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Contents
Part 1 3
Introduction 3
Health Disparities Faced by Refugees and Asylum Seekers 3
Planned Intervention 5
Background to Project 7
Aims and Objectives 7
References 9
Refugees and Asylum Seeker’s Health Care Needs: A Health Promotion Proposal
Part 1
Introduction
The world we live in is characterised by peace and conflicts that have often result to population movement. Those in conflict zones attempt to move to peaceful regions as refugees or asylum seekers. Under the 1951 UN convention and its 1967 protocol an asylum seeker is a person from another country entering another country to claim safe haven (Stewart, 2011). According to Davies et al. (2009) people will seek asylum for different reasons …show more content…
that may include running away from political and social unrest, armed conflicts, harassment or they are mistreated in their motherland. Refugees refers to a group of people who have been forced to live outside their country because they are afraid of being persecuted based on their race, nationality, political opinion, social membership, religion, and are therefore not assured of safety and protection by that country (Kirmayer et al., 2011). In Australia, asylum seekers describes any group of people who have applied for their refugee status but that status has not been determined or persons who have arrived in Australia with a temporary visa and have made an application for refugee status, this persons may include students and tourists (Stewart, 2011).
Australia receives most of its refugees and asylum seekers from regions that are experiencing humanitarian crisis which includes Lebanon, Vietnam, Africa, Middle East, post-war Europe and Asia (Russell et al., 2013). As such, refugees and asylum seekers are one of the most vulnerable populations that face multiple healthcare and social needs and increasingly face health inequalities. Additionally, this vulnerable group will comprise pregnant women, unaccompanied children, raped or tortured individuals, single men and women, and people with significant mental ill health. Russell et al. (2013) postulates that most of arriving refugees are below 30 years of age, have low socioeconomic status, have varied religious backgrounds, and speak little or no English. As result these makes there health care needs complex whether they are in the wider community or under immigration detention facilities.
Health Disparities Faced by Refugees and Asylum Seekers
Healthcare and social welfare needs of refugees and asylum seekers can be seen to be complex and different from other Australian communities when it comes to accessing primary healthcare.
Health disparities refers to any difference in the health status, including injury, violence, disease, that are preventable in regards to opportunities available to accessing optimal healthcare services that socially disadvantaged or vulnerable population experience (CDC, 2014). According to Kirmayer et al. (2011) restriction of asylum seekers access to healthcare started with the 1990s implementation of the Australian policy of protection visa applicants and has since then increased. Though published government policies proclaim that it is fundamental to provide organised, culturally sensitive and accessible health services to refugees, there exist challenges that compromise the long-term wellbeing and health of refugees and asylum seekers. According to Russell et al. (2013) key among the greatest health challenges faced by refugees and asylum seekers is stress and depression that results from forced migration or resettlement, discrimination, mistreatment and …show more content…
coercion.
Davies et al.(2009) explains that health challenges that refugees face both when in their country and while on transit, results from different factors such as psychological and physical torture, trauma, lack of education, food and shelter, poor sanitation, lack of clean water, and poor access to healthcare. Women refugee population face atrocities such as torture, rape, mutilation, coercion, sexual slavery or they may be denied liberty (Kay et al, 2010). Davidson et al (2004) reports that on-arrival refugees typically will be involved in poorly paying jobs, earn low income, are discriminated, and experience language or other communication barriers that affect access to optimal healthcare services. It is also apparent that refugees and asylum seekers face common settlement challenges such as accessing affordable accommodation, writing and / or speaking English, finding employment, mothers gaining affordable child care, interpreting health information, understanding community and health services, dealing with the change in family structures, separation from family, friends and community; these challenges have significant impact on their health or access to health (Kirmayer et al., 2011).
According to Davidson et al (2004) one should remember that refugees or asylum seekers frequently suffer from trauma and stress as a recurring impact of their resettling experience and that some of the refugees may have been in refugee camps for prolonged period such that they may have suffered infectious diseases, developed malnutrition, been injured or just based on the horrible experience they have been subjected owing to activities undertaking in their country of origin. Kay et al (2010) adds that it is factual that all refugees have undergone some kind of trauma or torture, some have been tortured and they often, owing to their condition and status, have poor access to healthcare. It is then certain that refugees and asylum are vulnerable population whose majority reach Australia already facing significant health difficulties which may require quick help or some may arrive with chronic diseases that will require sustainable health care interventions. Due to the above mentioned challenges faced by refugees and asylum seeker, refugees and asylum seekers in Australia have health needs that differ from the wider population and according to Stewart (2011) this includes increased prevalence of health conditions, obstetric complications, nutrition deficiency, particular infectious diseases and disability. A well planned healthcare intervention programme is required to assist Australia to cope with such health challenges faced by refugees and asylum seekers.
Planned Intervention
According to the World Health Organisation (WHO), health promotion is a process of enabling people to have increase control and improve their health by focusing past individual behaviour and including wide range of environmental and social interventions (WHO, Online).
