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Zdravkovic, Slobodan
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Publications (10 of 46) Show all publications
Dalingwater, L., Mangrio, E., Strange, M. & Zdravkovic, S. (2023). Policies on marginalized migrant communities during Covid-19: migration management prioritized over population health. Critical Policy Studies, 17(2), 316-336
Open this publication in new window or tab >>Policies on marginalized migrant communities during Covid-19: migration management prioritized over population health
2023 (English)In: Critical Policy Studies, ISSN 1946-0171, E-ISSN 1946-018X, Vol. 17, no 2, p. 316-336Article in journal (Refereed) Published
Abstract [en]

Migration management policies in many states have marginalized significant numbers of individuals on the basis of their precarious residency status, negatively impacting their health. This article looks at how three European states with high levels of contagion - France, Sweden, and the United Kingdom - adapted their migration management policies to the changed circumstances during the Covid 19 pandemic in which there was new pressure for prioritizing population health over other concerns. The analysis compares globally-recognized 'best practices' for migrant health during the pandemic with policies adopted by France, Sweden, and the UK - selected as prominent migrant-hosting states and that experienced high rates of Covid-19. The article draws on supplementary evidence through interviews with civil society organizations working directly with migrants living on the margins of society - what are termed here 'marginalized migrants' (MMs). As the article concludes, the national policies often fell below international 'best practices' such that migration management was often prioritized over population health despite the crisis. The perspective developed in this paper is important for understanding where migration control policies have been prioritized over public health.

Place, publisher, year, edition, pages
Routledge, 2023
Keywords
Marginalized migrants, Migration management, covid 19, France, Sweden, United Kingdom, population health
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mau:diva-54057 (URN)10.1080/19460171.2022.2102046 (DOI)000828963400001 ()2-s2.0-85134598485 (Scopus ID)
Available from: 2022-08-02 Created: 2022-08-02 Last updated: 2023-10-18Bibliographically approved
Hansen, M. U., Vejzovic, V., Zdravkovic, S. & Axelsson, M. (2022). Ambulance nurses' experiences of using prehospital guidelines for patients with acute chest pain - A qualitative study.. International Emergency Nursing, 63, 1-7, Article ID 101195.
Open this publication in new window or tab >>Ambulance nurses' experiences of using prehospital guidelines for patients with acute chest pain - A qualitative study.
2022 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 63, p. 1-7, article id 101195Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Ambulance nurses have an important role in early recognition and treatment often being the first medical contact for patients with acute chest pain. However, there is sparse knowledge on the experiences of ambulance nurses with regard to use of Prehospital Guidelines for patients with Acute Chest Pain.

AIM: To explore ambulance nurses' experiences of using prehospital guidelines for patients with acute coronary syndrome.

METHOD: A qualitative descriptive study design. Semi-structured interviews with 22 ambulance nurses recruited through purposive sampling strategy. The material was transcribed and analysed using content analysis.

RESULTS: Two main categories emerged from the results. The first category Sense of professional obligation included experiences of having an important role in caring for patients with acute chest pain. Understanding this role and the collaboration in the chain of care prompted ambulance nurses to adhere to the guidelines. However, not receiving enough feedback on the provided care made them uncertain whether to use guidelines. The second category Clinical difficulties using guidelines consisted of experiences of being surrounded by practical challenges while using guidelines. Ambulance nurses meet these challenges by relying on their clinical experience, which sometimes led to them deviating from the guidelines.

CONCLUSIONS: The ambulance nurses experienced a mixture of feeling secure and insecure when using the guidelines. Foremost, when encountering patients with unspecific chest pain, they felt a lack of feedback and an insufficient collaboration within the chain of care, which made them deviate from guidelines. To increase adherence in guidelines, post-registration education to update the knowledge and skills about guidelines for acute chest pain is needed followed by formal inter-disciplinary feedback on the care provided.

