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Insertion et entre-soi : l’immigration chinoise est diverse
No full textLa population immigrée de la France compte aujourd’hui moins de 2 % d’immigrés d’origine chinoise, soit environ 116 000 personnes, qui résident aux deux-tiers en Île-de-France. Les migrants économiques sont plus âgés et moins diplômés que les immigrés entrés en France pour y faire des études supérieures et qui sont restés. Ils ont une moins bonne maîtrise du français et leurs réseaux de sociabilité et professionnels restent ancrés dans un entre-soi reposant sur leur origine régionale ou nationale. C’est moins le cas des anciens étudiants internationaux
« Avant on traitait un peu à l’aveugle, c’était un diagnostic syndromique. » Perceptions des médecins dans une prise en charge globale des infections sexuellement transmissibles chez des travailleuses du sexe en Côte d’Ivoire
No full textObjectifs : Le projet ANRS 12381 Princesse a proposé une offre de soins globale et communautaire en santé sexuelle et reproductive (SSR), dont la prise en charge des infections sexuellement transmissibles (IST) auprès des travailleuses du sexe (TS) ≥ 18 ans dans la région de San Pedro. Notre objectif est d’analyser les perceptions des médecins dans la prise en charge globale (PEC) des IST.
Matériels et Méthodes : Le dispositif de santé Princesse (26/11/2019 – 30/06/2023) comprenait pour la PEC des IST, à la fois en clinique mobile et fixe, un dépistage syndromique trimestriel des IST, ainsi que des prélèvements vaginaux et anaux pour la recherche annuelle de chlamydia trachomatis et de neisseria gonorrhée. Des entretiens individuels ont été réalisés en juin/juillet 2023 avec les quatre médecins intervenant dans la PEC des IST des participantes du projet, afin d’analyser leurs perceptions sur cette PEC.
Résultats : L’offre de dépistage et de PEC des IST a été bien appréciée par l’équipe médicale. Pour les médecins, l’acquisition de nouvelles connaissances pour la PEC des IST, la possibilité de réaliser des examens de laboratoire directement sur site et en clinique fixe, et le fait de pouvoir remettre directement des kits de soins IST aux patientes ont été un atout du projet et une source de motivation à travailler sur du long terme. Cela a également favorisé la création d’une relation de confiance entre les médecins et les TS. Cependant, certaines difficultés opérationnelles, incluant notamment un retard fréquent en approvisionnement des kits IST et le rendu tardif des analyses médicales, ont contribué, par moments, à entacher cette relation de confiance et ont compliqué la PEC des IST en temps voulu, la mise en place d’un traitement adéquat et un suivi régulier en cas d’IST, dans un contexte déjà tendu en raison de la forte mobilité des TS. Une autre limite relevée était la non PEC du ou des partenaires stables de la TS traitée, car ne permettant pas de rompre la chaîne de contamination et d’éviter les éventuelles réinfections. Enfin, l’inaccessibilité de certains sites du fait du mauvais état des routes en saisons pluvieuses a également compliqué la PEC des IST.
Conclusion : Le dépistage et la PEC des IST ont été perçus comme une réponse adaptée aux besoins en SSR des TS. Cependant, des barrières à la fois structurelles et opérationnelles ont rendu sa mise en œuvre complexe. La mise à disposition d’outils point of care, notamment l’utilisation de tests rapides IST, pourrait être pertinente pour cette population particulièrement mobile
Gender and Age Domination
No full textThis presentation focuses on age and gender domination that occur within sexual violence situations, during adolescence. Quantitative analyses are based on the survey “VIRAGE”, which is a national survey on gender-based violence carried out in France in 2015 among 27,000 people (Hamel et al., 2016). I also have conducted sixty in-depth interviews with 50 men and 10 women (my doctoral research focuses on sexual violence against men), who had previously participated to VIRAGE survey. This poster focuses on the characteristics of sexual violence before the age of 18, especially during adolescence. Intersectionality between gender and age domination drives the analysis (Calasenti et Slevin, 2006 ; Crenshaw, 1991 ; Levy, 1988). First, I introduce the presentation by describing the context of sexual violence before 18 years old, according to gender but also regarding to age domination. Two groups emerged from this analysis: exposure to sexual violence between 0-11 years old (childhood) and between 12-17 years old (adolescence). As we will see, during childhood, sexual violence occurs within the family (or it close circle), principally by adult men; age and gender are linked: for two third of women (67.6%) but also for more than half of men (57.7%). After 11 years old, configurations of violence remain approximatively the same for women during teenagerhood, even if sexual violence in early relationships cannot be ruled out (23.4% of women report violence outside the family). Girls are socialised to stay at home, compared to boys who are socialised to stay more often outside from earlier ages. Moreover, during adolescence, men are principally assaulted outside the household. Almost three quarters (72.2%) report violence by non-adult perpetrators which are not family members. The data collected during the qualitative interviews highlight two contexts of violence: experiences of socialisation between men (especially before 15/16 years old) and during the beginning of sexual practices or relationships (heterosexual or bi men but also and more importantly for gay men). Therefore, this presentation end with analysing the role of sexual orientation (Coxell et King, 2002)
