Understanding unique needs

The health and wellbeing of people from refugee backgrounds can be different from the general population. Their experiences before and after settlement may involve psychological and physical health challenges due to exposure to torture and conflict.

People from refugee backgrounds may have come from countries with limited healthcare and poor resources, including access to clean water and sanitation. They may have poor health, including undiagnosed or poorly treated health conditions.

After arriving in Australia, refugees face additional barriers to healthcare, such as:

  • competing priorities in the settlement process (for example, housing, employment, education and health)
  • increased stress
  • low literacy levels
  • difficulty understanding and navigating the healthcare system.

Recognising these unique needs will support the effective and efficient delivery of healthcare to people from refugee backgrounds.

Common health issues

Health issue Recommended resources

Diet

  • Nutritional deficiencies, including anaemia
  • Vitamin deficiencies, including vitamin D deficiency

Nutritional assessment

Source: Victorian Refugee Health Network

Low vitamin D

Source: Australian Refugee Health Practice Guide

Chronic conditions

  • Infectious diseases, including hepatitis B
  • Hearing and vision issues
  • Chronic pain and mobility issues

Hepatitis B fact sheet for primary care providers

Source: Victorian Refugee Health Network

Hearing, vision and oral health

Source: Australian Refugee Health Practice Guide

Other conditions

  • Poor oral health and dental issues
  • Psychological issues, including post-traumatic health disorder, avoidance behaviours, dissociation and psychosomatic conditions
  • Sexual and gynaecological dysfunctions, including female genital mutilation and mutilation of body parts

Oral health - Immigrant Health Service

Source: The Royal Children's Hospital, Melbourne

Management of psychological effects of torture or other traumatic events

Source: Australian Refugee Health Practice Guide

Transcultural Mental Health Centre

Source: NSW Health

NSW education program on female genital mutilation

Source: Western Sydney Local Health District

For a more comprehensive list of common health concerns that people from refugee backgrounds may experience, refer to the Australian Refugee Health Practice Guide.

Health literacy

Shirley, a refugee nurse in Wagga Wagga, assisting a community member.

People from refugee backgrounds may arrive to Australia with very low levels of health literacy. They may not understand local health services and how to navigate the  healthcare system. This can limit a person's ability to make health decisions.

Below are some examples that highlight the impact low health literacy can have on people:

  • A young woman seeking care in the late stages of her pregnancy did not know she was pregnant and had no understanding of antenatal care.
  • A young man experiencing back pain did not know he had kidney issues or what a kidney is.
  • People only seeking health support for emergencies; and not understanding health prevention.
  • A child being given adult doses of medication because the parent did not know there was a different dosage for children.
  • A young woman refused to drink water while she was breast feeding because she feared it may harm her baby.
  • People being referred to attend radiology, pathology or specialist appointments but not attending because they didn’t understand the process, the importance of the appointment or how to attend the appointment.

Health education

Targeted education sessions, health promotion programs and resources, and interaction with bicultural health workers will help improve health literacy among the community.

Michele Greenwood, Clinical Nurse Consultant, Refugee/Multicultural Health North Coast Public Health Unit, leads an information session for the local Burmese community.

Resources

NSW Health Literacy Framework: A guide to action

Source: Clinical Excellence Commission

Consumer enablement guide – covers communication, health literacy, culturally responsive practice and working with culturally and linguistically diverse groups

Source: Agency for Clinical Innovation

Health literacy publications – for health professionals and consumers

Source: Multicultural Health Communication Services

Health literacy: taking action to improve safety and quality

Source: Australian Commission on Safety and Quality in Healthcare

Trauma-informed care

Using a trauma-informed approach to healthcare means that you recognise and understand the ways that trauma affects people, while emphasising safety and minimising re-traumatisation in service delivery. This is particularly important when caring for people from refugee backgrounds.

If a refugee has experienced traumatic events or been persecuted, they may feel anxious about using state and government services. Refugee health and support services need to enable people to feel safe and welcome.

Resources

Trauma-informed care framework

Source: Agency for Clinical Innovation

Approach to consultation and management – considering the impact of past trauma on consultation when caring for people from refugee backgrounds.

Source: Australian Refugee Health Guide

Trauma-informed care and practice – a graduate course for NSW Health staff from the Health Education and Training Institute (HETI)

Source: HETI Higher Education

Clinician video

The unique healthcare for people of refugee backgrounds

Resources

Prescribing tips – improving understanding of how, why, and when to take the prescribed medication

Source: Australian Refugee Health Guide

Prescribing for refugees – article in Australian Prescriber

Source: NPS Medicinewise

Refugee and migrant health – fact sheets, publications and news from an international perspective

Source: World Health Organization

Common health needs of refugees and migrants –  literature review

Source: World Health Organization

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