Place, publisher, year, edition, pages
Elsevier, 2022
Keywords
Ambulance nurses, Chest pain, Guideline adherence, Myocardial infarction, Prehospital care, Qualitative research
National Category
Nursing
Identifiers
urn:nbn:se:mau:diva-54130 (URN)10.1016/j.ienj.2022.101195 (DOI)000836194400003 ()35802956 (PubMedID)2-s2.0-85133702998 (Scopus ID)
Available from: 2022-08-02 Created: 2022-08-02 Last updated: 2024-02-05Bibliographically approved
Svensson, P., Agardh, A., Zdravkovic, S. & Asamoah, B. O. (2022). Investigating pathways for predisposing, enabling and need factors in predicting the use of STI/HIV-testing services among Syrian and Iraqi migrants in Scania, Sweden - a cross-sectional study with directed acyclic graphs for modelling pathways to testing. BMC Public Health, 22(1), 2177, Article ID 2177.
Open this publication in new window or tab >>Investigating pathways for predisposing, enabling and need factors in predicting the use of STI/HIV-testing services among Syrian and Iraqi migrants in Scania, Sweden - a cross-sectional study with directed acyclic graphs for modelling pathways to testing
2022 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, p. 2177-, article id 2177Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Some groups of migrants have increased vulnerability to Sexually Transmitted Infections (STI) and Human Immunodeficiency Virus (HIV) transmission partly due to a lower uptake of disease preventive activities targeting the general population in receiving country. Limited access to economic and social resources and poor language skills may exacerbate exposure to sexual risks and utilization of health services.

AIM: To explore general and migrant specific predictors for STI/HIV-testing among Syrian and Iraqi migrants in Sweden and to investigate potential pathways that link predisposing, enabling and need- factors to STI/HIV-testing.

METHOD: Cross-sectional study design based on a migration specific framework for health care utilization. Directed acyclic graphs (DAGs) were used to model assumptions about factors associated with the uptake of STI/HIV-testing services. Bi-variable and multivariable logistic regression analyses assessed individual predictors while adjusting for covariates. The magnitude of the indirect effect of mediating variables were estimated with bootstrap analyses and a method for decomposing the total effect.

RESULT: The pathways between younger age, unmarried, and self-identifying as bi- or homosexual and testing were mainly indirect, mediated by experiences of sexual coercion and other risk behaviours. One third of the indirect mediating effect of the pathway between higher education and testing could be attributed to Swedish language skills.

CONCLUSION: Utilization of STI/HIV-testing services among Syrian and Iraqi migrants seemed to be motivated by sexual risk exposure and risk awareness. Interventions should focus on language-adapted information about available screening services and where to go for advice on sexual wellbeing and sexual rights. Such activities should be implemented within an integration promoting framework, addressing structures that increase STI/HIV risk exposure, specifically targeting vulnerable subgroups of migrants.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2022
Keywords
Directed acyclic graph, Health care utilization, Migrant, Prevention, STI/HIV-testing, Sexual risks
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mau:diva-56605 (URN)10.1186/s12889-022-14615-6 (DOI)000888746900011 ()36434617 (PubMedID)2-s2.0-85142493437 (Scopus ID)
Available from: 2022-12-13 Created: 2022-12-13 Last updated: 2024-02-05Bibliographically approved
Mangrio, E., Nieuwenhuijsen, K., Wahel Sebhatu, R., Strange, M. & Zdravkovic, S. (2022). Rapport #2 PHED-kommissionen för framtiden för hälso-och sjukvård efter Covid-19: allmän hälso- och sjukvård för en gemensam framtid. Baserad på offentliga seminarier som hållits mars - juni 2021. Malmö: Malmö universitet
Open this publication in new window or tab >>Rapport #2 PHED-kommissionen för framtiden för hälso-och sjukvård efter Covid-19: allmän hälso- och sjukvård för en gemensam framtid. Baserad på offentliga seminarier som hållits mars - juni 2021
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2022 (Swedish)Report (Other academic)
Abstract [sv]

