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Matching health needs of refugee children with services: how big is the gap?
Shanti Raman1, Nicholas Wood, Murray Webber
1Faculty of Medicine, University of New South Wales, Western Clinical School, Liverpool Hospital, New South Wales. s.raman@unsw.edu.au
Insights
Many refugee children in New South Wales (NSW) have significant health needs but limited access to comprehensive services. Gaps in screening and follow-up care require urgent attention for optimal child wellbeing.
Area of Science:
- Public Health
- Pediatrics
- Immigration Health
Background:
- Refugee children face unique health challenges.
- Access to specialized healthcare services is crucial for this population.
Purpose of the Study:
- To identify health needs of refugee children under 14 in New South Wales (NSW).
- To assess the alignment of needs with existing services and identify service gaps.
- To inform improvements in healthcare delivery for refugee children.
Main Methods:
- Analysis of clinical data from three refugee-specific pediatric clinics in NSW (2005).
- Comparison of clinic data with the number of refugee children settling in NSW.
- Data included screening results, immunizations, and identified health issues.
Main Results:
- 1,557 refugee children (<14 years) arrived in NSW in 2005; only 21% accessed specialized clinics.
- High prevalence of conditions: 25% anemia, 27% schistosomiasis, 16% malaria, 25% positive tuberculin skin test, 69% hepatitis B non-immune, 20% low vitamin D.
- Most children required catch-up immunizations; chronic, developmental, and behavioral issues were also noted. Screening and follow-up varied and were often inadequate.
Conclusions:
- A small fraction of arriving refugee children receive comprehensive health screening and assessment despite substantial needs.
- Significant variations in screening practices and poor follow-up care were observed.
- High rates of diseases with personal and public health implications underscore the need for improved services.
Objectives:
To document the health needs of refugee children accessing comprehensive refugee health services in New South Wales (NSW), to match needs with available services and establish gaps in services.
Methods:
We collated clinical data on all children aged under 14 years attending the three refugee specific clinics seeing children in NSW in 2005. We compared these data to the number of refugee children settling in NSW in 2005.
Results:
NSW received 1,557 refugee children (<14 years) in 2005. Around one in five (n=331) was seen in a refugee specific clinic. Most were asymptomatic. Of those tested, 25% had anaemia, 27% were serology positive for schistosomiasis, 16% had evidence of current or recent malaria, 25% were tuberculin skin test positive, 69% were hepatitis B non-immune and 20% had low vitamin D levels. Most children needed catch up immunisation. Other problems included chronic health, developmental and behavioural problems. Screening tests varied across sites. Follow up was problematic for most.
Conclusions:
A small proportion of refugee children arriving in NSW have access to comprehensive screening and assessment, in spite of significant health needs. There is variation in screening practices, and follow up is poor. There is a high pick up rate for diseases of personal and public health significance.
Implications:
There is a strong moral and public health imperative to provide appropriately resourced, culturally competent and comprehensive health care to optimise refugee children's wellbeing.
