Written by Riggs E1, 2 Davis E1, Gibbs L1, Block K1, Szwarc J3, Casey S3, Duell-Piening P3, Waters E1
People from certain refugee backgrounds may have had limited access to healthcare services prior to settling in Australia. They may experience difficulties accessing services here because there is a lack of culturally appropriate information and they do not understand the health system well.
Recent research has explored the experiences of refugee-background families using Maternal and Child Health services (MCH)* in Melbourne, from the perspective of mothers, service providers and bicultural workers.
Well-child healthcare visits are useful in identifying health issues early. There is concern that families from refugee backgrounds may discontinue visits after initial contact with the MCH service. There has been limited investigation into the use of these services by families from refugee backgrounds.
A qualitative study was conducted with 87 women from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds. Participants had a total of 249 children, 150 of whom were born in Australia. Eighteen service providers and bicultural workers participated.
A major finding was that the MCH service was not formally notified of newly-arrived families with young children when they settled in the area. Only families with children born in Melbourne were linked to the service routinely through the birth notification system. For newly arrived families, there were several ways they were linked to the service which occurred on an ad hoc basis.
For all families who had used the service, they were introduced to their local MCH service in four main ways:
- the hospital notified the MCH service of a newborn;
- Refugee Health Nurses;
- bicultural workers at playgroups; and
- settlement workers from AMES, the provider of English language tuition and other settlement services to adults.
However, continued engagement with the service proved difficult for many participants. The barriers included:
- lack of mothers’ confidence to speak English;
- difficult appointment booking systems (e.g., central phone lines requiring users to leave voicemail messages rather than direct access to their nurse);
- inadequate use of interpreters;
- limited appropriate translated resources;
- transport difficulties (e.g., no access to private transport, unreliable public transport);
- limited awareness of preventive health and the purpose of preventative health assessments; and
- poor mechanisms for follow-up between MCH, General Practitioner and specialist health care.
Service users and providers reported that continuity of nurse and interpreter increased client-provider trust and ongoing service engagement.
The research also identified innovative service engagement strategies. One example was MCH nurses working with bicultural workers to visit playgroups where mothers and children already gather and feel comfortable. Strategies such as these should be evaluated to determine their effectiveness and potential to be transferred to other cultural groups and settings.
* The Maternal and Child Health (MCH) Service in Victoria is a universal joint local and state government free service for families with children from birth to school age. MCH nurses work within the ‘Key Ages and Stages’ framework, which includes ten health and development assessments coinciding with the child’s age from birth to three and a half years.
1The Jack Brockhoff Child Health and Wellbeing Program, The McCaughey Centre, The University of Melbourne
2Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute
3The Victorian Foundation for the Survivors of Torture (Foundation House)
This study was supported by the Victorian Foundation for the Survivors of Torture (Foundation House) Research Program which is funded by the Sidney Myer Fund and William Buckland Foundation.