Bukola Salami

Motivations of nurses who migrate to Canada as domestic workers

BACKGROUND While some trained nurses migrate to destination countries to work as domestic workers, little is known about their migration motivations. AIM This study explores the motivations of Philippine educated nurses who migrated to Canada through the Live-in Caregiver Program from 2001 to 2011 (a Canadian domestic worker programme). METHODS A single case study qualitative methodology and the transnational feminist concept of global care chains were utilized for this study. Interviews of 15 Philippine educated nurses who migrated to Canada as domestic workers were conducted in the province of Ontario, Canada, between February to October 2012. All participants had a baccalaureate degree from the Philippines. Interviews were tape recorded, transcribed verbatim and analysed using critical discourse analysis, aided by NVIVO 10 data analysis software. RESULTS Findings reveal a multi-step immigration process in which nurses migrate from the Philippines to the Middle East (especially Saudi Arabia) and finally to Canada. While emigration from the Philippines is mainly economically driven, migration from the Middle East to Canada is primarily motivated by the desire for Canadian citizenship for the family. Also, perceived social status and lifestyle in Canada as compared to the Middle East motivates this group of women to migrate to Canada. LIMITATION The major limitation of this study is the lack of input from nursing policy makers. CONCLUSION Gender-based familial ideologies and perspective on social status influence the migration decision of this group of nurses. IMPLICATIONS FOR NURSING AND HEALTH POLICY Implications for nursing and health policy makers include the provision of clear pre-migration information (including on the nursing registration process) to internationally educated nurses, advocacy for stronger immigration policies to ensure the integration of internationally educated nurses and a consideration of gender in all health human resource policies.

Workforce Integration of Philippine-Educated Nurses who Migrate to Canada through the Live-in Caregiver Program

Nurses who migrate through the Canadian Live-in Caregiver Program face significant barriers to their subsequent workforce integration as registered nurses in Canada. This study applies the concept of global care chains and uses single case study methodology to explore the experiences of 15 Philippine-educated nurses who migrated to Ontario, Canada, through the Live-in Caregiver Program. The focus is the various challenges they encountered with nursing workforce integration and how they negotiated their contradictory class status. Due to their initial legal status in Canada and working conditions as migrant workers, they were challenged by credential assessment, the registration examination, access to bridging programs, high financial costs, and ambivalent employer support. The results of the study are pertinent for nursing policymakers and educators aiming to facilitate the integration of internationally educated nurses in Canada.

Interventions to improve immigrant health. A scoping review

Abstract Background: Disparities in health between immigrants and their host populations have been described across countries and continents. Hence, interventions for improving health targeting general populations are not necessarily effective for immigrants. Aims: To conduct a systematic search of the literature evaluating health interventions for immigrants; to map the characteristics of identified studies including range of interventions, immigrant populations and their host countries, clinical areas targeted and reported evaluations, challenges and limitations of the interventions identified. Following the results, to develop recommendations for research in the field. Methods: A scoping review approach was chosen to provide an overview of the type, extent and quantity of research available. Studies were included if they empirically evaluated health interventions targeting immigrants and/or their descendants, included a control group, and were published in English (PubMed and Embase from 1990 to 2015). Results: Most of the 83 studies included were conducted in the USA, encompassed few immigrant groups and used a randomized controlled trial (RCT) or cluster RCT design. Most interventions addressed chronic and non-communicable diseases and attendance at cancer screening services, used individual targeted approaches, targeted adult women and recruited participants from health centres. Outcome measures were often subjective, with the exception of interventions for cardiovascular risk and diabetes. Generally, authors claimed that interventions were beneficial, despite a number of reported limitations. Conclusions: Recommendations for enhancing interventions to improve immigrant health are provided to help researchers, funders and health care commissioners when deciding upon the scope, nature and design of future research in this area.

African immigrant women’s experience in western host societies: a scoping review

Abstract There is a dearth of literature on new African immigrant populations in Canada, especially women from Sub-Saharan Africa. Much of the sparse literature focuses on men’s experiences. We analyzed the sparse literature on African immigrant women in western host countries with a focus on previous and emerging trends in the discourse, gaps in literature, important areas for consideration in future research as well as potentially viable theoretically and methodological directions that scholars could follow. We also briefly shared the results of a set of focus group discussions with African women in Canada that followed our scoping review. The findings of our scoping review of literature, largely reinforced in the focus group discussions, underscore the need for more studies on Sub-Saharan African immigrant women’s experiences within and outside the family. Active community engagement as well as the mobilization of womens agency and cultural knowledge, resonate as crucial factors that enhance the transition and integration of Africans into Western host societies.

Parenting Practices of African Immigrants in Destination Countries: A Qualitative Research Synthesis

Problem While studies have discussed the parenting practices and challenges of African immigrants, no paper has synthesized the results of these qualitative studies. We conducted a qualitative synthesis of the literature to summarize and interpret knowledge of African immigrants’ parenting practices and challenges in destination countries to identify future directions for research, policy, and practice. Eligibility We used a qualitative research synthesis method involving meta‐summary and meta‐synthesis of the literature. A research librarian assisted in searching ten databases. Two members of the research team independently reviewed 1794 articles. We included articles that: (a) reported a qualitative research study; (b) was written in English; and (c) provided the perspective of African immigrant parents on their parenting practices and/or challenges. Sample A total of 24 articles met our inclusion criteria. Results Our results indicate that parenting practices of African immigrants include the following: changes in discipline practices across transnational borders and the use of physical discipline, respect as a deeply embedded value of parenting, integration of cultural values into parenting, and integration of religious practices into parenting. We also found gender differences in parenting. Challenges faced by African immigrants in parenting their children in destination countries include lack of informal/community support, access to services and lack of formal support, cultural conflict in parenting, fear related to social services, and language barriers. Conclusion and Implications Our study identifies a need for culturally appropriate policies and practices that build on the strengths of African immigrants in destination countries while addressing their unique challenges. HighlightsAfrican immigrants integrate physical discipline, cultural values, and religious practices into their parenting practices.African immigrant parents highly value respect across generational lines.There are gendered dynamics across transnational lines that affects parenting practices.Parenting challenges include the lack support, cultural conflict in parenting, and language barrier.

