //&,-& 6-
 - /,$ #&,-2 !&  .-" &/& -/," &- &
 .- 0$#.- / ,,-2,,  &-%E0&E-0
())='"  0, !!  -3&"&, -- -
 6,   .- -&6-$ 0,-&&
  &-3, .. %.  .-'&, --- --!.
.-% -.-'" &/-& &-3  &/, - -. 
-/"&.  -$-,--.&&- 6-
40!.-!03" :&&-&--& -- /.
 ---"&-,. -2,&.&!.-3/
 1$ 0& 2&-0, !.- &4,&36-"
-  - , 6-  0, &$ &-& /,- &"
&!.-/ &-,-20A  "!&-"
--"-2"$A& &/"! &-3 !&
..!% -&<!()))'$
#,.  -!    .-" (8 & !0  & ,- !&"
&.(7 &- %6- .,-//&'& - 
!0$ &&&!5-0  &-%H*8'"&/ "
-/2",.-&,! &-",E.-"
&D !0$"*=.-&*G0,-//&", /-.
.**%.-.,9A*+0-&'$&&/ &-3
!" ! ,-  !--6&/-!   $ E,/-"
&!-,0&- &-&0.3-" -
 -&  ,  - !0!!- %! ())9'$  - &-3  
-/- -",./ ! -02 .- -/ 0
&&!,20&-0$@ ! &-&0.50& 
/" -,-!--&---&52 -6-$ 
. .  !- /.6& : 0.
 -!& 0-.".." 0.-
.-!2-$
Young migrants’ health behaviours and engagement with health services post-migration
&-!.- /&..,   -/-.-0 
 !5-0%-$())>?$()*)'$
 !.-&&-- -/ % $ ()**'" -/-0 0!
/& 1-/&0!.-"-&/,-/
/$ -!&/& ,!.-3   /---
 !0 !.-& . -!0!&- ,
0$ &---.0&0 -!3&  &  0
 /-%!()*G'$ -&/!.&/& /20- -
  % ())>' &"      !.- !" - / &
2,&.    -    &  - %B.. & F!-"
()**'$
E  /- & - !0 -   -/ !- - &/& &
!" 0-.-&0-.6",  - &-&0.
  " !0"- .-& . - &%B--, ()*)'$@ 
! - !   .& &-0 "   &- !.-
&!0&/! ! - !-%()*8'" -
/ ! &   ! - & :   !2 / 
-!--& -%B1&-2$()*G?D-()*G'$-
& &-!0, &  0 /-&. "!0!&
0 /0&-&0  0&--/$
--- "!  &-&0../-.0/ -
 /-& ,- & -!. -/ /"  F"
 -!" &&$B &-,-&--
   0! &  -   0 -&  &"  !2.
!- , -/  0 &-& - -0-.$ .
!! 0,&&- -!:0-/A-6!" -
-  !  !& A 0 -.-0!!&   -
:0 --&:!& -----/ &
 2&0/&
ID %*('B0 &&!&- 2&- -" 3 -$
!0&0.-&-"0F$
 -%*8' 2  &---$
D%*G' 2  ! -& -$
@%*G' 2  0 /-:! -$% .-'
@ ! &-,--.-&, !0&-%-F'"!,-"&,-
-!-.0-/$!&  0 &2-.-
, &- & &  - -0-.$ -& !3& 
-/ 0,-!-, " ---,-2&",  ! 
--,0&!,&2 --.-, -/
 -,-0
We haven’t been here [in Scotland] long, so we didn’t register yet with a doctor, but mum
said we can go to the hospital in case of anything. But we are usually quite healthy.%B-"
 "*('
My mum says we might not stay here [in Scotland] long if she cannot find work, so we kept
our doctor back in Poland, just in case. %B-2" "*)'
B0 &- &0.  !!&   &-& -   -
-!   !& $   ./  !   !,-! & //! 
& --&,.&-
I feel they talk to you more here [in the UK] and they ask you what you want, [they do] not
just [ask] your mother.%"*8".-'
 &-,  - & !!& --&--.   
