A case study about “The Benefits and Challenges of Health Promotion and Awareness Programme “REFUGIUM” for Refugees Living in Camps in Hamburg, Germany”

Abstract

Background: More than 1 million refugees immigrated into Germany 2015-2016. To address the complex gaps between accessing proper health services or preventive interventions adequate for their needs and living situations in the new host country; health interventions based on innovative peer-led idea were required. Peer-to-peer health awareness programme REFUGIUM was set up to meet the health needs of refugees regarding prevention in temporary accommodation settings, aiming to activate refugee’s health resources to cope with the living conditions in Germany. In 2016, 35 refugees (9 women - 27 men) attended 6-session facilitator training and participated in programme development. Objectives: This research aims to describe the experiences of REFUGIUM first generation peer facilitators to assess and analyze benefits gained and challenges of the programme. This research gives recommendations and an overview on the ways of conducting health interventions for refugees in camps and health burdens they face in Germany. Methods: Data was collected in 12-month participatory observation and 8 in-depth interviews with participants, 4 women and 4 men aged 19-63 from 5 different countries in Arabic and English. Qualitative content analysis identified benefits and challenges of peer-facilitator-training and collaborative research using intrinsic case study approach. Results: 4 categories and 11 codes were developed and associated with the health intervention. Refugees in Hamburg were not aware about other similar health interventions. The followed methods in approaching refugees in camps were successful and faced challenges in motivating women due to cultural differences and resource obstacles in having separate workshops for them. Participants felt ownership of the programme, its content, relevance and culture appropriateness. They felt for the first time in Germany that they could talk freely about health burdens in camps without fear of getting transferred and, accepted as knowledgeable and resourceful. Participants felt they could be useful instead of just receiving charity. Peer-facilitators gained different health knowledge, psychological benefits and built new social networks from participating, and expressed different challenges and suggestions. Mental health, daily-hygiene, and health care system including entitlements to health services were identified as the most important types of information needed for refugees. Different organizational challenges were faced mainly due to limitations of resources Outlook: This study gave refugees in Hamburg a voice to reveal their experiences, health needs and burdens. Participation in peer facilitator training and participatory action research empower refugees to integrate into host country and improve their mental health. Urgent mental support and better living conditions in refugee camps are required. Various and precise recommendations on conducting such interventions in developed countries as Germany were revealed, but still there is need for more future research.