Obstetric and gynaecological violence in the EU - Prevalence, legal frameworks and educational guidelines for prevention and elimination
No full textThis study presents an overview of how the issue of obstetric and gynaecological violence is currently being apprehended in the EU. Based on research carried out across the EU 27 Member States, it identifies issues and challenges; looks at the legal framework currently applicable to this form of violence; examines ongoing political and legal developments; and gathers initiatives carried out at the national level to improve understanding and prevention of this form of gender-based violence by healthcare professionals and society in general. Finally, it provides recommendations for different stakeholders
Depression and loneliness among Sub-Saharan immigrants living in the greater Paris area: results from the MAKASI empowerment stepped wedge cluster randomised controlled trial
No full textPurpose
The MAKASI intervention aimed to empower Sub-Saharan African immigrants living in precarious situations in the Paris metropolitan area. Because there are factors specifically related to immigration that may increase the risk for common mental disorders, the present study aimed to examine participants’ levels of depression and loneliness and analyze the effect of the intervention on depression and loneliness.
Methods
The MAKASI study was designed as a stepped wedge cluster randomized trial. Study participants were recruited through an outreach program led by a nongovernmental organization and randomly assigned to two clusters, with an intervention delay of 3 months between them. Participants were assessed for 6 months after inclusion and the effect of the intervention on depression and loneliness was assessed using generalized linear mixed models. The study was conducted from 2018 to 2021 and took in consideration whether being interviewed during one of the Covid-19 confinement had an effect on the results.
Results
Between 2018 and 2021 a total of 821 subjects participated in the Makasi study. High levels of depression and loneliness were found in the study population. We found no effect of the intervention on depression [95% CI 0.77 to 2.40]. Similarly, no effect of the intervention was found on loneliness [95% CI 0.87 to 2.54].
Conclusions
The intervention tested did not appear to improve the level of depression and loneliness among participants. However, the high prevalence of mental and emotional problems in the study population suggests a public health crisis among immigrants in the greater Paris area
Return Migration and Fertility: French Overseas Emigrants, Returnees, and Nonmigrants at Origin and Destination
No full textAlthough growing research has emphasized the critical importance of studying returns for understanding various aspects of migration processes, knowledge regarding return migrants’ fertility behaviors remains limited. This study addresses this knowledge gap by comparing rates of first births and completed fertility among three groups: nonmigrants (at origin), migrants, and return migrants. Using extensive data collected both in the home regions and at destination, we analyze female migration from Martinique, Guadeloupe, French Guiana, and Réunion Island to metropolitan France (European France). We find intermediate fertility behaviors for return migrants relative to nonmigrants and migrants: on average, completed fertility levels are lower among return migrants than nonmigrants but slightly higher among return migrants than migrants. Some of these differences can be attributed to selection into migration and return, although significant gaps persist among women with similar socioeconomic characteristics. Our findings highlight three key observations. First, when migrants return before beginning childbearing, their transition to motherhood closely resembles that of nonmigrants with similar characteristics. Second, the lower fertility rates among prospective return migrants indicate an anticipation of disruption effects. Finally, reduced fertility while residing in metropolitan France translates into lower completed fertility rates for return migrants
Sibling influence on migration pathways from the French overseas to mainland France
No full textResearch shows that economic, political and social factors all drive migration, but we still know little about their interaction, especially the interplay between increasingly selective migration policies and family relations. Studies stress the role played by social capital in responding to migration restrictions and the importance of intermediaries in encouraging access to institutional resources, but we lack systematic analyses linking migrant networks and recourse to migration-facilitating programs. This paper fills this gap by investigating how siblings’ influence and migration programs combine in shaping migration from the French Overseas departments (DOM). Using a survey with detailed information on DOM families’ migration histories (MFV, INED, 2010), it assesses whether individuals stay, migrate with or without the support of migration