Caring for refugees in general practice: perspectives from the coalface
Rebecca Farley A B D , Deborah Askew A C and Margaret Kay AA Discipline of General Practice, The University of Queensland School of Medicine, Level 8, Health Sciences Building, Building 16/910, Royal Brisbane and Women’s Hospital, Herston, Qld 4029, Australia.
B Inala Primary Care, 64 Wirraway Parade, Inala, Qld 4077, Australia.
C Inala Indigenous Health Service, 64 Wirraway Parade, Inala, Qld 4077, Australia.
D Corresponding author. Email: r.farley1@uq.edu.au
Australian Journal of Primary Health 20(1) 85-91 https://doi.org/10.1071/PY12068
Submitted: 27 May 2012 Accepted: 25 November 2012 Published: 21 December 2012
Abstract
This qualitative research project explored the experiences of primary health care providers working with newly arrived refugees in Brisbane. Data from 36 participants (20 general practitioners, five practice nurses and 11 administrative staff) involved in five focus groups and four semi-structured interviews were analysed. The results indicated that despite difficulties, providers are committed and enthusiastic about working with refugees. The flexibility of the general practice setting enables innovative approaches. The establishment of a specialised refugee health service in Brisbane has improved providers’ capacity to deliver refugee health care. However, most practices continue to feel isolated as they search for solutions, and the need for greater supports and a more coordinated approach to care were emphasised. The themes of communication, knowledge and practice and health care systems encapsulated the factors that influence health care providers’ ability to care for refugees and provide a framework for improving available supports. Australian primary health care is currently undergoing great change, which provides an opportunity to make significant gains in the provision of care for refugees and other minority groups within our community. As health care reforms are implemented it is essential that they are responsive to the expressed needs of health care providers working in these areas.
Additional keywords: Australia, primary health care, qualitative research.
References
Adams KM, Gardiner LD, Assefi N (2004) Healthcare challenges from the developing world: post-immigration refugee medicine. British Medical Journal 328, 1548–1552.| Healthcare challenges from the developing world: post-immigration refugee medicine.Crossref | GoogleScholarGoogle Scholar |
Benson J, Smith M (2007) Early health assessment of refugees. Australian Family Physician 36, 41–43.
Davidson N, Skull S, Burgner D, Kelly P, Raman S, Silove D, Steel Z, Vora R, Smith M (2004) An issue of access: delivering equitable health care for newly arrived refugee children in Australia. Journal of Paediatrics and Child Health 40, 569–575.
| An issue of access: delivering equitable health care for newly arrived refugee children in Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD2cvlvFelsg%3D%3D&md5=76d55361d5cac3310f9570cd100af9beCAS |
Department of Health and Ageing (2010) ‘A national health and hospitals network for Australia’s future: delivering the reforms.’ (Commonwealth of Australia: Canberra) Available at http://www.yourhealth.gov.au/internet/yourHealth/publishing.nsf/Content/DeliveringTheReforms/$FILE/DeliveringTheReforms.pdf [Verified 21 May 2012]
Department of Health and Ageing (2011) ‘Improving primary health care for all Australians.’ (Commonwealth of Australia: Canberra) Available at http://www.yourhealth.gov.au/internet/yourHealth/publishing.nsf/Content/improving-primary-health-care-for-all-australians-toc/$FILE/Improving%20Primary%20Health%20Care%20for%20all%20Australians.pdf [Verified 21 May 2012]
Department of Immigration and Citizenship (2011) ‘Fact sheet 60 – Australia’s refugee and humanitarian program.’ (Commonwealth of Australia: Canberra) Available at http://www.immi.gov.au/media/fact-sheets/60refugee.htm [Verified 21 May 2012]
Finlay L (2002) Outing the researcher: the provenance, process and practice of reflexivity. Qualitative Health Research 12, 531–545.
| Outing the researcher: the provenance, process and practice of reflexivity.Crossref | GoogleScholarGoogle Scholar |
Finney Lamb C, Smith M (2002) Problems refugees face when accessing health services. NSW Public Health Bulletin 13, 161–163.
