Developmental Disability in Newly Arrived Refugee Children in South Western Sydney
Shanti Raman,Mitchell Smith,Paul Hotton,Charles Freeman
South Western Sydney Local Health District University of New South Wales
Background : International studies have documented significant health problems in refugee children settled in western countries. Less described is the burden of disability in this population. Anecdotal reports suggest increasing numbers of refugees presenting with disability in Sydney. Our aims were to identify the health, social and service needs of refugee children and youth presenting with disability in South Western Sydney (SWS) and explore barriers to access to culturally appropriate support for refugee families.
Material : Clinical data were collated on children and youth attending refugee specific clinics in SWS between 2010 and 2015, with a focus on those with a disability. In-depth semi-structured interviews were conducted with 10 refugee families who had a child with a disability and key stakeholder interviews carried out with service providers. Simple descriptive analysis was done on the clinical data; qualitative data was analysed using thematic content analysis.
Results : A total of 159 children were seen in paediatric refugee clinics in SWS in the period. Mean age was 7.3 years, 60% were male, and the majority were of Middle-Eastern origin. The proportion of children with developmental disability went from an average of 12% in 2010 to 2013, to 41% in 2015; significantly more presentations with severe disability and co-morbid conditions were seen in 2014-2015. Analysis of qualitative data identified barriers at the systemic level, provider level and individual family level, with many refugee families facing financial constraints, having difficulties negotiating pathways to health, education and disability services; but good practice including in providing healthcare interpreters was highlighted.
Conclusions : Developmental disability and co-morbid chronic health conditions are emerging issues in newly arriving refugee families in Australia. Better planning and coordination between health, education and welfare professionals is essential; contextualised to individual families’ dealing with compound settlement issues. Findings from this study will help inform the planning of culturally competent health and welfare services for this vulnerable group.
Keywords: refugee health developmental disability health needs access
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