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Emergency care provided to refugee children in Europe: RefuNET: a cross-sectional survey study
Ruud Gerard Nijman1,2, Johanna Krone3, Santiago Mintegi4
1Department of Infectious Diseases, Section of Paediatric Infectious Diseases, Imperial College London, London, UK r.nijman@imperial.ac.uk.
Insights
European hospitals face challenges in providing urgent care for refugee children. Key obstacles include language barriers, mental health concerns, and lack of medical history, highlighting a need for better guidelines and education.
Area of Science:
- Pediatric Healthcare
- Public Health
- International Migration
Background:
- Refugee children possess complex health needs requiring specialized acute care.
- Existing research on emergency healthcare provision for refugee children in Europe is limited.
Purpose of the Study:
- To delineate the urgent and emergency healthcare requirements of refugee children across Europe.
- To pinpoint barriers hindering the delivery of effective care to this population.
Main Methods:
- A cross-sectional online survey was administered to European healthcare professionals from February to October 2017.
- The survey targeted health professionals assessing refugee children under 18 presenting to emergency departments, covering system resources, obstacles, and patient demographics.
Main Results:
- 148 healthcare professionals from 23 European countries responded, predominantly from academic settings.
- Limited availability of guidance was reported for immunizations (30%), safeguarding (31%), infection screening (32%), and mental health (14%).
- Major perceived obstacles included language barriers (60%), unknown medical history (54%), and psychological trauma (52%).
Conclusions:
- European hospitals are often unprepared to deliver urgent and emergency care to refugee children.
- While clinicians manage presenting illnesses well, significant obstacles like communication, mental health support, and access to prior medical records persist.
- There is a critical need for enhanced guidelines and targeted educational initiatives focused on refugee child health.
Background:
Refugee children and young people have complex healthcare needs. However, issues related to acute healthcare provision for refugee children across Europe remain unexplored. This study aimed to describe the urgent and emergency healthcare needs of refugee children in Europe, and to identify obstacles to providing this care.
Methods:
An online cross-sectional survey was distributed to European healthcare professionals via research networks between 1 February and 1 October 2017 addressing health issues of children and young people aged <18 years fulfilling international criteria of refugee status, presenting to emergency departments. Survey domains explored (1) respondent's institution, (2) local healthcare system, (3) available guidance and educational tools, (4) perceived obstacles and improvements required, (5) countries of origin of refugee children being seen and (6) presenting signs and symptoms of refugee children.
Results:
One hundred and forty-eight respondents from 23 European countries completed the survey, and most worked in academic institutions (n=118, 80%). Guidance on immunisations was available for 30% of respondents, and on safeguarding issues (31%), screening for infection (32%) or mental health (14%). Thirteen per cent reported regular teaching sessions related to refugee child health. Language barriers (60%), unknown medical history (54%), post-traumatic stress disorder (52%) and mental health issues (50%) were perceived obstacles to providing care; severity of presenting illness, rare or drug-resistant pathogens and funding were not.
Conclusions:
Many hospitals are not adequately prepared for providing urgent and emergency care to refugee children and young people. Although clinicians are generally well equipped to deal with most types and severity of presenting illnesses, we identified specific obstacles such as language barriers, mental health issues, safeguarding issues and lack of information on previous medical history. There was a clear need for more guidelines and targeted education on refugee child health.
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