Den här rapporten ger en sammanfattning av de seminarier som organiserades under våren 2021 av PHEDKommissionen för framtiden för hälso- och sjukvården efter covid-19, som bjöd in till vittnesmål från hälso- och sjukvårdspersonal, tjänstemän, tankesmedjor, forskare, civilsamhället och andra intresserade parter baserat på de erfarenheter de fått och lärt sig av under pandemin. De vittnesmål som framfördes kom från många olika geografska platser och många olika nivåer, vilket gjorde dem relevanta både för Sverige och globalt. De fastställer fera centrala rekommendationer för att skydda och förbättra folkhälsan. Dessa rekommendationer både kompletterar och i hög grad utökar de rekommendationer som togs fram i den första rapporten, som var mer fokuserad på Sverige (”Ojämlikhet i samhället gör oss sårbara för pandemier”) och baserad på vittnesmål från hösten 2020, och som kan nås via: https://phed.uni.mau.se/. Den stora mängd erfarenheter som sammanfattas här går långt utöver pandemiperioden och tillhandahåller idéer och praktisk vägledning för att skydda och stärka människors hälsa så att den blir mer motståndskraftig inför framtida kriser. 

Place, publisher, year, edition, pages
Malmö: Malmö universitet, 2022. p. 25
National Category
Social Sciences Interdisciplinary Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Care science; Urban studies; Health and society; Global politics
Identifiers
urn:nbn:se:mau:diva-58838 (URN)10.24834/isbn.9789178773282 (DOI)978-91-7877-327-5 (ISBN)978-91-7877-328-2 (ISBN)
Projects
PHED - Precision Health and Everyday Democracy
Funder
The Swedish Foundation for International Cooperation in Research and Higher Education (STINT), SG 2017-6954
Available from: 2023-03-27 Created: 2023-03-27 Last updated: 2024-02-22Bibliographically approved
Mangrio, E., Nieuwenhuijsen, K., Wahel Sebhatu, R., Strange, M. & Zdravkovic, S. (2022). Report #2 PHED commission on the future of healthcare post covid-19: universal health coverage for a real future. Based on sessions conducted from March until June 2021. Malmö: Malmö universitet
Open this publication in new window or tab >>Report #2 PHED commission on the future of healthcare post covid-19: universal health coverage for a real future. Based on sessions conducted from March until June 2021
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2022 (English)Report (Other academic)
Abstract [en]

This report summarises the Spring 2021 sessions of the PHED Commission on the Future of Healthcare Post Covid-19, which invited testimony from healthcare practitioners, civil servants, thinktanks, researchers, civil society, and other interested parties based on their experiences learnt during the pandemic. The evidence presented came from multiple geographies and levels, making it relevant both to Sweden and globally. It identifes several key recommendations for protecting and improving public health. These recommendations supplement and greatly expand upon those identifed in the report (‘Societal inequity makes us vulnerable to pandemics’) based on testimony from Fall/Autumn 2020, which can be accessed via: https://phed.uni.mau.se/. The wealth of experience summarized here goes well beyond the pandemic period, providing ideas and practical guidance for protecting and strengthening human health to be more resilient in the face of future crises.

Place, publisher, year, edition, pages
Malmö: Malmö universitet, 2022. p. 24
Keywords
Public health, health equity, democracy, covid
National Category
Social Sciences Interdisciplinary Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Care science; Urban studies; Health and society; Global politics
Identifiers
urn:nbn:se:mau:diva-58833 (URN)10.24834/isbn.9789178773305 (DOI)978-91-7877-329-9 (ISBN)978-91-7877-330-5 (ISBN)
Projects
PHED - Precision Health and Everyday Democracy
Funder
The Swedish Foundation for International Cooperation in Research and Higher Education (STINT), SG 2017-6954
Available from: 2023-03-27 Created: 2023-03-27 Last updated: 2024-02-22Bibliographically approved
Mangrio, E., Zdravkovic, S. & Ivert, A.-K. (2022). Risk for mental illness following exposure to violence and threats among newly arrived refugees. BMC Research Notes, 15(1), Article ID 361.
Open this publication in new window or tab >>Risk for mental illness following exposure to violence and threats among newly arrived refugees
2022 (English)In: BMC Research Notes, E-ISSN 1756-0500, Vol. 15, no 1, article id 361Article in journal (Refereed) Published
Abstract [en]