!.!   - &" & ,  0 &  &  , /,  
!&"-&-..., !&$ &&&-
!& ,--&- !&&--" -:0
 2& !&0.,&-, $20 &-
&0.!!&,",  !&!--
---/-!-&",  1" -&
,-!.&0 F- --$&&!- !!&"  
  - & --   !- &- -& &      -&
.. ,-  - &- ,  ! &&&  -/ -&  
 -$".-.-,  & -0&"6& , 
-/& .,.!--.& ",   -
& -! -3&-/.-&-. ,0
Well, here, you wait like months to get to a doctor which is annoying boring you
know you have an appointment, but it’s so far away that you forget about it and just live your
life and by the time your appointment comes, you are OK. So we went to see the Bulgarian
doctor, the one that operated on me. And she said it’s OK if we wait and see how it goes,
because it might get worse if they operate again. And I trust her more, I feel safer with her.
%"*8".-'
Barriers for young migrants’ access to health
--!!0& !.-!--.--- -/
 !-!.  -%!()*G?()*)? !()*)?()*8'$ 
1 6" ,   .  - -& !     -"
0-!.-"0.& -!-..
&-&   0! -,-0& -..!, -/
-/&-$  &&"   -0 /- - !3 !   - &
-!"0!!&0 -  - --/"-&- -/ &
- -!&..---!2 6-. 
-/!- &$ ",!  -0--- --
 &&  .  -  !.- .-" &. 2  &:
-!"-&- -/-& ..---$-
 -! &-&0.3 -/" - 6-- &
-!&3 ,/, & 0. -   . -/
 -  - !" &   -   -!  -.   &  -
! !5-0..%!&202D()*='$
Lack of adequate information on entitlements and services available
 &-&0.3 6- !.- -.-&0-.
-",  & --3/"-&!0!-$-
!" ! - ,-  5 ,  - /  :"  ,-2. 
-."&-.".----5$B0,!,- !!2-"
&  -!& .  ..2$  ! !0 !-&  
!" --&&&/0 ,-2$#!0!
.&:0 .%&B())7'- 0. - &
,  !.-/%BF $()*8'"!. !.- &-&0.
!0!!-.&& !6- - 5-."
 0"&$ ,! & /-0!0 & - - &
&-&/.&$0.-&,!!&-
. &-/"!.-3  -/& 0  - , --/$
-/---:0&-/&-&!.-!0-2-!
-0, -0.  %-$())>'$&&" /0
  , 0!& 2 &-6- -., -/  - ,
-0!0  !  &&/. -!  -! -/
/$
!0-- "2&,0--/&!.- &- 0&  --/
/ !!0" -,." -!--
- & -!-  $--, - /-!&2,&.
!.,!.--//0%!&#6()*G?!()*='$B0
!" ,0 --/&" ,-  -   - !    -/"
 . --$ 0-&&&!-.0%J'-
4 ! . &3&,-,0 -.-&, &- -&$ &-
-!-  & !& -. -!    !0! !-2 &
,- !   &0 %! &.- ,-    !
!!-',-&0 -!3--&  -$ ! 
!"!!&&-&---&-&
!&-!,   --,&&,&&- -
!!.-$
-!     -/   !&& 0 " ,  & !
-!" -. ---    6 - ,   - -/ -
/ 0-/0!&- ! &"!"   !
-.-,  &- -& -  -.- -!-!$  -"
 &-! !- 4--2-3 - -!" -.-!-
6-.--!-/"-6!"-$
 ,, -%!&202D()*='" &-3 &.!
. &-.-, -/ -.   !46-3 
!0& - ! -&/. /- --" 0  -3
.!&/.$ -/--!!  &-
 / !-!&. -!3-",  
& -& !/  &-,-&  --3 !&.."