Enhancing Critical Reflection of Brazilian Community Health Agents’ Awareness of Social Determinants of Health

This project aims to assess how Brazilian community health agents’ critical awareness of the social determinants of health was enhanced and led to a greater understanding of the major structural changes necessary to sustain health promotion initiatives. Educational workshops inspired by Paulo Freire’s ideas on critical pedagogy were delivered to 82 community health agents in three Brazilian cities. The workshops utilized evocative objects to link and develop participants’ conceptual and experiential knowledge. The participants exchanged connections and experiences and created hypothetical action plans to be implemented in collaboration with community members. The discussions were audio recorded, transcribed verbatim, and submitted to content analysis. The connections provoked by evocative objects were related to required assets for the development of a healthy community. As social advocates, they are already committed to a social movement for health equity to catalyze a more equitable distribution of social goods, promote social inclusion, and liberate communities.

Downward occupational mobility of baccalaureate-prepared, internationally educated nurses to licensed practical nurses

AIM This study explored the experience of baccalaureate-prepared, internationally educated nurses who work as licensed practical nurses in Canada. BACKGROUND/INTRODUCTION Internationally educated nurses experience several barriers to workforce integration on arrival in destination countries. Given these barriers, evidence suggests that internationally educated nurses sometimes experience downward occupational mobility and deskilling in destination countries. Some baccalaureate-prepared, internationally educated nurses work as licensed practical nurses in destination countries, but there is minimal research on this population. METHODS We used an exploratory transnational feminist qualitative research design. Following ethics approval, a total of 14 baccalaureate-prepared, internationally educated nurses who currently or recently worked as practical nurses in Canada were interviewed for the study. Data were thematically analysed with the aide of NVivo 11 data software. RESULTS Our results revealed four key themes related to the experiences of this group of nurses: they migrate to Canada with hope for a better personal and professional life; they experience barriers to workforce integration as registered nurses and discover an easier path in the licensed practical nurse registration process; they experience deskilling and ambivalent skill recognition; and they feel dissatisfied as a licensed practical nurse in Canada. DISCUSSION/CONCLUSION There is a need for policy to support the upward mobility of baccalaureate-prepared, internationally educated nurses who work as practical nurses. IMPLICATIONS FOR NURSING POLICY Implications for policymakers include the need to address the barriers to becoming registered nurses, including application processing times and lack of adequate access to educational programmes.

Detecting antepartum and postpartum depression and anxiety symptoms and disorders in immigrant women: A scoping review of the literature

A scoping review of the literature was conducted to compile existing evidence and identify gaps on detection methods and practices of antepartum and postpartum anxiety and depression symptoms and disorders in immigrant women. With the assistance of a health science librarian, four databases were searched between January and March 2016. Thirteen articles met the inclusion criteria and their findings were compiled using numerical summary and thematic analysis. No articles specifically addressing the screening of anxiety disorders or symptoms in antepartum or postpartum immigrant women were found. Some studies showed positive results for using translated tools. Other studies showed similarities in immigrant and non-immigrant assessment. However, several challenges in detection existed. Some of these challenges include cultural appropriateness of some questions and the accuracy of interpretive services and instrument translation. Limited literature was found, indicating a need to design and test targeted strategies to ensure that immigrant women are provided with appropriate antepartum and postpartum emotional support and mental health services based on appropriate policies and practices.

Human Resources for Health Challenges in Nigeria and Nurse Migration

The emigration of sub-Saharan African health professionals to developed Western nations is an aspect of increasing global mobility. This article focuses on the human resources for health challenges in Nigeria and the emigration of nurses from Nigeria as the country faces mounting human resources for health challenges. Human resources for health issues in Nigeria contribute to poor population health in the country, alongside threats from terrorism, infectious disease outbreaks, and political corruption. Health inequities within Nigeria mirror the geographical disparities in human resources for health distribution and are worsened by the emigration of Nigerian nurses to developed countries such as the United States and the United Kingdom. Nigerian nurses are motivated to emigrate to work in healthier work environments, improve their economic prospects, and advance their careers. Like other migrant African nurses, they experience barriers to integration, including racism and discrimination, in receiving countries. We explore the factors and processes that shape this migration. Given the forces of globalization, source countries and destination countries must implement policies to more responsibly manage migration of nurses. This can be done by implementing measures to retain nurses, promote the return migration of expatriate nurses, and ensure the integration of migrant nurses upon arrival in destination countries.

‘And when a certain health issue happen, they try to cover it’: Stakeholder perspectives on the health of temporary foreign workers and their families

ABSTRACT This study examines stakeholders’ perspectives on the health and well-being of temporary foreign workers (TFWs) and their families in Alberta, Canada. We used a critically informed qualitative methodology. We interviewed 13 stakeholders, including service providers and policy makers. Stakeholders involved in providing services to TFWs perceived that the workers experience (1) barriers in accessing mental health services, (2) mental health challenges, (3) family health challenges, (4) occupational health challenges, and (5) income and social status as a social determinant of health. Immigration and class status intersect to influence the health of this vulnerable population in Canada.