Objective: There is an association between pre-migration exposure to threats and violence, and the risk for mental illness among newly arrived refugees (NAR). The aim of this study is therefore to investigate the effect of pre-migration violent and threatening experiences on the mental health of NAR in Sweden. The participants were recruited between February 2015 and February 2016, undergoing the naturalisation process in Sweden. In total, 681 questionnaires were returned (response rate of 39.5%).

Results: The results showed that almost 50% of the sample were at risk for mental illness. Analysis of pre-migration exposure to violence or threats, and risk for mental illness, showed a significant odds ratio for violence as well as for threats. Analysing men and women separately resulted in a significant odds ratio for women for pre-migration threats. For men, pre-migration violence and threats were significantly associated with the risk for mental illness. The host society receiving NAR must screen for mental illness and be prepared to provide support and care for refugees who were exposed to violence or threats, and who are subsequently at risk for mental illness. This must be considered in order to improve health and subsequently the social integration of refugees.

Place, publisher, year, edition, pages
BioMed Central (BMC), 2022
Keywords
Mental illness, Newly arrived refugees, Quantitative research, Threats, Violence
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and society
Identifiers
urn:nbn:se:mau:diva-55542 (URN)10.1186/s13104-022-06239-1 (DOI)000896581400002 ()36494826 (PubMedID)2-s2.0-85143706924 (Scopus ID)
Available from: 2022-10-31 Created: 2022-10-31 Last updated: 2024-02-05Bibliographically approved
Mangrio, E., Grahn, M., Zdravkovic, S. & Cuadra, C. (2022). Social relations and mental ill-health among newly arrived refugees in Sweden: a cross-sectional study. PLOS Global Public Health, 2(7), Article ID e0000362.
Open this publication in new window or tab >>Social relations and mental ill-health among newly arrived refugees in Sweden: a cross-sectional study
2022 (English)In: PLOS Global Public Health, E-ISSN 2767-3375, Vol. 2, no 7, article id e0000362Article in journal (Refereed) Published
Abstract [en]

Background: Previous research indicates that social relations have an impact on the well-being of refugees and that well-being is important for effective integration into the host country. Few studies in Sweden have, to the best of our knowledge, looked at the association between social relations and mental ill-health among newly arrived refugees. The aim is to investigate what effect social relations have on the mental health of newly arrived refugees in the south of Sweden. Methods: A cross-sectional study was conducted in Scania, the southernmost county of Sweden, between February 2015 and February 2016. The study population consisted of newly arrived adult refugees speaking Dari or Arabic, who received the civic and health information that is part of an introduction course for all newly arrived refugees. Results: Individuals who rarely met with friends had higher odds of experiencing mental ill-health (OR=1.70, 95% CI, 1.03-2.82) than individuals who frequently spent time with friends. Furthermore, individuals who seldom attended social/community meetings or activities in an organisation or group, such as a sports association or another kind of association, a church, a mosque, or women’s or men’s meetings, had higher odds of mental ill-health (OR=1.58, 1.1-2.28), compared to those who frequently did so. Conclusions: The study suggests a link between spending time with friends, as well as engaging in social/community activities, and the mental health of newly arrived refugees in the southernmost county of Sweden, which is one of the counties in Sweden that received the highest number of refugees. The results are in line with a previous study on the same subject in Sweden.

