ABSTRACT
BACKGROUND: Migrants are individuals who move to a different country from their usual place of residence. Japan's migrant population, particularly technical interns and students, has been growing. Even before the pandemic, previous studies have highlighted difficulties faced by migrants in utilizing healthcare services. This study examined the uptake of COVID-19 vaccination, testing, and medical care among Myanmar migrants in Japan; identified the factors associated with this uptake; and described the difficulties encountered when utilizing these services. METHODS: A cross-sectional study was conducted between March and April 2023 targeting Myanmar migrants over 18 years residing in Japan for more than 6 months. An online self-administered questionnaire in Myanmar language covered socioeconomic characteristics; history of COVID-19 vaccination, testing, and medical care; and difficulties encountered while utilizing these services with multiple-choice questions. Multivariate logistic regression analysis was performed separately to identify the factors associated with the uptake of COVID-19 vaccination, testing, and medical care. RESULTS: Among the 207 participants, 52% (n = 108) were under 30 years, 30% (n = 62) were male, and 31% (n = 65) were low-skilled workers (technical interns and students). Overall, 91% (n = 189) had received the COVID-19 vaccination, 76% (n = 157) had been tested for COVID-19, and 43% (n = 68) tested positive. However, only 77% (n = 52) of COVID-19 patients sought medical care. Participants under 30 years of age were less likely to receive the COVID-19 vaccine compared to those aged 30 and older (adjusted odds ratio [aOR] 0.10, 95% confidence interval [CI] 0.01-0.88, p = 0.038). Low-skilled workers were less likely to seek medical care compared to those holding other categories of residential status (aOR 0.12, 95% CI 0.02-0.79, p = 0.027). Among service users, 5% faced difficulties with COVID-19 vaccination, 10% with testing, and 17% with receiving medical care. Long waiting times and complex reservation processes were the main difficulties encountered. CONCLUSIONS: The uptake of COVID-19 vaccination, testing, and medical care in this sample was reasonably good. However, individuals under 30 years of age showed lower uptake of vaccination, while low-skilled workers had lower uptake of medical care. Strengthening education and support for young migrants and low-skilled workers regarding COVID-19 and other infectious diseases is essential, especially in workplaces and educational institutions.
ABSTRACT
Objectives: This study aimed to review the progress and challenges of COVID-19 vaccine roll-out for migrants in Japan and discuss the approaches to address the challenges and better prepare for future waves of COVID-19 and other pandemics. Methods: We conducted a literature review using an assessment framework which we developed building upon existing frameworks and tools on access to health services and COVID-19 vaccination among migrants. Results: COVID-19 vaccination coverage among foreigners might be lower than that of nationals although the data on foreigners were not widely available. A gap appeared to exist between the government's efforts to disseminate vaccine-related information through multi-lingual websites and migrant communities as recipients. A series of barriers for migrants were identified at different stages of the vaccination process. While efforts were made by different units of local governments, NGOs, migrant communities, and international exchange associations, linkages across sectors and scaling-up appeared to be an issue. No foreigners were explicitly excluded from the entitlements of COVID-19 vaccination. The national level guidance, however, allowed sub-national levels to make a decision on whether or not undocumented foreigners should be reported to the immigration office or law enforcement when providing the services. In consequence, units in charge of public health and vaccination of some municipalities did not offer vaccination to those in need. Conclusion: Migrants, especially those unregistered face various barriers in accessing COVID-19 vaccination. It is critical to assess and address challenges concerning channels of information dissemination, pathways to access services, obstacles for vulnerable migrants, and data for evidence-based actions.
ABSTRACT
This paper discusses the challenges of disseminating COVID-19 information to migrant populations by sharing our trial-and-error approach. In 2018, the Migrants' Neighbor Network & Action (MINNA), a consortium of individuals and organizations that addressed the issues of accessing relevant information and services for migrants in Japan, was launched. Amidst the COVID-19 pandemic, the MINNA attempted to investigate and improve access to health information among Vietnamese, Nepali, and Burmese migrants in Japan. We had three assumptions in distribution of information to reach a large audience, such as building a multilingual website, requesting stakeholders to disseminate information, or posting on Facebook. None of our assumptions were sufficient to reach the target audience in the context of COVID-19, as total number of views that accessed our materials were less than 300 at most. We viewed these myths as the result of overlooking critical elements of effective communication strategies. Eventually, MINNA managed to establish communication with the manager of a Facebook page with the largest number of followers from the Vietnamese community in Japan. Compared with our previous attempts, the messages were delivered to a large audience on the Facebook page, such as the article on COVID-19 vaccines that was viewed more than 300,000 times. In public health emergencies, interactive process of information dissemination is necessary. It is a key component for risk communication and should be prioritized. Breakthroughs in communicating with a larger audience could be possible through partnerships with online communities.
ABSTRACT
AIM: In Cambodia, the Japan Society of Obstetrics and Gynecology and the Cambodian Society of Gynecology and Obstetrics have an on-going project, started in 2015, for cervical cancer prevention and treatment. The project, currently aimed at factory workers, includes a women's health education program that leads into cervical cancer prevention by establishment of a system for early detection and treatment. It begins by health education, screening for human papillomavirus (HPV), followed by colposcopy and quicker treatment of earlier precursor lesions. METHODS: Rates for participant screening, HPV test positivity, cervical intraepithelial neoplasia (CIN) detection and distribution of HPV types were compared between two screening programs, factory-based and hospital-based. Some HPV test samples were divided into two, one of which was sent to Japan for a quality-control check of the Cambodian testing. RESULTS: The factory-based participant screening rate was 19% (128/681). HPV was detected more frequently in the factory-based program participants (12%) than in the hospital-based program participants (5%). Unfortunately, however, the rate of receiving proper secondary colposcopy screening among the HPV-positive females was significantly higher in the hospital-based program (94%) than the factory-based program (40%) (P < 0.001). The Cambodian laboratory HPV testing accuracy was 92.6%. HPV types demonstrated no significant difference between the two prevention programs. CONCLUSION: We could successfully introduce HPV-based screening, starting from health education. However, low rate of screening, especially secondary screening for HPV positive factory workers was identified. Also, HPV testing could be further improved for accuracy through close monitoring.