programs, depending on their siblings’ past trajectories. A longitudinal approach and the nesting of individuals within families allow controlling for unobserved heterogeneity. Siblings migrating without the programs’ support decrease the chances of migration with it and increase the chances of migration without it. Siblings migrating with the programs’ support increase the chances of migration with it and decrease the chances of migration without it. This work shows how DOM populations engage with selective pro-migration policies, stressing the role of family relations in driving cumulative patterns of migration. It contributes to uncovering the way social and political factors interact in contexts of high migration prevalence with increased selectivity of migration and especially pro-migration policies
Régulation du secteur des Ehpads : autorisation, habilitation, tarification, conventionnement
No full textMesurer l’accessibilité géographique et financière des prises en charge en établissement d’hébergement médicalisé (type Ehpad) nécessite de prendre en compte les différents outils légaux dont disposent les Conseils départementaux pour contrôler partiellement le nombre de places en Ehpad et leur coût. En effet, au delà du niveau même des tarifs, différents paramètres interviennent pour définir le régime de tarification de l’établissement et in fine, le prix payé par le résident : la proportion de places habilitées à l’aide sociale dans l’établissement, la proportion de résidents bénéficiaires de l’aide sociale à l’hébergement (ASH), le fait que le résident soit ou non bénéficiaire de l’ASH lui-même et l’existence d’une convention d’aide sociale. Cette note détaille ces différents outils et leurs implications en termes tarifaires pour le résident. En raison de l’absence d’un suivi statistique national des conventions d’aide sociale, et ce, malgré leur développement, il est difficile de dresser un état des lieux complet des différents tarifs pratiqués. Sous certaines hypothèses cependant, on peut proposer une estimation. Sur les 570 000 résidents en hébergement permanent fin 2019, 59 % s’acquitteraient d’un tarif hébergement libre ou semi-administré dans le cadre d’une convention d’aide sociale et 41 % d’un tarif strictement administré. Parmi ces derniers, 57 % ne seraient pas allocataires de l’ASH
Parental emotional support and adolescent well-being
No full textParental emotional support, alongside material and temporal support, is an important determinant of children's subjective well-being and academic success. However, not all children benefit from the same level of parental support, and there are major differences depending on families' socio-economic status and child gender. Using the PISA 2018 surveys, this paper examines differences in parental support reported by 15-year-olds both within countries according to social status and between girls and boys, and between countries. We show that differences in parental emotional support by parents' education level and child gender are substantial. Some of these differences are (largely) explained by other characteristics such as family wealth, country of origin, and school urbanicity and private/public status. Greater parental emotional support is also found to be associated with higher PISA test scores and greater subjective wellbeing, with little variation by parental education. On the whole, our findings suggest that a significant enhancement in parental support and related child outcomes, especially in countries with lower average levels of parental emotional support, can be attained through a combined effort on several fronts: by addressing monetary and material poverty within families, by facilitating parents in balancing work and taking care of their children, by promoting greater parental involvement in their children's school life, and by offering appropriate services to assist families with special needs and facing greater challenges
Is there an end to mobility? Circular and onward migrants
No full textInternational migrations have long been depicted as one-time and one-way movements, from the origin country to a unique destination. This approach has since been widely challenged, as many studies show that migration trajectories are often more complex. Building on a now large and still growing body of literature, this chapter looks at the multiple forms of migration pathways. The first two parts are dedicated to return migrations to the country of origin and distinguish permanent returns from circular movements to and from the destination country. The third part examines other patterns of temporary migration which have been more recently investigated by empirical studies: moving from one destination to another. By introducing new potential destinations, these so-called onward migrations enlarge the traditional bipolar perspective in the literature on transnationalism focusing on the homeland and a unique residence country. The final section considers the methodological difficulties raised by the study of migration. If there is no end to mobility, it argues that there is at least an end to the complexity of migration trajectories that can be observed in most data. The conclusion discusses how new types of data open the way to promising avenues for studying other migration patterns, such as short-term movements or the continuity of migration experiences across generations