A Global Toolkit Promotes Inclusive Health Care for Marginalized Refugees | Nebraska today

Recent years have seen an increase in global initiatives aimed at providing mental health support in low- and middle-income countries to those affected by disaster, conflict and forced migration; however, older refugees and refugees with disabilities have received less attention in humanitarian research and often face barriers to accessing health-promoting interventions.

Julie Tippens, associate professor of child, youth, and family studies, and Angela Palmer-Wackerly, associate professor of health communication, are participating in a collaborative international project designed to address this critical gap among marginalized refugees through the creation and evaluation of an interactive research toolkit— “HESHIMA: A Guide to Collaborative and Inclusive Health Research in Humanitarian Settings”.

“Heshima” is Kiswahili for respect or dignity. For this project, the acronym HESHIMA stands for “Honoring Experience and Shared Humanity in Mobilizing for Action.”

Funded by a grant from [ELRHA](Enhanced Learning and Research for Humanitarian Assistance) Fund for Humanitarian Innovation, HESHIMA is a collaboration between researchers, humanitarian and human rights officials and refugee-related stakeholders. Partners include the University of Nebraska–Lincoln, Amref Health Africa, Amref International University, Albinism Society of Kenya, HelpAge International-Kenya and an advisory board consisting of older refugees and refugees with disabilities.

Tippens and Palmer-Wackerly will collaborate with the advisory board and other partners to co-produce the toolkit, which will include guidance on participatory research procedures such as research ethics, partnership development, and tools for recruitment, data collection and dissemination .

“It’s been an incredible amount of work and coordination from all partners, and we’re all learning how to work effectively together by recognizing each other’s strengths and perspectives,” Palmer-Wackerley said.

Data will be collected from refugees living in Nairobi, Kenya. Refugees living in cities outside refugee camps do not have access to the typical humanitarian support provided in the camp, such as food, water, housing, health care and other necessities. Information about what matters most to refugee partners and actors will be used to create a research toolkit and to improve humanitarian responses in urban settings.

The researchers aim to complete the instrument set by the end of 2023, then field test it in Nairobi, Kenya, in the spring of 2024.

“We want to develop tools that highlight strengths and focus on what inclusion and participation means to refugees themselves,” Tippens said. “We’re trying to understand their perspectives in identifying the primary stressors – what mental health means for older refugees or refugees with disabilities to be mentally healthy, what they prefer as support and what resources will help.”

It is critical, she said, to be able to conduct research in Kenya and other low- and middle-income countries, where most of the world’s refugees live.

“Only 1 percent of refugees have ever been resettled in the U.S., Europe or elsewhere, but most research comes from studies with these resettled populations,” Tippens said. “So being able to collect evidence from those places is so important.”

Tippens’ previous projects have included several community participation and engagement studies, many of which focused on older refugees. Palmer-Wackerly is collaborating with research partners to study the health of immigrants and refugees in rural Nebraska.

“I feel like everything I’ve done before has led to this project,” Tippens said. “It’s a nice culmination of previous projects where I’ve worked with the same populations and an opportunity to strengthen our partnerships with other organisations.”

Taking this participatory approach with refugees in their own communities and using their direct input to co-develop projects is also something Tippens is keen to do.

“It is exciting to begin a collaborative action research project across international borders,” she said. “This is something I’ve wanted to do for a long time, but my research partners and I weren’t necessarily up for the challenge. Now, after working together for several years, we are ready.”

Learn more about this project on the CYFS Research Network.

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