- & &0"  ,  -. -- &- ./   -0$
 &-&0.-!-20-,  - &- -. 0
&-!"&&." -!-
%!()))'$- !!0-0- &-&/
,-2,  - .-"& --!&-
-!!0--$E,/-",-2--!0
,0  -/.! 4&-3%$$"  &!!'/-,!-$
#-6!" &-&0.!02,.."/- /
 -,-!,-2... -, -&..-/$
! " !.-  &- -&  -! -!  - -& &  - !&
6--/, -3&&$ -0.!.-
/2 -!3..!, -/ ---:-
!62&&&///0--/&-&$ ,
-!0-&-- !"&.-2 -!  &
,.$
Cultural differences in provision and rules of engagement with services
-/ 6-     0!    !& ,  !.-3
 /-- ,   0! ,-0&"6
 ,-/-&- !&$--&, -
%!()*G'  --3/, &--/&&!
!.!.-", !&,."--&&
&--  -!$ !! !   -/&4-!
-3", -----!&2--&!!0-&,
 --$
I was very sick last year, and they give me only paracetamol, and I was ill for two months. It
was something with my neck, I couldn’t speak. I was in the hospital and they just give me
that.%.2"*=" '
-/&&--  -. & &!!&
!- -!- ,-&/.  -!" -0.!0&
-& - &/ & -!$   -  && !-.0 /   
!&&-&&&/&4,.3 1- .  -.
--/-? - 2. !0!!-  !&- 2 &. ,
2,!&  !&$
Romek [son] got an allergy after the swimming pool, so I went to emergency. The woman
looked at photos on the internet and then she gave me a prescription for some cream. But
then I read the instructions and realised it was for scabies, so I called Agata, my friend,
because her son had a similar problem, and I borrowed from her the cream that she got in
Poland and it helped. %.!-" ! -'
We couldn’t get antibiotics here, and my mum was sure the doctor was wrong, so we called
my auntie back home and she went to our local doctor [in Poland], told them what I have and
then they posted me the medicine.%B-2"*G"&'
 20&.--& --  !.--,-2 &!
!-!-,  0!" 0-&,-2-&!-
-!&  6. -/ & ,   -$ - , - -
!%!&#6()*G?BF $()*8'"-6!" --&!3
--/-&!--0"- .--.!"   -&.--
-" , /,  !/.   - -   - ,-2 -
!-/$  !.- -/  !-/  - ,-2 & /. -!"  -
&-&.&6  -/ .%B..&F!-()**'$
  &-&0." &"-& .-&
 -!!- !!0!  -   /-"& 
&,.&6  -/-20 ./-!$ 
6"--&,-  ..-!.-36&
 -& /-&//-!"--/&&-. -&
&2 - ../&6$
The language barrier
..  20 ---  !0 !.-3    -/$ B.- /
&- /  !    ..   - & -0 &  -
&/.! !5-0.. -0-!
-/&!"& -6--., !&--&
&-&.-!$-&0" &-&/& -!
. ! !--&0   --&  -  &" 0 ,-
2&0 ----!!-----!&
!
When you don’t understand, it’s hard to know [what is available], like my mum when the
nurses were visiting her, she said that she doesn’t understand and they try to translate it,
point it out until she will understand. Or if I am home, then I do it for her, tell her what they
said, read the paperwork for her.%1&"*8" '
&&/" &-&0.!0&------"
& 0!0./ !-! ,..", 
2.    /-0  - -0$ #- --" .  &- 
---&-.&"--/-&0&---
 &- ,   -&/. !--!6 -!.0&
/0 !& /- -0" & .& - ,& -:- -
---   2& - !& !$ @-2. , !  -. 
---/- .-! .--".-!"
6. -! & ! --"  ! - 0 !!&$ 
&&" //.---- !&/0----
!!!-0..!0&0!&&-!-!...,
-/$ -   . . & ,!.-3.  -
-/&-/& "-" -. &.&-&2
--!2-!-!-6" -!  -/&-
 --0-.%F$()*)?B..&F!-()**'$
Conclusion
  -!&!!- /&&6--! 
-/-! -/!.- &-"0.& -!$B0
 6-  &-&0. /!.--20 /&-
! - ,.$  -:0 &-0.-& 0 - !3
!-!"  . - &  ,   0 /&  --& 
,-2 !.-"  -   -. & -  & - ./-!