Place, publisher, year, edition, pages
PLoS, 2022
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mau:diva-55048 (URN)10.1371/journal.pgph.0000362 (DOI)36962385 (PubMedID)
Available from: 2022-09-21 Created: 2022-09-21 Last updated: 2024-02-29Bibliographically approved
Mangrio, E., Enskär, K., Ramji, R., Sjögren Forss, K., Tengland, P.-A., Theodoridis, K., . . . Rämgård, M. (2022). The Need for Parental Support for Migrant Parents in Transition Into Sweden: A Perspective. Frontiers In Public Health, 10, Article ID 680767.
Open this publication in new window or tab >>The Need for Parental Support for Migrant Parents in Transition Into Sweden: A Perspective
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2022 (English)In: Frontiers In Public Health, ISSN 2296-2565, Vol. 10, article id 680767Article in journal (Refereed) Published
Abstract [en]

Migration is a stressful experience and research shows that newly arrived migrants in Sweden suffer from different challenges and struggle to relate to parenting in a new culture that is different from their own. The Swedish Child Health Services (CHS) focuses on promoting health among children, as well as supporting parents in parenting. Although this is a goal, migrant parents participate at lower rates in parental support groups. This paper aims to discuss how the Swedish CHS can support these families and address the need for improvement in the parental support offered to migrant parents during transition into their host country. In addition, this paper also aims to review and discuss the advantages of using a community-based participatory research approach together with the Swedish CHS to identify and apply culturally appropriate support programs to increase health literacy among migrant parents.  

The Swedish government decided to place greater emphasis and resources on supporting parents and promoting equal health among families in Sweden, with special emphasis on migrants and other vulnerable groups. This report from the Swedish government indicates the importance of creating knowledge about new ways, methods, and actions that may be needed to increase this support. One suggestion of this paper is to provide culturally appropriate healthcare work using a community-based participatory research approach, where migrant parents themselves are actively involved in the development of support programs. This approach will not only provide migrant families knowledge and support, it will also build on their needs and the challenges they can share, and receive support to overcome.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2022
National Category
Health Sciences
Research subject
Care science
Identifiers
urn:nbn:se:mau:diva-51484 (URN)10.3389/fpubh.2022.680767 (DOI)000795620600001 ()35570884 (PubMedID)2-s2.0-85130038294 (Scopus ID)
Available from: 2022-05-17 Created: 2022-05-17 Last updated: 2024-02-05Bibliographically approved
Dalingwater, L., Mangrio, E., Strange, M. & Zdravkovic, S. (2022). The well-being of marginalized migrants in Europe duing the Covid-19 epidemic: evidence from France, Sweden, and the UK. In: Louise Dalingwater,Vanessa Boullett, Iside Costantini & Paul Gibbs (Ed.), The Unequal Costs of Covid-19 on Well-being in Europe: (pp. 177-202). Springer Nature
Open this publication in new window or tab >>The well-being of marginalized migrants in Europe duing the Covid-19 epidemic: evidence from France, Sweden, and the UK
2022 (English)In: The Unequal Costs of Covid-19 on Well-being in Europe / [ed] Louise Dalingwater,Vanessa Boullett, Iside Costantini & Paul Gibbs, Springer Nature, 2022, p. 177-202Chapter in book (Refereed)
Abstract [en]

International guidance set forth recommendations to protect marginalized migrant populations during Covid-19 given the significant inequalities in terms of social and economic well-being reported in the literature. However, a cross-country study of three European countries with high rates of Covid-19 infections and deaths has shown that migrant well-being has significantly decreased since the outbreak of Covid-19 in Europe from March 2020 and that policy measures to help those marginalized populations have been insufficient. The conclusions on migrant well-being during Covid-19 draw on interviews with prominent civil society organizations in all three countries that work specifically on migrant health and welfare. All interviews were semi-structured and conducted between October and November 2020. The analysis mainly focuses on objective/material measures of well-being related to access to health care, information on prevention of infection, housing and exclusion by host population.

