BACKGROUND Mental health services in destination countries for migration are increasingly required to support service users from diverse cultural backgrounds. Although migrants may experience elevated mental health challenges, existing approaches are often insufficient to meet their needs. There is a need for tools that support practitioners in delivering competent and ethical intercultural care and navigating complex ethical decision-making. OBJECTIVE To beta-test the ETHICA-4P ethical decision-making toolkit and evaluate its potential to support clinicians in addressing ethical challenges arising in intercultural practice. METHODS Feedback was collected from stakeholders and practitioners in two destination countries for migration, Chile and the United Kingdom, through focus groups and anonymous surveys. Data were analysed using Reflexive Thematic Analysis to compare participants' perspectives and suggestions regarding the use and further development of the toolkit. RESULTS Three themes were identified: 'Shared ethical dilemmas', 'Prioritising different levels of analysis according to place-based needs', and 'Practical guide, or tool for reflection?'. Participants reported similar ethical challenges and shared perspectives on the potential use of ETHICA-4P in practice. However, they differed in how intercultural care needs were conceptualised and addressed according to context, with some emphasising systems-level responses and others clinician-level approaches. These differences generated distinct suggestions for improving the toolkit. CONCLUSIONS The findings provide guidance for the continued development of ETHICA-4P and highlight the importance of flexibility in supporting ethical intercultural practice across diverse service and national contexts.
BACKGROUND Literature on the prevalence and factors associated with good self-reported health among older adults in the Greater Kampala Metropolitan Area (GKMA), including sex-stratified analyses, remains limited. OBJECTIVES This study aimed to examine the prevalence of good self-reported health and its associated factors among older adults (50-64 years) in the GKMA, with sex-stratified analyses. METHODS Data stem from the 'The Remaking of the Family in East Africa (FAMILEA)' survey of 2024. A set of cross-sectional variables from a subsample of 651 older adults (aged 50-64) was used. We applied frequency distributions for descriptive statistics and a multivariable modified Poisson regression model to investigate factors associated with self-reported health status among older adults in the GKMA, with sex-stratified patterns. RESULTS In the GKMA, 58% of older adults (64% of males and 52% of females) declared good health. Older adults living in Wakiso District, satisfied with accommodation, working, not living in a household-owned house, in the second and fourth quintiles, and not functionally constrained, reported good health. Accommodation satisfaction and non-limited functional status were positively associated with good health, irrespective of sex. Among males, living in a nuclear family, working, not reporting the lowest wealth quintile, and being affiliated with the Catholic religion were positively associated with good health. Among females, living in Wakiso District and never lacking companionship were positively associated with good health. CONCLUSION Good self-reported health was associated with various factors among older adults (50-64 years) in the GKMA, with some patterns observed in the sex-stratified models.