0!2--.&:0&&:  -/-,0
--/&!.-0 $ - /-0:/-- -
 6,  ,0--/&!.-..0,   -/&
  - /,  6-   "    - & 0 ---  0
-.-/$ #- -!-"&  !.-3  & 
-/-& 0"-0-.". 0 1-!!.-
---&&, &/&  -$!& ..
  -"&. &-&0.&2. -/,
5.&-"!-5&-/ /&0- 
 --. --&$
@-2., 0.!.-  6 .---
&-:- !2 - $. .-.-0.
, -/  F - &&"0./    0
/-!/-!0&$ &-&0." ,/-"
6- --"!00-.-!&&.-! -
-&-/ /"  20 !-&  . !2
&&-&-/&-/-/$--0 !&
-&- 4  -!3 &--  -/ &-&
!.- 1"!.-!!&-.-0-/&
& -/ -   -/" &. -/ & - -$
- 0  - . -  , !.- 0.  & - 
 0 /-&-A 0!0!-&&,  -"
&-! 0.-!  "!&&  --  , .."
,  /.-/-!0&$B.-3/,  -/&
6- !&   --- 6-&  ! &-&0
 -- 1$- &--/&6
 -..!, -/&!&!-6,0--/&
!.--&--.. !  -!. /-&. --$
--&-/,, -/ &-& -!-!!2.
 -.  -/$ ..   -/&&/-&
-0/!-", ,- &-&0.3
!&!!$
/& !0!.-. .- &-&0.
&! -  "   /-&,.$#-!.- &-&0.
"-  !.-6-%/-./'". -&
  , -0" ! " ." .&- & - !0  6
&-   /-&!$ -/-&&  --20
&0 --3-!.-&!
!.-"& ---6-  -$ 6" -/,  -
&&-  -&--!0 &--3 /-$E -
-/&-!/&- -- !.- &-&
 -!3&  .. , -/&,-2 ,  ! --/
, /-$-  , !! -/-0
-2  -! -! ,-2,  0 2 -   -/   ,
-0$.  - -. !-& /-!.-&
!2.& -  --/& &-&0.
-20-,  &$
B.- &- - --&  -!     /-  0
 & &" &   -/  & /  -  
--$@   --!. /!-   -0! 0-!-
, & 0&-&-" &-,6&..!!&-
  /-0 - &-.-$E --,-2., ,0
--/&!.- &-  & !& ! !  -
6&&.. !/-&0!0 &&&-
0 -  0 !.  /$  0.  &/  - &-&.  ,
 --  - ,-0" 20  -- & ,
 ./-!$ "  &-3.!. !! !-
&/&    -- &  - ." !.- &-!0  !
!!&--2,&.-// -!%!&
#6()*G?!&202D()*='$
-  -/-!0-!0-!.-"
0 -,0--!.-"&  --&,-
 &-36-0&--$!- . . 
  &-&0.!.-!-0, / ! 
6- - !$ 6. --  , , &-  & !
-! -   ! -. -   &-3 :  !
%B--,()*)? B1&-2 $ ()*G'$ -" &- &0. 3 
-!.-,2-.,-", &
0 -!3-/-&  $ --!&-0
&-&/!-   !.-.-", 
..! &-&0.-. &5",
.&-$
References
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F"$"$&!&$-./%()*='"The Effects of Immigration on NHS
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... The absence of child-specific approaches is noted in the broader international literature. Indeed, the health of child migrants has received little attention in research, with many existing migration studies taking an adult-centred approach and drawing on parents' migration status and health to assess children's own experiences (Carballo and Mboup 2005;Ingleby 2009;Sime 2016;Curtis et al. 2018;Spencer et al. 2018). Some exceptions include Chase et al. (2008) and Liabo et al. (2017). ...
... Some exceptions include Chase et al. (2008) and Liabo et al. (2017). Because of this, very little is known about children's own perspectives on health and their migration experiences (Carballo and Mboup 2005;Ingleby 2009;Sime 2016;Curtis et al. 2018;Spencer et al. 2018)-despite acknowledgement of the importance of ascertaining children's views on matters affecting them, and as enshrined in the Convention on the Rights of the Child (UN 1989). A recent systematic review from Europe has examined the available evidence on child migrants' health ). ...
