Methods: The sample included 122 students involved in a pilot program of higher education in two refugee camps in sub-Saharan Africa and one urban setting in the Middle East. Data collection procedures included both a quantitative and qualitative component. Respondents completed a brief quality of life measure developed by the World Health Organization (WHOQOL-BREF) and participated in semi-structured focus groups (22 focus groups total). Quantitative data were standardized and analyzed using bivariate t-tests. Qualitative data were coded and analyzed by 3 groups of 3 researchers with oversight by the principal investigator. Each group developed and clustered codes into themes for analysis through independent and joint review, using a process of open and axial coding to develop a grounded theory of refugee students’ experience in higher education.
Results: On standardized WHOQOL-BREF domains, respondents indicated an average of 50.0 (SD=17.0) out of 100.0 on the domain of Physical Health (α=.65), and 29.0 (SD=16.0) for Environmental Well-Being α=.81), much lower than norms. Significant differences emerged across sites for both domains (p<.01) and for the majority of individual indicators within domains (p<.05). Qualitative analyses revealed that students received multiple benefits from higher education, related to gaining skills, greater personal and community empowerment, expansion of worldview, and hope. Yet, significant barriers emerged to fully realizing the potential of this education, and these challenges differed greatly across sites. In one site, physical proximity to the study detracted from studies, while in another site, students found it difficult to balance studies with getting enough food for themselves and their families. Many students also expressed concerns for their future opportunities once their involvement in the program ended.
Conclusions and Implications: Refugee students reported gratitude for the opportunity to pursue higher education, but uncertainty about the future and widely different challenges across sites. These challenges highlight the need to identify next steps for refugees once they complete the program and remain in camps, as well as anticipated student outcomes beyond the achievement of learning goals. In the context of forced migration, a program of higher education that offers hope for a better future may inadvertently constitute a psychosocial intervention as much as an educational program. This unique dynamic begs the need for systemic thinking with significant implications for program planning and service delivery. These implications are framed in the context of the ongoing vertical vs. horizontal debates in global health and international development.