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      Effects of International Labour Migration on the Mental Health and Well-Being of Left-Behind Children: A Systematic Literature Review

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          Abstract

          Labour migration is a challenge for the globalised world due to its long-term effects such as the formation of transnational families. These families, where family members of migrant workers are “left-behind”, are becoming a common phenomenon in many low- and middle-income countries. Our systematic literature review investigated the effects of international parental labour migration on the mental health and well-being of left-behind children. Following the PRISMA guidelines, we performed searches in PubMed, PsychINFO, Web of Science, Cochrane Library and Google Scholar, resulting in 30 finally included studies. We found that mental health and well-being outcomes of left-behind children differed across and sometimes even within regions. However, only studies conducted in the Americas and South Asia observed purely negative effects. Overall, left-behind children show abnormal Strengths and Difficulties Questionnaire scores and report higher levels of depression and loneliness than children who do not live in transnational families. Evidence from the studies suggests that gender of the migrant parent, culture and other transnational family characteristics contribute to the well-being and mental health of left-behind children. Further research utilising longitudinal data is needed to better understand the complex and lasting effects on left-behind children.

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          Health impacts of parental migration on left-behind children and adolescents: a systematic review and meta-analysis

          Summary Background Globally, a growing number of children and adolescents are left behind when parents migrate. We investigated the effect of parental migration on the health of left behind-children and adolescents in low-income and middle-income countries (LMICs). Methods For this systematic review and meta-analysis we searched MEDLINE, Embase, CINAHL, the Cochrane Library, Web of Science, PsychINFO, Global Index Medicus, Scopus, and Popline from inception to April 27, 2017, without language restrictions, for observational studies investigating the effects of parental migration on nutrition, mental health, unintentional injuries, infectious disease, substance use, unprotected sex, early pregnancy, and abuse in left-behind children (aged 0–19 years) in LMICs. We excluded studies in which less than 50% of participants were aged 0–19 years, the mean or median age of participants was more than 19 years, fewer than 50% of parents had migrated for more than 6 months, or the mean or median duration of migration was less than 6 months. We screened studies using systematic review software and extracted summary estimates from published reports independently. The main outcomes were risk and prevalence of health outcomes, including nutrition (stunting, wasting, underweight, overweight and obesity, low birthweight, and anaemia), mental health (depressive disorder, anxiety disorder, conduct disorders, self-harm, and suicide), unintentional injuries, substance use, abuse, and infectious disease. We calculated pooled risk ratios (RRs) and standardised mean differences (SMDs) using random-effects models. This study is registered with PROSPERO, number CRD42017064871. Findings Our search identified 10 284 records, of which 111 studies were included for analysis, including a total of 264 967 children (n=106 167 left-behind children and adolescents; n=158 800 children and adolescents of non-migrant parents). 91 studies were done in China and focused on effects of internal labour migration. Compared with children of non-migrants, left-behind children had increased risk of depression and higher depression scores (RR 1·52 [95% CI 1·27–1·82]; SMD 0·16 [0·10–0·21]), anxiety (RR 1·85 [1·36–2·53]; SMD 0·18 [0·11–0·26]), suicidal ideation (RR 1·70 [1·28–2·26]), conduct disorder (SMD 0·16 [0·04–0·28]), substance use (RR 1·24 [1·00–1·52]), wasting (RR 1·13 [1·02–1·24]) and stunting (RR 1·12 [1·00–1·26]). No differences were identified between left-behind children and children of non-migrants for other nutrition outcomes, unintentional injury, abuse, or diarrhoea. No studies reported outcomes for other infectious diseases, self-harm, unprotected sex, or early pregnancy. Study quality varied across the included studies, with 43% of studies at high or unclear risk of bias across five or more domains. Interpretation Parental migration is detrimental to the health of left-behind children and adolescents, with no evidence of any benefit. Policy makers and health-care professionals need to take action to improve the health of these young people. Funding Wellcome Trust.
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            Migrant Parents and the Psychological Well-Being of Left-Behind Children in Southeast Asia

            Several million children currently live in transnational families, yet little is known about impacts on their health. We investigated the psychological well-being of left-behind children in four Southeast Asian countries. Data were drawn from the CHAMPSEA study. Caregiver reports from the Strengths and Difficulties Questionnaire (SDQ) were used to examine differences among children under age 12 by the migration status of their household (N = 3,876). We found no general pattern across the four study countries: Indonesia, the Philippines, Thailand, and Vietnam. Multivariate models showed that children of migrant fathers in Indonesia and Thailand are more likely to have poor psychological well-being, compared to children in nonmigrant households. This finding was not replicated for the Philippines or Vietnam. The paper concludes by arguing for more contextualized understandings.
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              Child Development in the Face of Rural-to-Urban Migration in China: A Meta-Analytic Review.

              In the last 30 years, China has undergone one of the largest rural-to-urban migrations in human history, with many children left behind because of parental migration. We present a meta-analytic review of empirical studies on Chinese children's rural-to-urban migration and on rural children left behind because of parental migration. We examine how these events relate to children's emotional, social, and academic developmental outcomes. We include publications in English and in Chinese to uncover and quantify a part of the research literature that has been inaccessible to most Western scholars in the field of child and family studies. Overall, both migrant children and children left behind by migrant parents in China show significantly less favorable functioning across domains than other Chinese children. It appears that, similar to processes found in other parts of the world, the experience of economic and acculturation stress as well as disrupted parent-child relations constitute a risk for nonoptimal child functioning in the Chinese context. Further, we found evidence for publication bias against studies showing less favorable development for migrant children and children left behind. We discuss the results in terms of challenges to Chinese society and to future empirical research on Chinese family life.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                17 June 2020
                June 2020
                : 17
                : 12
                : 4335
                Affiliations
                [1 ]Heidelberg Institute of Global Health, Heidelberg University Hospital, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany; johannes.boucsein@ 123456uni-heidelberg.de (J.B.); a.deckert@ 123456uni-heidelberg.de (A.D.); peter.dambach@ 123456web.de (P.D.); thomas.jaenisch@ 123456urz.uni-heidelberg.de (T.J.); olaf.horstick@ 123456uni-heidelberg.de (O.H.); volker.winkler@ 123456uni-heidelberg.de (V.W.)
                [2 ]Department of Public Health, Institute of Health Sciences, Faculty of Medicine, Vilnius University, M. K. Čiurlionio str. 21, LT-03101 Vilnius, Lithuania; justina.racaite@ 123456mf.vu.lt (J.R.); gene.surkiene@ 123456mf.vu.lt (G.Š.)
                Author notes
                [* ]Correspondence: khatia.antia@ 123456uni-heidelberg.de ; Tel.: +49-15227857798
                Author information
                https://orcid.org/0000-0001-5524-2099
                https://orcid.org/0000-0001-8426-1459
                https://orcid.org/0000-0003-0526-6249
                https://orcid.org/0000-0002-1086-6866
                https://orcid.org/0000-0002-9974-1145
                Article
                ijerph-17-04335
                10.3390/ijerph17124335
                7345580
                32560443
                80de3fde-aad1-4b75-8a28-7888df4f77fc
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 08 May 2020
                : 15 June 2020
                Categories
                Review

                Public health
                left-behind,children,labour migration,parent,mental health,well-being,transnational families
                Public health
                left-behind, children, labour migration, parent, mental health, well-being, transnational families

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