... Similar to a recent review from Europe , our synthesis of the evidence from the Western Pacific region demonstrates significant gaps in the scope and quality of the research on the health experiences of child migrants. A notable finding from this review is the relative paucity of research reporting children's own perspectives and experiences-a sentiment increasingly echoed across the children's literature (Sime 2016). Moreover, research that has sought to access and illustrate migrant children's perspectives has largely focused upon a restricted number of biomedical health issues and, in some cases, has been highly localised (e.g. ...
Article
One of the key social determinants of health that can impact children and young people is migration. Advances in health research have seen a shift away from a biomedical model of health to understanding health as a multifactorial, holistic state - mentally, physically, and socially. The aim of this article is to illustrate how different methods (i.e., adult-centric, child/youth-centered) and frameworks (i.e., biomedical, strengths-based) can impact on research findings in childhood research. Drawing on findings from a systematic review, we examine the approaches taken in eleven studies investigating the health and wellbeing of young migrants in the Western Pacific region. The systematic review highlighted a range of methods (quantitative surveys, drawings, photo novellas) that were used to capture child/youth perspectives, and identify contextual factors beyond immediate biomedical factors that impacted their wellbeing. Adult-centric biomedical approaches were limited in understanding these broader environmental contexts, yet these approaches were prevalent in this body of literature. We highlight the importance of developing more strengths-based approaches and child/youth-centered methods to gain a comprehensive understanding of social and physical environments that child and youth migrants draw upon to support their wellbeing.
... The absence of child-specific approaches is noted in the broader international literature. Indeed, the health of child migrants has received little attention in research, with many existing migration studies taking an adult-centred approach and drawing on parents' migration status and health to assess children's own experiences (Carballo and Mboup, 2005;Ingleby, 2009;Sime, 2016;Spencer et al., 2018). Some exceptions include Chase et al. (2008) and Liabo et al. (2017). ...
... Some exceptions include Chase et al. (2008) and Liabo et al. (2017). Because of this, very little is known about children's own perspectives on health and their migration experiences (Carballo and Mboup, 2005;Ingleby, 2009;Sime, 2016;Curtis et al., 2018;Spencer et al., 2018)despite acknowledgement of the importance of ascertaining children's views on matters affecting them, and as enshrined in the Convention on the Rights of the Child (UN, 1989). A recent systematic review from Europe has examined the available evidence on child migrants' health . ...
... Similar to a recent review from Europe , our synthesis of the evidence from the Western Pacific region demonstrates significant gaps in the scope and quality of the research on the health experiences of child migrants. A notable finding from this review is the relative paucity of research reporting children's own perspectives and experiencesa sentiment increasingly echoed across the children's literature (Sime, 2016). Moreover, research that has sought to access and illustrate migrant children's perspectives has largely focused upon a restricted number of biomedical health issues and, in some cases, has been highly localised (e.g. ...
Article
Migration is a key social determinant of health affecting children’s life chances and health outcomes. Yet, relatively little is known about young migrants’ own health experiences. This paper reports findings from a systematic review examining the health experiences of children who migrated in the Western Pacific region. A systematic search of the peer-reviewed literature from 2007–17 was conducted using MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Database of Systematic Reviews, Web of Science, ASSIA and IBSS. Included articles reported data generated with children up to 18 years and who had migrated across international borders to the Western Pacific region (predominantly Australasia). The Mixed Methods Appraisal Tool was used to assess study quality. Eleven of 499 articles identified were included in the review and focused on three areas: diet and body size; mental health; and social integration. The review exposes the paucity of research on the health experiences of child migrants in the Western Pacific region. More child-centred research that examines the health-related impacts of migration on young people, and from their own perspectives, is urgently needed.
... Despite increasing attention towards migrant health, the experiences of children and young people who migrate have been relatively overlooked in research to date (Carballo and Mboup, 2005;Ingleby, 2009;Sime, 2016). Moreover, very little is said about the development of relevant forms of health education and promotion with migrant children. ...
