Matching health needs of refugee children with services: how big is the gap?
OBJECTIVE
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.


CONCLUSIONS
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.
Raman
Shanti
S
Faculty of Medicine, University of New South Wales, Western Clinical School, Liverpool Hospital, New South Wales. s.raman@unsw.edu.au
Wood
Nicholas
N
Webber
Murray
M
Taylor
Kellie-Ann
KA
Isaacs
David
D
D000293:Adolescent; D002648:Child; D002669:Child Welfare / Q000706:statistics & numerical data; D002675:Child, Preschool; D003695:Delivery of Health Care / Q000458:organization & administration*; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data*; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data*; D054624:Health Status Disparities; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008403:Mass Screening; D009517:New South Wales; D012036:Refugees / Q000706:statistics & numerical data*