| Problems refugees face when accessing health services.Crossref | GoogleScholarGoogle Scholar |
Hansen E (2006) ‘Successful qualitative health research: a practical introduction.’ (Allen & Unwin: Sydney)
Henderson S, Kendall E (2011) Culturally and linguistically diverse peoples’ knowledge of accessibility and utilisation of health services: exploring the need for improvement in health service delivery. Australian Journal of Primary Health 17, 195–201.
| Culturally and linguistically diverse peoples’ knowledge of accessibility and utilisation of health services: exploring the need for improvement in health service delivery.Crossref | GoogleScholarGoogle Scholar |
Howes F, Hansen E, Williams D, Nelson M (2010) Barriers to diagnosing and managing hypertension − a qualitative study in Australian general practice. Australian Family Physician 39, 511–516.
Johnson D, Ziersch A, Burgess T (2008) I don’t think general practice should be the front line: experiences of general practitioners working with refugees in South Australia. Australia and New Zealand Health Policy 5, 20
Kay M, Jackson C, Nicholson C (2010) Refugee health: a new model for delivering primary health care. Australian Journal of Primary Health 16, 98–103.
| Refugee health: a new model for delivering primary health care.Crossref | GoogleScholarGoogle Scholar |
Krueger R (1998) ‘Developing questions for focus groups.’ (Sage Publications: Thousand Oaks)
Murray SB, Skull SA (2005) Hurdles to health: immigrant and refugee health care in Australia. Australian Health Review 29, 25–29.
| Hurdles to health: immigrant and refugee health care in Australia.Crossref | GoogleScholarGoogle Scholar |
Phillips CB, Smith MM, Kay M, Casey S (2011) The Refugee Health Network of Australia: towards national collaboration on health care for refugees. The Medical Journal of Australia 195, 185–186.
Queensland Health (2008) ‘Queensland Refugee Health Service. Service plan. Executive summary.’ (Queensland Government: Brisbane) Available at http://www.health.qld.gov.au/multicultural/health_workers/QRHS_exe_summ.pdf [Verified 21 May 2012]
Sheikh M, Pal A, Wang S, MacIntyre C, Wood N, Isaacs D, Gunasekera H, Raman S, Hale K, Howell A (2009) The epidemiology of health conditions of newly arrived refugee children: a review of patients attending a specialist health clinic in Sydney. Journal of Paediatrics and Child Health 45, 509–513.
| The epidemiology of health conditions of newly arrived refugee children: a review of patients attending a specialist health clinic in Sydney.Crossref | GoogleScholarGoogle Scholar |
Sheikh-Mohammed M, MacIntyre C, Wood N, Leask J, Isaacs D (2006) Barriers to access to health care for newly resettled sub-Saharan refugees in Australia. The Medical Journal of Australia 185, 594–597.
Smith MM (2006) Refugees in Australia: changing faces, changing needs. The Medical Journal of Australia 185, 587–588.
Stevenson AD, Phillips CB, Anderson K (2011) Resilience among doctors who work in challenging areas: a qualitative study. The British Journal of General Practice 61, e404–e410.
| Resilience among doctors who work in challenging areas: a qualitative study.Crossref | GoogleScholarGoogle Scholar |
Sypek S, Clugston G, Phillips C (2008) Critical health infrastructure for refugee resettlement in rural Australia: case study of four rural towns. The Australian Journal of Rural Health 16, 349–354.
| Critical health infrastructure for refugee resettlement in rural Australia: case study of four rural towns.Crossref | GoogleScholarGoogle Scholar |
United Nations High Commissioner for Refugees (2002) ‘Refugee resettlement: an international handbook to guide reception and integration.’ (UNHCR: Geneva) Available at http://www.unhcr.org/4a2cfe336.html [Verified 21 May 2012]
Victorian Foundation for Survivors of Torture (2012) ‘Caring for refugee patients in general practice: a desk-top guide.’ 4th edn. (Victorian Foundation for Survivors of Torture: Melbourne) Available at http://refugeehealthnetwork.org.au/learn/guides/ [Verified 5 December 2012]
Woodland L, Burgner D, Paxton G, Zwi K (2010) Health service delivery for newly arrived refugee children: a framework for good practice Journal of Paediatrics and Child Health 46, 560–567.
| Health service delivery for newly arrived refugee children: a framework for good practiceCrossref | GoogleScholarGoogle Scholar |