Place, publisher, year, edition, pages
Springer Nature, 2022
Series
Human well-being research and policy making, ISSN 2522-5367, E-ISSN 2522-5375
National Category
Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
Global politics; Health and society
Identifiers
urn:nbn:se:mau:diva-56036 (URN)10.1007/978-3-031-14425-7 (DOI)
Funder
The Swedish Foundation for International Cooperation in Research and Higher Education (STINT)
Available from: 2022-11-15 Created: 2022-11-15 Last updated: 2023-10-17Bibliographically approved
Mangrio, E., Zdravkovic, S. & Strange, M. (2022). Working With Refugees' Health During COVID-19: The Experience of Health- and Social Care Workers in Sweden. Frontiers In Public Health, 10, Article ID 811974.
Open this publication in new window or tab >>Working With Refugees' Health During COVID-19: The Experience of Health- and Social Care Workers in Sweden
2022 (English)In: Frontiers In Public Health, ISSN 2296-2565, Vol. 10, article id 811974Article in journal (Refereed) Published
Abstract [en]

Introduction

In Sweden, often seen as one of the most egalitarian countries, the COVID-19 pandemic exposed high levels of health inequality, especially harming people with a refugee background. This is also despite Sweden’s image as a refugee-friendly country. In this context, the aim of this paper is to better understand how Swedish health- and social workers have reacted to the health- and social needs of refugees during the pandemic. The Swedish case is particularly interesting because, as seen in the paper, health- and social workers had the task of communicating health guidance to refugees who were sometimes more reliant on information from abroad where the consensus on COVID-19 restrictions ran contrary to the approach recommended by the Swedish public health authority.

Method

The study utilizes a qualitative content analysis of 13 in-depth interviews with health- and social workers in Sweden, active in the care of refugees within different kinds of health- and social care settings. 

Results

The analysis showed that healthcare services have remained open during the pandemic but with new precautions at reception areas impacting how refugees access healthcare. As discussed in the article, the shift to digital tools has particularly impacted refugees, worsening already existing barriers to healthcare services faced by those with refugee status. Public health recommendations were poorly designed to the needs of refugees whose living conditions often prevented them from self-isolation and social distancing. Furthermore, Sweden’s initially non-restrictive approach to the pandemic instructed health- and social-workers to encourage refugees to take far fewer precautions (e.g. self-isolation, home-schooling, pregnant women to avoid virus hotspots) compared both with European neighbours and the international media typically used by refugees. When Sweden shifted towards a more restrictive approach, health- and social-workers had to revise their guidance in relation to the new recommendations around precautions.

Conclusion

Refugees have faced increased barriers to maintaining their health and well-being during the pandemic that exceed those experienced by the rest of the Swedish population. Refugees have, in general, taken precautions in regard to social distancing and followed recommendations but faced challenges with social distancing due to isolation and crowded living. Public health authorities have often failed to acknowledge that individuals use increasingly diverse sources of knowledge when trying to protect their health, and that not everyone has access to the knowledge needed to access healthcare and social systems. At the same time, there is a need to acknowledge that refugees are sometimes a source of expertise that was ignored by the Swedish health and social system during the pandemic. There is a need for urgent efforts to halt the worsening health conditions for this specific group, but also to counter knock-on societal effects and rising health inequity.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2022
National Category
Health Sciences
Identifiers
urn:nbn:se:mau:diva-51553 (URN)10.3389/fpubh.2022.811974 (DOI)000806048400001 ()35669746 (PubMedID)2-s2.0-85131347161 (Scopus ID)
Funder
The Swedish Foundation for International Cooperation in Research and Higher Education (STINT)
Available from: 2022-05-20 Created: 2022-05-20 Last updated: 2024-02-05Bibliographically approved
Projects
MILSA; Malmö UniversityPHED - Precision Health and Everyday Democracy; Malmö UniversityPublic health, epidemics and urban planning: reinstating the connection; Malmö University
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