Armitage, Alice Jane;
(2025)
Migrant child health outcomes and service development, interventions and policy recommendations for unaccompanied asylum-seeking children.
Doctoral thesis (M.D(Res)), UCL (University College London).
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Abstract
INTRODUCTION: Migration status is a key determinant of health, but health outcomes among migrant children and young people (CYP, those under the age of 18) are poorly understood. Unaccompanied asylum-seeking children (UASC) are particularly vulnerable and require intensive and joined-up support. There has been a failure to hear the voice of migrant CYP in service development and research. METHODS: I undertook a systematic review of mortality and communicable diseases among migrant CYP. I described a novel “integrated pathway” for UASC, and explored implementation in a second London borough, presenting data on UASC engaged with this service. Finally, I explored the current model of patient and public involvement (PPI), including ethical considerations, as applied to UASC. RESULTS: I found a lack of data on mortality among migrant CYP with better quality evidence exclusively from high-income settings. Studies showed higher cause-specific but equivocal all-cause mortality compared with the host population. Rates of all communicable diseases were high among migrant CYP with the highest risk among adolescents and those from Africa. The UASC evaluation showed high rates of communicable diseases, mental health problems, and physical and sexual abuse/assault. An integrated pathway was successfully implemented in two boroughs, showing the potential to improve outcomes and address barriers to engagement. I demonstrated that blurred boundaries and contradictory advice in guidance on PPI present barriers to engagement with, and research about, vulnerable migrant CYP. CONCLUSION: There is a paucity of research on health outcomes among migrant CYP and a failure to include their voice. An integrated pathway is an appropriate clinical approach for UASC and adds to the literature on best practice management of refugee children. Improving migrant CYP health requires equity in healthcare provision, integration of services and a trauma-informed care approach. Participatory and longitudinal research with broad geographical scope is needed, including policy-impact studies.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | M.D(Res) |
| Title: | Migrant child health outcomes and service development, interventions and policy recommendations for unaccompanied asylum-seeking children |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2025. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10214618 |
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