How do Australian maternity and early childhood health services identify and respond to the settlement experience and social context of refugee background families?

BMC Pregnancy and Childbirth

Stephanie Brown¹  Donna Chesters⁴  Philippa Duell-Piening⁴  Josef Szwarc⁴  Sue Casey⁴  Fatema Fouladi²  Sayed Wahidi²  Elisha Riggs³  Jane Yelland³ 

[1] School of Population and Global Health, University of Melbourne, Parkville, Victoria 3052, Australia;Healthy Mothers Healthy Families Research Group, Murdoch Childrens Research Institute, Flemington Road, Parkville, Victoria 3052, Australia;General Practice and Primary Health Care Academic Centre, University of Melbourne, Parkville, Victoria 3052, Australia;Victorian Foundation for Survivors of Torture, 4 Gardiner Street, Brunswick, Victoria 3056, Australia

关键词: Early childhood health care;    Maternity care;    Psychosocial;    Social and mental health inquiry;    Refugee families;    Afghan women and men;   

Others  :  1118414
DOI  :  10.1186/1471-2393-14-348

 received in 2014-07-04, accepted in 2014-09-30,  发布年份 2014

【 摘 要 】

Background

Refugees have poor mental, social and physical health related to experiences of trauma and stresses associated with settlement, however little is known about how refugee families experience maternity and early childhood services. The aim of this study was to explore the responsiveness of health services to the social and mental health of Afghan women and men at the time of having a baby.

Method

Participatory methods including community engagement and consultation with the Afghan community and service providers in Melbourne, Australia. Bicultural researchers conducted interviews with Afghan women and men who had recently had a baby. Interviews and focus groups were also conducted with health professionals working in the region.

Results

Thirty interviews were conducted with Afghan women and men who had recently had a baby. Thirty-four health professionals participated in an interview or focus group.

Afghan women and men reported significant social hardship during the period before and after having a baby in Australia, but were rarely asked about their social health by maternity and early childhood services.

Most health professionals recognised that knowledge and understanding of their client’s migration history and social circumstances was relevant to the provision of high quality care. However, inquiring about refugee background, and responding to non-clinical needs of refugee families was challenging for many health professionals. Factors that made it more difficult for health professionals to engage with Afghan families in pregnancy included limited understanding of the context of migration, dependency of many Afghan women on their husband for interpreting, short appointments, and the high likelihood of seeing different health professionals at each antenatal visit. Community-based maternal and child health nurses had more scope to work with interpreters, and build relationships with families, providing a stronger foundation for identifying and responding to complex social circumstances.

Conclusion

There are significant challenges in providing comprehensive, high quality primary health care for Afghan families accessing Australian maternity and early childhood services. The limited capacity of public maternity services to identify families of refugee background and provide tailored service responses are contributing to inequitable maternal and child health outcomes for families of refugee background.

【 授权许可】

   
2014 Yelland et al.; licensee BioMed Central Ltd.

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