... Such inconsistencies result in fundamental gaps in knowledge about how best to address the health-related needs of migrants (Tulloch et al., 2016) -including the development of relevant and effective health education responses. Furthermore, there is a distinct paucity of research that takes children's perspectives as its starting point (Sime, 2016) and the health of child migrants is often attached to, or conflated with, parents' and adults' migration and health status (Curtis et al., 2018;Vathi and Duci, 2016). This relative absence of children's own perspectives on health, and how these are shaped by their migration experiences, provides limited clues about their health education needs while simultaneously contributing to the broader tendency to position (child) migrants as being largely devoid of health and personal agency. ...
... Children as a distinct group are notably less visible in published research (Sime, 2014(Sime, , 2016. Migration studies that do include children often collate (and sometimes conflate) categories such as economic migrants with documented and undocumented refugees and asylum seekers, along with unaccompanied asylum-seeking and refugee children. ...
Article
Research on migration and health is gaining significant ground, with a focus on the adverse physical and mental health outcomes experienced by migrants. The health-related experiences of children and young people who migrate, however, are relatively absent, with children’s migration and health status often conflated with that of their parents. The omission of children’s own perspectives limits knowledge about how health is understood and experienced by child migrants, including the identification of best ways to support their health. Drawing on the empirical literature on child migrants and health from the World Health Organization’s (WHO) Western Pacific Region, we adopt a critical perspective to examine how the research to date supports a particular way of understanding and investigating the health of children and young people who migrate. Specifically, we highlight how a dominant focus on parents’ migration status, (negative) health outcomes and patterns of risk behaviours limits, rather than aids, the understanding of migrant children’s health. In doing so, we illustrate how much of the evidence base upholds Westernised biomedical notions of health and privileges the use of particular methodologies to assess health outcomes and reduce health risks. These preferences, in turn, shape the subsequent range of ‘appropriate’ forms of health education for, rather than with, children. We conclude by drawing on some exceptions and consider the opportunities these provide for developing health education in line with children’s own understandings of health – crucially underscoring the importance migrant children and young people attach to the more social aspects of their health and migration experiences.
... Indeed, a recent World Health Organization report underscores the need to promote the health of all migrants, including children and young people (7). In order to do so, there is a need to deepen our understanding of the particular health priorities and experiences of migrant populations, and crucially from the perspectives of children and young people (8). ...
Article
Full-text available
Calls to enhance the health of migrant population sub-groups are strengthening, with increasing evidence documenting the relationship between migration and health outcomes. Despite the importance of migration to global health promotion, little research has focused on the health experiences of young migrants. As part of a Worldwide University Network project, we completed four systematic reviews examining the existing evidence base on the health experiences of children and young people who migrate. In this commentary, we share commonalities with the international evidence but also reflect on some of the challenges, omissions and limitations. These insights expose significant gaps and methodological shortcomings in the evidence - providing space for new research that seeks to identify the influences on migrant children's health.
Book
Migration and Health: Critical Perspectives offers a radical rethinking of the field by unsettling conventional ideas of mobility and borders to highlight the ways in which they produce health inequalities. Covering a wide range of topics, the text provides insight through a critical lens, and proposes areas for intervention along with an added emphasis on the need for future research to address the health inequities that affect migrants. It illustrates how a critical perspective can deepen our understanding of the relationship between migration and health, which remains a defining global issue of our century. The text employs a critical approach to examine the structural conditions of inequality and larger historical and political processes, recognizing that exclusionary bordering practices increasingly occur away from physical points of entry. It posits the concept of migration as complex, tangled and multi-directional and underscores how migrant vulnerability can shape the lives of people in wider communities. Furthermore, it acknowledges diverse and intersectional standpoints, as well as shifting spatial and temporal influences. Chapters include coverage of health in transit; healthcare access and utilization; clinical encounters; communicable disease; labor and occupational health; gender and sexuality; immigration enforcement, detention, deportation; and the effects of forced displacement on refugee and asylum-seeker health. The text is useful for students and scholars of migration or health disparities seeking to understand how the two issues can be approached in a more holistic and critical way. It is further aimed at practitioners and policymakers who are interested in gaining familiarity with the structural conditions of inequality along with the larger historical and political processes that influence contemporary migration patterns.
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