"We want our freedom back, that's our only need": a qualitative study of health and social needs among asylum seekers and undocumented migrants crossing the borders from Belarus to Lithuania.

Background: The influx of undocumented migrants and asylum seekers into Lithuania, particularly during the COVID-19 pandemic, presents unique public health challenges. This study employs the Social Determinants of Health framework to explore the healthcare and social needs of this vulnerable population. Methods: In May 2022, we carried out a qualitative study through semi-structured interviews with asylum seekers across four centers in Lithuania. Employing both purposive and snowball sampling techniques, we selected participants for our investigation. The study comprised 21 interviews-19 conducted in Arabic and 2 in English-with durations ranging between 20 and 40 min each. We audio-recorded all interviews, transcribed them verbatim, and subsequently performed a thematic analysis using Atlas.ti software. This process of design and analysis strictly followed the principles of thematic analysis as outlined by Braun and Clarke, guaranteeing methodological precision and rigor. Findings: 21 interviews revealed critical insights into the healthcare access challenges, mental health issues, and social integration barriers faced by the participants. Key themes included 'Healthcare Needs and the Impact of the COVID-19 Pandemic 'and 'Social needs and Aspirations Amidst Pandemic-Induced Uncertainty '. The findings highlight the multifaceted healthcare and social needs of asylum seekers, juxtaposed against significant barriers they face. Access to medical services is hindered by long waiting times and financial constraints, especially for specialized care such as dental services. Communication issues during medical appointments due to language barriers and the lack of gender-specific healthcare, such as access to gynecological services, further exacerbate the challenges. Additionally, the COVID-19 pandemic introduces hurdles such as limited testing, isolation measures, language-specific information barriers, and insufficient social distancing practices. Mental health has emerged as a critical concern, with asylum seekers reporting significant stress and emotional exhaustion due to uncertainty and restrictive living conditions. Social needs extend to delayed asylum application processes, inconsistent language education opportunities, inadequate clothing, and nutrition that lacks cultural sensitivity, and living conditions characterized by overcrowding and insufficient facilities. The restricted freedom of movement within asylum seeking centres severely impacts their psychological well-being, underscoring a deep longing for autonomy and a better life despite the myriad of challenges faced. Discussion: The study illustrates the complex interplay between migration, health, and social factors in the context of a global pandemic. It highlights the need for culturally sensitive healthcare services, mental health support, and structured language education programs. Offering educational avenues alongside language courses for children and adults is essential for fostering social inclusion and securing economic prosperity. Addressing the challenge of language barriers is of utmost importance, as these barriers significantly impede undocumented migrants' and asylum seekers employment opportunities and their access to crucial services. The findings emphasized immigration as a health determinant and underscored the importance of inclusive health policies and advocacy for undocumented migrants and asylum seekers' rights and needs. Conclusion: There is an urgent need for comprehensive policies and practices that are grounded in the principles of equity, compassion, and human rights. Additionally, advocating for practice adaptations that are culturally sensitive, linguistically inclusive, and responsive to the unique challenges faced by undocumented migrants and asylum seekers. As global migration continues to rise, these findings are crucial for informing public health strategies and social services that cater to the diverse needs of this vulnerable population.

Cultural competency among Lithuanian nurses and preparedness to work with intercultural immigrants: A quantitative study protocol.

Introduction: Health care providers are increasingly required to provide care to patients from diverse cultural backgrounds. A culturally competent approach could be used to address gaps in the health care of migrants, whether they are refugees, asylum seekers, or undocumented migrants. From June 2021 onward, there are estimated to be 4,300 asylum seekers in Lithuania who crossed the Belarusian border. Furthermore, ~65 thousand Ukrainians registered within 6 months of the beginning of the war on 24 February 2022. Aim: To determine the cultural competence of Lithuanian nurses using the Nurse Cultural Competence Scale (NCCS) questionnaire. Methods: A quantitative study evaluating the cultural competency of nursing professionals will be conducted using the Lithuanian version of the Nurse Cultural Competence Scale (NCCS). The study will be conducted in Lithuanian municipalities and will involve primary, secondary, and tertiary health care providers. Discussion: This study will provide data that can guide the development and evaluation of interventions designed to reduce health disparities among migrants, including the need to identify the appropriate type of cultural competency training for nurses. In addition to the results of this study, it may provide an indication of other cultural competency required for nurses. This includes consideration of religion, sexual orientation, gender identity, household classifications on the basis of urban vs. rural areas, language spoken, and country of origin.

Health and social needs of asylum seekers and Ukrainian refugees in Lithuania: A mixed-method protocol.

Refugees, asylum seekers, and migrants often do not end up in the places they expected. Because of the pandemic impacts, their exposure to COVID-19 may be increased as a result of crowded camps and detention centers. A total of 4,537 undocumented migrants entered Lithuania via Belarus from June 2021 to November 30, 2022. In the period 24 February 2022 to 30 November 2022, Lithuania's Immigration Department registered 71,386 Ukrainian refugees. This study investigates the healthcare and social needs of recent asylum seekers who have crossed the Belarusian border and Ukrainian refugees in Lithuania. This is a study protocol for a mixed-methods study which will involve qualitative interviews with asylum seekers who crossed from Belarus in June 2021 and Ukrainian refugees. During a quantitative phase, refugees and asylum seekers will be asked to complete questionnaires. In this study, validated questionnaires will be used, including the Hopkins Symptom Checklist (HSCL-25), the Harvard Trauma Questionnaire (HTQ), and the Short Form 36 (SF-36). Participants will also be asked to self-report sociodemographic information. As a result of the findings of this study, it is possible to provide guidelines for improving access to health care services, including prevention (i.e., vaccination programs) and treatment of chronic and acute illnesses, through primary and secondary healthcare delivery, thereby reducing negative health outcomes. This study may shed light on the social needs of asylum seekers and refugees in Lithuania. In addition, this may provide insight into how they are integrating into the community, such as what their employment and educational prospects are.