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Lassi ZS, Singh A, Bhaumik S. Call for investing in understanding the health and well-being of South Asian migrants in Australia. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 43:101029. [PMID: 38333630 PMCID: PMC10851199 DOI: 10.1016/j.lanwpc.2024.101029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 02/10/2024]
Affiliation(s)
- Zohra S. Lassi
- Robinson Research Institute, University of Adelaide, Australia
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Australia
| | - Ankur Singh
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Melbourne Dental School, University of Melbourne, Melbourne, Australia
| | - Soumyadeep Bhaumik
- Meta-research and Evidence Synthesis Unit, Health Systems Science, George Institute for Global Health, Sydney, Australia
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Cavit L, Charania NA. Exploring factors that influence vaccination uptake for children with refugee backgrounds: An interpretive description study of primary healthcare providers' perspectives. Vaccine 2023; 41:6690-6699. [PMID: 37802749 DOI: 10.1016/j.vaccine.2023.09.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/21/2023] [Accepted: 09/26/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Children with refugee backgrounds are at high risk of acquiring vaccine preventable diseases (VPDs) due to a complex set of factors, one being under-immunisation. In Aotearoa New Zealand (NZ), reported age-appropriate vaccination rates are suboptimal among children with refugee backgrounds. METHODS A qualitative interpretive description study was undertaken to explore factors associated with access and uptake of immunisations and develop strategies to improve age-appropriate vaccinations among refugee children post-resettlement in NZ. Semi-structured interviews were conducted with healthcare providers (nurses and doctors) (N = 14) across seven resettlement locations in NZ. Collected data was transcribed verbatim and thematically analysed. RESULTS Five themes were derived from the data that demonstrate the interrelated factors that influence vaccination uptake across the refugee caregiver, health provider and system levels. Providers discussed how caregivers' competing resettlement priorities and challenges early in the resettlement phase influenced their knowledge and access of vaccines and health services in NZ. Providers' knowledge of refugee caregivers' concerns was seen as a driver for positive change in forming therapeutic relationships with, and delivering health services to, former refugees. They discussed system level factors that influence access to and provision of immunisation services, such as resourcing, resettlement policies, system inefficiencies and missed opportunities. Emphasis was placed on communication between patients and providers to facilitate positive immunisation experiences. Overwhelming, providers displayed high motivation to improve immunisation services. Strategies were suggested to overcome identified barriers and included the provision of culturally and linguistically appropriate resources, education campaigns, reducing access barriers (e.g., after-hours clinics), and improving system efficiencies. CONCLUSIONS These findings highlight root factors that impact immunisation uptake and experiences among children with refugee backgrounds. To reduce the burden of VPDs, broad system level changes are required to address the barriers to vaccine uptake faced by both families of refugee backgrounds and health providers.
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Affiliation(s)
- Larisa Cavit
- Department of Public Health, Auckland University of Technology, 640 Great South Road, Manukau, Auckland 2025, New Zealand
| | - Nadia A Charania
- Department of Public Health, Auckland University of Technology, 640 Great South Road, Manukau, Auckland 2025, New Zealand; Migrant and Refugee Health Research Centre, Auckland University of Technology, Auckland, New Zealand.