Health disparities that refugees and asylum seekers face also pose health risk to Australian communities, for example, possible breakout of highly infectious or communicable diseases. As such, it is important to have a health promotion program that not only focuses on refugees and asylum seekers, but also involves policy makers, health service providers, community and health professional. Thus, developing a refugees and asylum seekers round table education program as the proposed health promotion program will allow interactive sessions; enable networking and sharing of information that is vital in improving access to health service for refugees and asylum
seekers.
Australian refugees and asylum seekers create part of the Australian community and the purpose of health promotion is to build cultural and social understanding of diseases and health that can enable all people (including vulnerable population) have increased control over their health through advocacy and intersectoral action (Pedro, 2012). The role of health education intervention program, which is a component of health promotion, is to improve access to health services and information, thus giving refugees and asylum seekers more control over their health and well-being (Carlisle, 2000). Education intervention suits refugees and asylum seekers as vulnerable population because it not only deals how simple health facts are disseminated, but also delivers important skills and information to people about preventing diseases or illness (Pedro, 2012).
Apparently, an education program focused only on refugees and asylum seeker will not do significant improvement of health services. According to Whitehead (1992) health promotion involves people (vulnerable/non-vulnerable) as a whole, featuring there day to day life and is not focused only on risky groups of people. Having a round table education program that involves diverse communities is seen to have profound effect by being representative of local authorities/policy makers, health providers and professionals, supportive communities and the vulnerable population. As Parahoo (2014) puts it health promotion requires action on health determinants and as such cooperation of all sectors, those in and without health discipline, is required to represent the diversity of conditions that affect health. Conditions that influence health includes basics like information and life skills, giving people opportunities to make their health choices with regards to services and facilities, existence of supportive environment, and economic , social and cultural environments, physical conditions (WHO, 1984).
The round table education concept pursues an inclusion approach and is projected from the understanding that health promotion is a diverse approach that comprises of education, communication, legislation, community development, economic measures, and other local activities that are touching on health hazards (Feldman, 2006). It insists on the idea of the community working together in order to disseminate information about health and healthcare services and owning the initiatives so that it helps to forge partnership with local health authorities, community, health professional and, refugees and asylum seekers. Health education will ensure people have access to updated and relevant information that is important for them to make informed choices and decisions regarding health needs (Carlisle, 2000). The proposed education program can therefore be crucial in combating the identified health disparities by making health services and information available and help improve health literacy in attempt of combating diseases.
In 2012, refugee and asylum seeker health in rural and regional areas health promotion program was conducted as a round table discussion with the aim of identifying common concerns, joint priorities and opportunities for strategic collaboration (Victorian Refugee Health Network (VRHN), 2012). The roundtable discussion came up with possible areas for collaborations and innovations in refugee and asylum seekers health in rural and regional areas and indicated how government policy direction, local collaboration and service development can support health services to refugees and asylum seekers (VRNH, 2012). However, it did not document a framework of achieving that neither did it involve the refugees and asylum seekers as parties but involved organisations that deal with them. Another health promotion was conducted on 2011 outer east of Melbourne termed ‘a healthy mother, healthy babies’ and focused on pregnancy and post birth experience of women from refugee background (Nicolaou, 2011). The study aimed to ease the burden of chronic diseases by emphasising on maternal risk behaviours and provide support to pregnant women. The program achieved key recommendations through a research on appropriate model of making services effective and accessible in order to meet antenatal as well as postnatal needs of the refugee population in the study (Refugee Health Network, 2014). However, Paxton et al. (2013) argues that the recommendations have not been fully effective as either the target population are not aware of the information or do not meet the criteria to access the services.
Background to Project
Australia is increasingly becoming more culturally diverse community, thus creating the necessity of having equitable and fair healthcare services for all. A round table education program provides an integral community approach that stimulates and builds positive relations between the refugee and asylum seekers and the Australian community including the refugee and asylum seeker’s agencies and health professional bodies. The project recognises the importance of involvement and collective participation through education and training to improve health and human services as well as address the basic health service need of refugees and asylum seekers. The project believes that such an approach is based on focusing on major social determinants of health which include social relationships, education, justice and safety (Kindig & Stoddart, 2003). As a health promotion program the round table education program centres its approach on access to health to reduce inequalities that refugees and asylum seekers experience in Australia. The activity focuses on effective and concrete public participation in developing life skills for refugee and asylum seekers as a principle of primary health care (Braveman, 2003). Information and education are considered as the key factors that will influence the target population to have an informed base for making choices. Information and education in health promotion help to increase knowledge and disseminate information that relates to health and therefore may empower refugees on how to deal with their heath needs.
Aims and Objectives
The aims of this project is to educate and train refugees and asylum seekers about accessing health services in Australia and improve Australian community’s understanding and perceptions of health needs of refugee and asylum seekers.
The project objectives are:
To inform and educate refugee / asylum seekers how to seek or access health services
To promote collective effort to attain health by improving professional and public perceptions of refugee and asylum seekers health needs
To contribute to development of health promotional policies that embrace exchange of ideas, both lay and professional
To promote social behaviour changes that is conducive to health living through coping strategies.
References
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Carlisle, S. (2000). Health promotion, advocacy and health inequalities: a conceptual framework. Health Promotion International, 15(4), 369-376.
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