Legal Refugee Recognition in the Urban South: Formal v. de Facto Refugee Status
The legal relevance of the “urban refugee” concept in the Middle East and Africa stems from the practice of practicing different forms of refugee status determination (RSD) in rural as opposed to urban areas. Urban refugees are usually subject to rigorous individual adjudication, while rural refugees are typically recognized on a prima facie basis. This difference in procedure has no basis in the substance of refugee law, and it marginalizes urban refugees in two key ways. First, in Africa and the Middle East, refugee status recognition is used by host governments to prevent refugee integration, to force refugees to live far from population centres, and to transfer responsibility for their welfare to international agencies. Second, individualized RSD procedures in wide use by the United Nations generally lack key fairness safeguards, increasing the risk that genuine refugees will be wrongfully rejected. This phenomenon means that urban refugee populations will often be systematically undercounted, and will include a significant number of de facto refugees who are in fact refugees in danger of refoulement, but whose applications were rejected and who thus have no access to the protection and resources otherwise targeted at refugees.
Troubled Communication: Cross-Cultural Misunderstandings in the Asylum-Hearing
This article demonstrates how misunderstandings rooted in the differences between the asylum-seeker's and the official's cultural background can seriously distort the process of communication during the asylum-hearing and thus impair the ability of refugees from Third World countries to make their asylum-claims credible.
Study on essential drug use status and its influencing factors among cerebral infarction inpatients in county level hospitals of Anhui Province, China
Background and purpose Drug costs is one of the main components of hospitalization expenditure for cerebral infarction inpatients. In China, the National Essential Medicine System (NEMS) was created to relieve the heavy drug-cost burden for patients. The objective of this study was to investigate essential drug-use status and its influencing factors among cerebral infarction inpatients in county-level hospitals of Anhui province, China. Methods Three county-level hospitals were selected through a multi-stage cluster random sampling method. The hospitalization cost data of cerebral infarction inpatients in the three hospitals were extracted from the Anhui provincial information platform of the New Rural Cooperative Insurance System (NCMS), and whether the proportion of essential drug cost in the total drug cost reached the median value of 33.05% which was set as the evaluation index for essential drug-use status. Questionnaires for hospitals and physicians were designed and given to them to assess influencing factors. Results We retrieved the cost data of 2,189 inpatients from the NCMS platform and investigated 51 corresponding physicians in total. The drug costs accounted for 52.6% of the total hospitalization cost, and essential drug costs alone accounted for 37.0% of the total drug costs. The essential drug-cost proportion was high among physicians with a higher recognition degree on NEMS, older age, lower final academic degree, longer work experience and lower professional title. Married physicians and those with tight organizational affiliation also prescribed more essential drugs. Conclusions Increasing the proportion of essential drugs was an effective way to reduce the disease burden for cerebral infarction patients. Perfecting the NEMS, increasing government investment, reinforcing education and propaganda, and formulating relevant incentive and restrictive mechanisms were all effective ways to promote and increase the number of essential drug prescriptions written by physicians.