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The Institute for Global Health and Development

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/9

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Author: search.filters.author.Vidal, Nicole L.

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Now showing 1 - 10 of 14
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    Out of Reach: Social Connections and Their Role in Influencing Engagement Between Forcibly Displaced People and Police Scotland
    (MDPI, 2025-05-15) Nisbet, Bryony; Vidal, Nicole L.
    Forcibly displaced people in Scotland face multiple barriers in accessing health, social care, and policing services. This paper explores how social connections shape engagement with these services, particularly the role of police in community safety and wellbeing. Drawing on qualitative interviews and social connections mapping workshops, this study examines how third-sector organisations act as key intermediaries, shaping how people access statutory services. The findings show that while community policing and partnerships with trusted organisations can improve accessibility, concerns about racial discrimination, the underreporting of hate crime, and the lack of language support continue to undermine confidence in policing. Additionally, the growing reliance on police officers to respond to mental health crises reflects wider gaps in specialist service provision. This paper argues for a shift towards a cross-sector approach that strengthens community-led safety strategies, reduces police involvement in non-criminal matters, and improves language and cultural competency within public services. Strengthening institutional accessibility and trust-building initiatives is key to improving engagement with policing and health and social care services for forcibly displaced communities.
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    Rupture and liminality: Experiences of Scotland's refugee population during a time of COVID-19 lockdown
    (Elsevier, 2023-08-11) Vidal, Nicole L.; Sagan, Olivia; Strang, Alison; Palombo, Gianluca
    The disruption caused by the COVID-19 pandemic had profound effects on refugees. In migrating to seek safety, refugees demonstrate resilience, resourcefulness and the ability to adapt to stressful situations. However, social distancing and self-isolation measures greatly impacted these individuals as they stand to risk the most from interruptions to integration. In this paper, we examine the implications of increased loneliness and isolation for refugees’ experiences with integration. We argue, using original interview data, that the demands placed on some refugees through extremely harsh circumstances can leave many even more vulnerable, as was evident in extreme during the COVID-19 lockdowns. The findings of this study pertain to the refugee pandemic experience in relation to loneliness, hopelessness and, more so: agency, resilience and post-traumatic growth. In recognising that rupture and liminality are intrinsically linked to feelings of loneliness, mental wellbeing, or its erosion, the paper demonstrates the complexity of loneliness and its potential to cause long-term damage to mental and physical health. Our findings suggest the importance of an approach to integration that recognises the unique needs of refugees. Where emotionally supportive social networks are weak or absent, it must be a priority to enable meaningful connections with other trusted human beings.
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    Impacts of COVID-19 restrictions on Scotland’s Refugees: Sudden-onset isolation in a neglected population group.
    (Queen Margaret University, 2021-09-14) Vidal, Nicole L.; Salih, Maleeka; Strang, Alison; Sagan, Olivia; Smith, Cameron
    This report summarises the findings of a rapid COVID-19 response research project led by the Institute for Global Health and Development at Queen Margaret University, working with support from the Scottish Refugee Council and Scottish Local Authorities. The research cohort were refugees and asylum seekers receiving services from either the Scottish Refugee Council or Local Authorities and their respective partners.Vidal
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    Seldom-heard Communities: Refugee and asylum-seeker experiences, trust and confidence with Police Scotland.
    (Queen Margaret University, 2022) Vidal, Nicole L.; Nisbet, Bryony
    This report summarises the findings of research project led by the Institute for Global Health and Development at Queen Margaret University, working with support from Police Scotland and Freedom from Torture. The research cohort were refugees and asylum-seekers receiving services from Freedom from Torture, Police Scotland personnel, and staff from refugee support services.
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    Refugees, political bounding and the pandemic: Material effects and experiences of categorisations amongst refugees in Scotland
    (Routledge, 2022-04-25) Burns, Nicola; Mulvey, Gareth; Piacentini, Teresa; Vidal, Nicole L.
