Changing landscape of paediatric refugee health in South Western Sydney, Australia: a retrospective observational study
Objectives To examine the changing health needs of refugee children and young people (CYP) entering Australia, in relation to key government policy changes.Study design Retrospective analysis of health service use data over 11 years.Setting Paediatric refugee clinics in South Western Sydney (SWS), t...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2023-10-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/13/10/e064497.full |
| _version_ | 1797628946060148736 |
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| author | Karen Zwi Shanti Raman Raghu Lingam Nan Hu Lahiru Amarasena |
| author_facet | Karen Zwi Shanti Raman Raghu Lingam Nan Hu Lahiru Amarasena |
| author_sort | Karen Zwi |
| collection | DOAJ |
| description | Objectives To examine the changing health needs of refugee children and young people (CYP) entering Australia, in relation to key government policy changes.Study design Retrospective analysis of health service use data over 11 years.Setting Paediatric refugee clinics in South Western Sydney (SWS), the Australian region with the largest annual resettlement of refugees.Participants Refugee CYP (≤25 years) attending the SWS paediatric refugee clinics for their first visit between 2009 and 2019.Measures Clinician defined health conditions categorised as communicable and non-communicable disease (NCD).Results Data were analysed for 359 CYP, mean age 9.3 years; 212 male (59.1%). Most CYP (n=331, 92.2%) had health problems identified; 292 (81.3%) had ≥1 NCD and 24 (6.7%) had ≥1 communicable disease. The most frequent individual NCDs were dental disease (n=128, 35.7%) and vitamin D deficiency (n=72, 20.1%). Trend analysis showed increased odds of identifying an NCD from 2013 onwards (crude OR 1.77, 95% CI 1.06 to 2.96). Neurodevelopmental problems, especially Global Developmental Delay (n=31, 8.6%), emerged as more prevalent issues in the latter half of the decade. There were significantly increased odds of identifying a neurodevelopmental problem in 2016–2019, especially in 2016–2017 (adjusted OR 2.93, 95% CI 1.34 to 6.40). Key policy changes during this period included acceptance of refugees with disabilities from 2012, additional Australian Humanitarian Programme intake from the Eastern Mediterranean region and mandatory offshore processing for those seeking asylum by boat from 2013. In response to the changing needs, local health services adopted nurse-led primary healthcare screening, early childhood services, youth and disability clinics.Conclusions Refugee CYP in Australia are presenting with a growing burden of NCDs, with neurodevelopmental problems contributing. Government policy changes affect the sociodemographics of resettled populations, influencing health profiles. Paediatric refugee health services need to be responsive to the changing needs of these populations to optimise well-being. |
| first_indexed | 2024-03-11T10:46:23Z |
| format | Article |
| id | doaj.art-da75ae57c4424c25b5d71c0361b20dbe |
| institution | Directory Open Access Journal |
| issn | 2044-6055 |
| language | English |
| last_indexed | 2024-03-11T10:46:23Z |
| publishDate | 2023-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj.art-da75ae57c4424c25b5d71c0361b20dbe2023-11-14T04:30:08ZengBMJ Publishing GroupBMJ Open2044-60552023-10-01131010.1136/bmjopen-2022-064497Changing landscape of paediatric refugee health in South Western Sydney, Australia: a retrospective observational studyKaren Zwi0Shanti Raman1Raghu Lingam2Nan Hu3Lahiru Amarasena42 Community Child Health, Sydney Children`s Hospital Randwick – Sydney Children`s Hospitals Network, Sydney, New South Wales, Australia18 Community Paediatrics, South Western Sydney Local Health District, Sydney, New South Wales, AustraliaPaediatric Population Health, School of Women’s & Children’s Health, University of New South Wales, Sydney, New South Wales, Australia1 School of Women`s and Children`s Health, University of New South Wales – Randwick Campus, Sydney, New South Wales, Australia1 School of Women`s and Children`s Health, University of New South Wales – Randwick Campus, Sydney, New South Wales, AustraliaObjectives To examine the changing health needs of refugee children and young people (CYP) entering Australia, in relation to key government policy changes.Study design Retrospective analysis of health service use data over 11 years.Setting Paediatric refugee clinics in South Western Sydney (SWS), the Australian region with the largest annual resettlement of refugees.Participants Refugee CYP (≤25 years) attending the SWS paediatric refugee clinics for their first visit between 2009 and 2019.Measures Clinician defined health conditions categorised as communicable and non-communicable disease (NCD).Results Data were analysed for 359 CYP, mean age 9.3 years; 212 male (59.1%). Most CYP (n=331, 92.2%) had health problems identified; 292 (81.3%) had ≥1 NCD and 24 (6.7%) had ≥1 communicable disease. The most frequent individual NCDs were dental disease (n=128, 35.7%) and vitamin D deficiency (n=72, 20.1%). Trend analysis showed increased odds of identifying an NCD from 2013 onwards (crude OR 1.77, 95% CI 1.06 to 2.96). Neurodevelopmental problems, especially Global Developmental Delay (n=31, 8.6%), emerged as more prevalent issues in the latter half of the decade. There were significantly increased odds of identifying a neurodevelopmental problem in 2016–2019, especially in 2016–2017 (adjusted OR 2.93, 95% CI 1.34 to 6.40). Key policy changes during this period included acceptance of refugees with disabilities from 2012, additional Australian Humanitarian Programme intake from the Eastern Mediterranean region and mandatory offshore processing for those seeking asylum by boat from 2013. In response to the changing needs, local health services adopted nurse-led primary healthcare screening, early childhood services, youth and disability clinics.Conclusions Refugee CYP in Australia are presenting with a growing burden of NCDs, with neurodevelopmental problems contributing. Government policy changes affect the sociodemographics of resettled populations, influencing health profiles. Paediatric refugee health services need to be responsive to the changing needs of these populations to optimise well-being.https://bmjopen.bmj.com/content/13/10/e064497.full |
| spellingShingle | Karen Zwi Shanti Raman Raghu Lingam Nan Hu Lahiru Amarasena Changing landscape of paediatric refugee health in South Western Sydney, Australia: a retrospective observational study BMJ Open |
| title | Changing landscape of paediatric refugee health in South Western Sydney, Australia: a retrospective observational study |
| title_full | Changing landscape of paediatric refugee health in South Western Sydney, Australia: a retrospective observational study |
| title_fullStr | Changing landscape of paediatric refugee health in South Western Sydney, Australia: a retrospective observational study |
| title_full_unstemmed | Changing landscape of paediatric refugee health in South Western Sydney, Australia: a retrospective observational study |
| title_short | Changing landscape of paediatric refugee health in South Western Sydney, Australia: a retrospective observational study |
| title_sort | changing landscape of paediatric refugee health in south western sydney australia a retrospective observational study |
| url | https://bmjopen.bmj.com/content/13/10/e064497.full |
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