Social Science and Medicine
Volume 212, 2018, Pages 43-49

Complex narratives of health, stigma and control: Antimicrobial resistance screening among non-hospitalized refugees (Article)

Kamenshchikova A.* , Wolffs P.F.G. , Hoebe C.J. , Penders J. , Horstman K.
  • a Department of Health, Ethics and Society, School of Public Health and Primary Care (CAPHRI), Maastricht University, Postbus 616, Maastricht, MD 6200, Netherlands, Research Centre for Policy Analysis and Studies of Technologies (PAST-Centre), National Research Tomsk State University, Tomsk, Russian Federation
  • b Department of Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, Netherlands
  • c Department of Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, Netherlands, Department of Sexual Health, Infectious Diseases and Environmental Health, South Limburg Public Health Service (GGD South Limburg), Heerlen, Netherlands
  • d Department of Medical Microbiology, School of Public Health and Primary Care (CAPHRI), Maastricht University Medical Center (MUMC+), Maastricht, Netherlands, Department of Medical Microbiology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center (MUMC+), Maastricht, Netherlands
  • e Department of Health, Ethics and Society, School of Public Health and Primary Care (CAPHRI), Maastricht University, Postbus 616, Maastricht, MD 6200, Netherlands

Abstract

Antimicrobial resistance (AMR) is often presented as a major public health problem globally. Screening for AMR usually takes place in clinical settings. Recent developments in microbiology stimulated a series of studies focusing on AMR in communities, and particularly in travelers (any mobile individual), which was argued to be important for identifying potential public health risks. Against this background, microbiologists have become interested in non-hospitalized refugees as one of the traveler groups. However, this attention to refugees has provoked some professional debates on potential stigmatization of refugees as dangerous “others”. To contribute to these debates, and to explore the idea of AMR screening of non-hospitalized refugees from different perspectives, we conducted a qualitative study among four groups of stakeholders who were chosen because of their associations with potential microbiological screening: microbiologists, public health physicians, public health nurses, and refugees. The study took place in a Dutch city from June to August 2016 and had 17 participants: five microbiologists, two public health nurses, four public health physicians, and six refugees. While microbiologists and public health physicians demonstrated a de-contextualized biomedical narrative in arguing that AMR screening among non-hospitalized refugees could be important for scientific research as well as for AMR prevention in communities, public health nurses displayed a more contextualized narrative bringing the benefits for individuals at the center and indicating that screening exclusively among refugees may provoke fear and stigmatization. Refugees were rather positive about AMR screening but stressed that it should particularly contribute to their individual health. We conclude that to design AMR prevention strategies, it is important to consider the complex meanings of AMR screening, and to design these strategies as a process of co-production by diverse stakeholders, including the target populations. © 2018 Elsevier Ltd

Author Keywords

Netherlands Antimicrobial resistance screening Stigma Health Control Refugees

Index Keywords

Netherlands narrative refugee nurse mass screening health risk human Refugees middle aged travel statistics and numerical data stakeholder qualitative research Young Adult Humans psychology male female qualitative analysis clinical article verbal communication Social Stigma stigma Narration Article health care adult human experiment physician ambulatory care microbiology antibiotic resistance Drug Resistance, Bacterial attention Fear public health

Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85049596770&doi=10.1016%2fj.socscimed.2018.07.012&partnerID=40&md5=1dbd0ce211520a45709f47c23d6252d5

DOI: 10.1016/j.socscimed.2018.07.012
ISSN: 02779536
Cited by: 1
Original Language: English