    Scholars are increasingly interested in and concerned with both the way various migrant populations are categorised, and the lived impacts of that categorisation. In this article, we examine how categorisation was experienced by people at various stages of the refugee journey during the biggest public health crisis for generations. We argue, using original interview data, that the way refugees are categorised, or politically bound, has material impacts on the way they experience their lives, and that this was evident in extremis during the Covid-19 lockdown in Scotland. As populations attempted to traverse public health messaging, this is shown to interact with longstanding state proclivities to control, marginalise and stratify. Consequently, how people experienced and managed the request to ‘stay home and save lives’ varied markedly by where they were in their refugee journey and how they arrived in the UK.
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    Relational dynamics of treatment behavior among individuals with tuberculosis in high-income countries: A scoping review
    (Dove Press, 2021-09-21) Arakelyan, Stella; Karat, Aaron S.; Jones, Annie S. K.; Vidal, Nicole L.; Stagg, Helen R.; Darvell, Marcia; Horne, Rob; Lipman, Marc C. I.; Kielmann, Karina
    Although tuberculosis (TB) incidence has significantly declined in high-income, low-incidence (HILI) countries, challenges remain in managing TB in vulnerable populations who may struggle to stay on anti-TB treatment (ATT). Factors associated with non-adherence to ATT are well-documented; however, adherence is often narrowly conceived as a fixed binary variable that places emphasis on individual agency and the act of taking medicines, rather than on the demands of being on treatment more broadly. Further, the mechanisms through which documented factors act upon the experience of ‘being on treatment’ are poorly understood. Adopting a relational approach that emphasizes the embeddedness of individuals within dynamic social, structural, and systems contexts, this scoping review aims to synthesize qualitative evidence on experiences of being on ATT and mechanisms through which socio-ecological factors influence adherence in HILI countries. Six electronic databases were searched for peer-reviewed literature published in English between January 1990 and May 2020. Additional studies were obtained by searching references and citations of included studies. Narrative synthesis was used to analyze qualitative data extracted from included studies. Of 28 included studies, the majority (86%) reported on health systems factors, followed by personal characteristics (82%), structural influences (61%), social factors (57%), and treatment-related factors (50%). Included studies highlighted three points that underpin a relational approach to ATT behavior: (1) individual motivation and capacity to take ATT is dynamic and intertwined with, rather than separate from, social, health systems, and structural factors; (2) individuals’ pre-existing experiences of health-seeking influenced their views on treatment and their ability to commit to long-term regular medicine-taking; and (3) social, cultural, and political contexts play an important role in mediating how specific factors work to support or hinder ATT adherence behavior in different settings. Based on our analysis, we suggest that person-centered clinical management of tuberculosis should (a) acknowledge the ways in which ATT both disrupts and is managed within the everyday lives of individuals with TB; (b) appreciate that circumstances and the support and resources that individuals can access may change over the course of treatment; and (c) display sensitivity towards context-specific social and cultural norms affecting individual and collective experiences of being on ATT.
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    Community and health staff perceptions on non-communicable disease management in El Salvador’s health system: A qualitative study
    (BioMed Central, 2020-05-27) Vidal, Nicole L.; León García, Montserrat; Jiménez, Marta; Bermúdez, Keven; De Vos, Pol
    Background: Non-communicable Diseases (NCDs) are the leading cause of global mortality and disability with a rising burden in low- and middle-income countries. Their multifactorial aetiology, and their requirement of long-term care, implies the need for comprehensive approaches. From 2009, the Ministry of Health (MoH) in El Salvador has developed a national public health system based on comprehensive primary health care. This study aims to describe the different stakeholders’ perceptions about the management of NCDs along the pathways of care in this health system. Methods: During three fieldwork periods in 2018, three complementary qualitative data collection methods were deployed and conducted in settings with high prevalence of NCDs within El Salvador. First, illness narrative methodology was used to document the life histories of people living with a chronic disease and being treated in second and third level health facilities. Second, through social mapping, support resources that NCD patients used throughout the process of their illness within the same settings were analysed. Third, semi-structured interviews were conducted in the same locations, with both chronic patients and health personnel working at different levels of the primary health care setting. Participants were recruited through purposive and snowball sampling, and a deductive approach was implemented for coding during the analysis phase. After grouping codes into potential themes, a thematic framework was developed using a reflexive approach and following triangulation of the data. Results: This innovative approach of combining three well-defined qualitative methods identified key implications for the implementation of a comprehensive approach to NCD management in resource-poor settings. The following elements are identified: 1) social risk factors and barriers to care; 2) patient pathways to NCD care; 3) available resources identified through social connections mapping; 4) trust in social connections; and 5) community health promotion and NCD prevention management. Conclusions: The Salvadoran public health system has been able to strengthen its comprehensive approach to NCDs, combining a clinical approach – including long-term follow-up – with a preventive community-based strategy. The structural collaboration between the health system and the (self-) organised community has been essential for identifying failings, discuss tensions and work out adapted solutions.