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De Souza R. Commentary: Quantifying the health needs of migrants in vulnerable circumstances registered with a nurse-led primary care service. J Res Nurs 2022; 27:242-244. [PMID: 35813166 PMCID: PMC9264406 DOI: 10.1177/17449871211064068] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Ruth De Souza
- Vice-Chancellor’s Fellow, School of Art College of Design and Social Context, RMIT University, Melbourne, VIC, Australia
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Kelton S, Marcus K, Liston G, Masoe A, Sohn W. Refugee and Asylum Seeker Trauma Informed Care Training for Oral Healthcare Professionals in NSW, Australia. FRONTIERS IN ORAL HEALTH 2022; 3:907758. [PMID: 35711623 PMCID: PMC9194469 DOI: 10.3389/froh.2022.907758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
People from refugee and asylum seeker (RAS) backgrounds who have re-settled in Australia experience inequitable health outcomes. As a result, people from RAS backgrounds need access to culturally safe and responsive care. To provide this care, oral health professionals must understand how experiences of trauma influence a patient's oral health. The aim of this study was to highlight the lessons learnt from providing trauma informed care (TIC) to oral health professionals in New South Wales (NSW). TIC is a model that emphasises trust, patient safety, choice and empowerment to foster healthcare equity. This study was designed and piloted by the Centre for Oral Health Strategy (COHS), NSW Ministry of Health in partnership with NSW Refugee Health Service, local Multicultural Health Services, and four Local Health Districts (LHDs): Hunter New England, Mid-North Coast, Murrumbidgee and Illawarra Shoalhaven. Pre and post TIC training surveys were distributed to oral health professionals. This captured baseline versus intervention data to understand their knowledge of TIC. Seven training sessions were provided by NSW Refugee Health Service in four LHDs. A total of 152 participants attended a TIC training session, 106 participants completed the pre-survey, and 67 participants completed the post-survey. At baseline, only 50% of staff reported confidence in delivering TIC care to RAS populations. After the intervention, 97% of staff reported feeling extremely, very, or somewhat confident in understanding and delivering TIC. Findings demonstrate that TIC training can support oral health professionals to provide culturally safe and responsive care to people from RAS backgrounds.
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Affiliation(s)
- Siobhan Kelton
- Centre for Oral Health Strategy, NSW Ministry of Health, North Sydney, NSW, Australia
- *Correspondence: Siobhan Kelton
| | - Kanchan Marcus
- Population Oral Health, Faculty of Medicine and Health, The University of Sydney School of Dentistry, Sydney, NSW, Australia
| | - Graeme Liston
- Centre for Oral Health Strategy, NSW Ministry of Health, North Sydney, NSW, Australia
| | - Angela Masoe
- Centre for Oral Health Strategy, NSW Ministry of Health, North Sydney, NSW, Australia
| | - Woosung Sohn
- Population Oral Health, Faculty of Medicine and Health, The University of Sydney School of Dentistry, Sydney, NSW, Australia
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Adhikari M, Kaphle S, Dhakal Y, Duwadi S, Subedi R, Shakya S, Tamang S, Khadka M. Too long to wait: South Asian migrants' experiences of accessing health care in Australia. BMC Public Health 2021; 21:2107. [PMID: 34789215 PMCID: PMC8596381 DOI: 10.1186/s12889-021-12132-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 10/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migrants settling in a new country experience multiple complexities in navigating health care systems and adapting to a new way of life in the host country. In South Asia, migrating to another country for better life opportunities has been an ongoing trend and migration to Australia has significantly increased in recent years. Lower utilisation of health services and higher risks of chronic diseases among South Asian migrants poses a continuing challenge for the Australian health care system and little is known about why this demographic group does not access health services at the same rate. This study aimed to explore factors influencing access to health care by South Asian migrants in Australia. METHODS Using a mixed-method design, we conducted 62 online survey and 14 in-depth interviews with participants from four South Asian countries: Nepal, India, Bhutan, and Sri Lanka. Participants were recruited using a purposive snowball sampling approach following a standard ethical approval process. Survey data were analysed descriptively in SPSS and interview data were recorded, transcribed, and analysed thematically. RESULTS South Asian migrants experienced various complexities while accessing health services in Australia. The findings of this study highlighted a number of negative factors influencing their experiences of accessing health care: long waiting times for public health care, the expense of private health care, and communication problems due to socio-cultural differences. South Asian migrants also expressed their concern for a greater investment of resources into public health care to enable them to access quality and affordable care in these settings. CONCLUSIONS Given limited evidence available to help understand factors leading to the lower utilisation of health care and higher risks of chronic diseases among South Asian migrants, this study plays an important role in highlighting social, cultural, financial, and institutional factors that are critical to designing appropriate health-care strategies. This study recommends incorporating a collaborative and culturally competent model of care to increase access to health care and thereby help reduce existing disparities in health outcomes among South Asian migrant populations.
