2.2 Empirical Literature Review
2.2.6 Protective Factors /Coping Strategies
26 Michalak, Schneider, & Margraf, 2019; von dem Knesebeck, Pattyn, & Bracke, 2011). A study by von dem Knesebeck et al. (2011) covering 22 European countries concerning education and depressive symptoms found that individuals with lower education have higher risk of experiencing symptoms of depression. In another study, Crespo, López-Noval, and Mira (2013) showed that an extra year of education decreases the probability of depression by 6.5 percentage points. These findings highlight the importance of education in tackling issues of mental health challenges. There is therefore the need to develop interventions targeting migrant workers. These interventions are needed to target the risk factors of migration including economic hardships, physical harm, poor living conditions, social isolation, and poor living conditions (WHO, 2018). Despite the existence of risk factors associated with internal migration, the review of academic literature showed that most interventions have targeted asylum seekers and refugees (Craig, 2015; Giacco & Priebe, 2018; Meffert et al., 2014;
Rahman et al., 2016; Stenmark, Catani, Neuner, Elbert, & Holen, 2013; Weinstein, Khabbaz,
& Legate, 2016). Most of these interventions have focused on education, vocational training reducing social isolation with the aim of promoting social integration and better mental health outcomes.
In Ghana, there has not been any known comprehensive intervention programme that targets the psychosocial needs of vulnerable groups in society such as the Kayayei. Due to this, some organisations such as the IOM in 2016 provided 200 solar lanterns to the Kayayei association to help protect them against gender-based violence, sexual harm, theft, exploitation, and abuse (IOM, 2016). Furthermore, to make health care accessible to the Kayayei, the Pamela Bridgewater Project, a non-governmental organisation that supports Kayayei and their children, in collaboration with the National Health Insurance Scheme (NHIS), enrolled 200 Kayayei in Accra (Daily Graphic, 2016). These interventions are, however, not sustainable in addressing the physical and mental health challenges of the Kayayei. There is, therefore, the urgent need to develop a compressive intervention programme targeting the needs of Kayayei and other vulnerable groups holistically, particularly the physical and mental health issues.
27 appraisal of the situation. Lazarus and Folkman (1984, p. 141), defined coping as “constantly changing cognitive and behavioural efforts to manage specific external and/or internal demands that are appraised as taxing or exceeding the resources of the person.” Lazarus and Folkman identified two strategies of coping including emotional focus coping which is the ability to control emotional response to stress, and problem focused coping, that is reducing the demand of the situation or increasing the resources handling it. Lazarus (1993) developed a model of stress and of ways individuals cope with stressful situations. He constructed two main approaches to coping. The first approach emphasises style and sees coping as a personality characteristic, coping is seen as a defence mechanism which deals with any threat to psychological integrity. The second way of coping emphasises a process, which is the effort to manage stress that changes over time and is shaped through the ability to adapt to the context in which it is generated. This means that coping changes over time and following the situational context in which it occurs. There are differences among individuals in how they deal with stressors of life.
Religion: According to Phinney and Haas (2003), coping mechanisms vary greatly in accordance with the nature of challenges and diversity of context. For instance, in a study among Philippine migrant workers in Hong Kong, by Nakonz, and Shik (2009), religion was found to be the main source of coping among migrants. The study further stated that many migrants had the belief that ‘‘whatever the tragedy was in their lives, it was a plan of God and not a human being” (Nakonz & Shik 2009, p. 30), The study further stated that this belief system which represents an external locus of control, gives spiritual significance to events which makes it easier for them to be accepted by individuals. In a study to examine the relationships of religion, health status, and socioeconomic status to the quality of life of individuals who are HIV positive, Flannelly and Inouye (2001) found that religious affiliation was positively associated with quality of life. In another study, Ross (1990) examined the relationship between religion and psychological distress among 401 community respondents and showed that individuals with religious beliefs had lower levels of distress compared to individuals with weak belief or to those who belonged to their religion out of indifference rather than commitment. This finding is an indication that it is not enough just to know if an individual is religious or not, but to understand how that individual makes use of that religion will determine whether it will be beneficial or not.