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    Comprehensive primary health care and non-communicable diseases management: A case study of El Salvador
    (BMC, 2020-04-06) Jimenez Carrillo, Marta; León García, Montserrat; Vidal, Nicole L.; Bermúdez, Keven; De Vos, Pol
    One of today's greatest challenges in public health worldwide - and especially its key management from Primary Health Care (PHC) - is the growing burden of non-communicable diseases (NCDs). In El Salvador, since 2009 the Minister of Health (MoH) has scaled up a national public health system based on a comprehensive PHC approach. A national multi-sectorial strategic plan for a comprehensive approach to NCDs has also been developed. This analysis explores stakeholders' perceptions related to the management of NCDs in PHC and, in particular, the role of social participation. A case-study was developed consisting of semi structured interviews and official document reviews. Semi-structured interviews were developed with chronic patients (14) and PHC professionals working in different levels within PHC (12). Purposive sampling was used to recruit participants. A non-pure, deductive approach was implemented for coding. After grouping codes into potential themes, a thematic framework was elaborated through a reflexive approach and the triangulation of the data. The research was conducted between March and August of 2018 in three different departments of El Salvador. The structure and the functioning of the Salvadoran PHC system and its intersectoral approach is firstly described. The interdisciplinary PHC-team brings holistic health care closer to the communities in which health promoters play a key role. The findings reflect the generally positive perception of the PHC system in terms of accessibility, quality and continuity of care by chronic patients. Community engagement and the National Health Forum are ensuring accountability through social controllership mechanisms. However, certain challenges were also noted during the interviews related to the shortage of medication and workforce; coordination between the levels of care and the importance of prevention and health promotion programmes for NCDs. The Salvadoran PHC and its comprehensive approach to NCDs with an emphasis on intersectoral participation has been positively perceived by the range of stakeholders interviewed. Social engagement and the NHF works as a driving force to ensure accountability as well as in the promotion of a preventive culture. The challenges identified provide keys to amplify knowledge for addressing inequalities in health by strengthening PHC and its NCDs management.
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    The role of social movements in strengthening health systems: The experience of the National Health Forum in El Salvador (2009–2018)
    (SAGE Publications, 2020-02-19) León, Montserrat; Jiménez, Marta; Vidal, Nicole L.; Bermúdez, Keven; De Vos, Pol
    In 2009, the newly elected FMLN government of El Salvador launched a comprehensive health reform, which gave the National Health Forum (NHF) a key role in developing community participation. This study aims to examine and analyze the content and impact of this social movement during the study period 2009–2018. The context was analyzed through relevant documents, which helped identify key stakeholders. Semi-structured interviews took place at 3 levels of decision making: the political level, the health professionals, and the community. Data were analyzed using a qualitative methodology. Participation is carried by a structure created by the Ministry of Health, the National Health Forum. The NHF developed 3 strategies: (1) leadership building in the communities through the strengthening of social, political, and economic skills, where they developed social accountability mechanisms at all decision-making levels of the health system; (2) the strategy carried by the sectoral working groups, where they responded to prioritized needs identified by the community; and (3) advocacy for human rights-based policies. The NHF, and its role in the strengthening of the National Public Health System, provides strong evidence of community participation strategies and co-governance with the health system within the social determinants of health scope.