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Affiliation(s)
- Manju Adhikari
- LA GRANDEE International College, Pokhara Metropolitan City, Province 4 Nepal
| | | | - Yamuna Dhakal
- Central Queensland University, Melbourne, VIC Australia
| | - Sabina Duwadi
- Central Queensland University, Melbourne, VIC Australia
| | - Rajan Subedi
- Central Queensland University, Melbourne, VIC Australia
| | - Sonu Shakya
- Central Queensland University, Melbourne, VIC Australia
| | - Sunil Tamang
- Central Queensland University, Melbourne, VIC Australia
| | - Mukesh Khadka
- Central Queensland University, Melbourne, VIC Australia
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Marwaha P, Ghanim A, Shankumar R. Risk indicators of dental caries among refugee patients attending a public dental service in Victoria. Aust Dent J 2021; 67:21-29. [PMID: 34499752 DOI: 10.1111/adj.12873] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 08/13/2021] [Accepted: 08/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about the relationship between dental caries prevalence and the social risk factors of asylum seekers and refugees in Australia. METHODS An oral health interview and a clinical oral examination were carried out on 201 asylum seekers and refugees patients, aged 18-68, attending Monash Health Dental Services, Melbourne, Victoria. RESULTS Data illustrated that 82% of participants had at least one tooth with untreated decay. Tooth level analysis revealed that white spot lesions were most prevalent in age groups 18-29 and 30-39, with respective mean values of 4.45 ± 4.95 and 3.49 ± 4.74. Binary logistic regression models identified multiple social factors as a barrier to receiving dental care. These included, but were not limited to; medication intake, consumption of soft drinks and long waiting lists. These social factors in addition to oral health factors, such as white spot and hypomineralization lesions, were significant predisposing factors to the presence of cavitated carious lesions. CONCLUSIONS Multiple social and oral health risk factors were identified and significantly associated with dental caries among refugee and asylum seeker patients. Addressing these underlying risks is an integral component to reducing the prevalence of dental caries among this population group and improving their overall general and oral health.
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Affiliation(s)
- P Marwaha
- Monash Health Dental Services, Monash Health, Dandenong, Victoria, Australia
| | - A Ghanim
- Monash Health Dental Services, Monash Health, Dandenong, Victoria, Australia.,Melbourne Dental School, The University of Melbourne, Parkville, Victoria, Australia
| | - R Shankumar
- Monash Health Dental Services, Monash Health, Dandenong, Victoria, Australia
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Bestman A, Lloyd J, Hawkshaw B, Kabir J, Harris E. The Rohingya Little Local: exploring innovative models of refugee engagement in Sydney, Australia. Aust J Prim Health 2020; 26:367-373. [DOI: 10.1071/py20045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 08/11/2020] [Indexed: 11/23/2022]
Abstract
The Rohingya community living in the City of Canterbury-Bankstown in Sydney have been identified as a priority population with complex health needs. As part of ongoing work, AU$10000 was provided to the community to address important, self-determined, health priorities through the Can Get Health in Canterbury program. Program staff worked with community members to support the planning and implementation of two community-led events: a soccer (football) tournament and a picnic day. This paper explores the potential for this funding model and the effect of the project on both the community and health services. Data were qualitatively analysed using a range of data sources within the project. These included, attendance sheets, meeting minutes, qualitative field notes, staff reflections and transcripts of focus group and individual discussions. This analysis identified that the project: (1) enabled community empowerment and collective control over funding decisions relating to their health; (2) supported social connection among the Australian Rohingya community; (3) built capacity in the community welfare organisation –Burmese Rohingya Community Australia; and (4) enabled reflective practice and learnings. This paper presents an innovative model for engaging with refugee communities. Although this project was a pilot in the Canterbury community, it provides knowledge and learnings on the engagement of refugee communities with the health system in Australia.
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