28 Social Support: Social support plays an important role in enabling migrants to settle in their new environment. Scholars have identified three types of social support including emotional support (feeling of belonging, security, love, and ability to trust others), informational support (provision feedback, advice, and guidance), and instrumental support (provision of goods and materials, as well as provision of services) (Taylor, 2006; Wills & Fegan, 2001). To mitigate the migration challenges, internal migrants rely on their social networks to provide initial accommodation and assistance in finding a job. Studies show that these networks are usually made through place of origin or kin relations. New arrivals end up living and working in areas with people of the same origin or ethnicity (Awumbila et al., 2014). This collaborative network of friends and family will be there to provide the needed assistance in difficult times, and this can help to improve the health and wellbeing of the migrant. The support migrants receive from family and friends is linked to assisting them meet immediate needs that will enable them to settle, it also allows migrants to participate in social activities which contribute to better mental health outcomes (Heaney & Israel, 2008).
Though migrants receive interpersonal support from friends and family, this support is usually not sufficient to meet their needs (Neufeld, Harrison, Stewart, Hughes, & Spitzer, 2002; Wen
& Hanley, 2016). Due to this, in Ghana for instance, in a bid to create a social support system for internal migrants in the city of Accra, the two main political parties have, over the years, adopted some positions. Kpessa-Whyte (2017) argued that the New Patriotic Party (NPP), for instance, in the 2017 national budget statement, ordered that market tolls imposed on Kayayei by some District Assemblies be abolished to make their lives easier. He further claims that the NPP regards Kayayei as free citizens who choose to pursue a career in head porterage as an economic enterprise. They know their interest and implications of the choices they make and as a result the abolishment of these tolls will ensure Kayayei engage in their choice of occupation without any taxation barriers. However, Ziblim (2013) recognising the need to empower Kayayei to reduce the need to engage in head porterage for survival, recommended that government through the Livelihood Empowerment and Social Development Programmes (LESDEP) and the Ministry of Women and Children Affairs (MOWAC) institute a programme targeting the young girls for vocational training. This he noted will equip the Kayayei with employable skills that will enable them to become self-employed in their home regions. This view was also argued by Kpessa-Whyte (2017) to be the position of the National Democratic Congress, which used a policy option of skills training and entrepreneurial support by unlocking the human potential of the Kayayei.
29 Resilience: when migrants face challenges during the migration process, they are more likely to cope if their resilience levels are high. Resilience is the ability to withstand a threatening and challenging situation successfully, to recover from a situation of extreme distress and/or trauma or even to prosper in the mist of adversity (Southwick, Bonanno, Masten, Panter-Brick, &
Yehuda, 2014). It is the psychological quality that allows people who are knocked down by the adversities of life to bounce back and to prosper. Luthans (2002), defined resilience as “the capacity to rebound or bounce back from adversity, conflict, failure or even positive events, progress, and increased responsibility” (Luthans, 2002, p. 702). The individual’s ability to bounce back from stressful events determines their health outcome (Smith, Tooley, Christopher, & Kay, 2010). In the face of difficulty, resilience is important to basic human survival, and it helps individuals adjust and establish a new life in their new environment (Kuo, 2014).
In an integrated review on the resilience of African Migrants, Babatunde-Sowole, Power, Jackson, Davidson, and DiGiacomo (2016) has established that migrants use personal values and skills to maintain stability to achieve positive outcomes during migration and settlements.
For instance, in an earlier qualitative study by Schweitzer, Greenslade and Kagee (2007) on coping strategies of refugees from Sudan, they found that apart from social support and religious beliefs, the refugees also used personal qualities such as being strong and a resolution to fight for what they believe to be right helped them cope with the challenges faced. Other studies also found the use of cognitive resilience among migrants as a coping strategy. A study by Khawaja, White, Schweitzer, and Greenslade (2008), for instance, found that migrants used cognitive techniques such as reframing the situation and relying on their inner resources they focused on their future wishes and aspirations to cope with the present situation. Drawing on their psychological capital which includes optimism, hope, resilience and self-efficacy, migrant workers develop self-confidence, to take on the challenges they encounter and put in the necessary effort to succeed. They become optimistic about the future, and this empowers them to persevere towards achieving their goals. They are, therefore, able to remain resolute during adversity and to bounce back to attain success at the end (Luthans, Youssef, & Avolio, 2007).
The use of social comparison determines the ability of individuals to cope with their circumstances. The Theory of Social Comparison is proposed by Festinger (1954) to illustrate the inner drive of people to assess themselves in comparison to others. Studies show that individuals who use upward comparison are more likely to have lower self-esteem and are less
30 likely to be able to cope with situations (Wang, Wang, Gaskin, & Hawk, 2017) while those who compare downwards are more likely to cope well. A study by Schweitzer et al. (2007) found that migrants rely heavily on downward comparison with others who are less able than themselves to cope with their challenges. In realising that in spite of the circumstances they find themselves, they are still better than others, they will be able to cope better with the stresses of migration.