Importance of community engagement in primary health care: the case of Afghan refugees

Abstract

Refugees can experience problems accessing and utilising Australian primary health care services, resulting in suboptimal health outcomes. Little is known about the impact of their pre-migration health care experiences. This paper demonstrates how the Afghan pre-migration experiences of primary health care can affect engagement with Australian primary care services. It considers the implications for Australian primary health care policy, planning and delivery. This paper is based on the international experiences, insights and expert opinions of the authors, and is underpinned by literature on Afghan health-seeking behaviour. Importantly, Afghanistan and Australia have different primary health care strategies. In Afghanistan, health care is predominantly provided through a community-based outreach approach, namely through community health workers residing in the local community. In contrast, the Australian health care system requires client attendance at formal health service facilities. This difference contributes to service access and utilisation problems. Community engagement is essential to bridge the gap between the Afghan community and Australian primary health care services. This can be achieved through the health sector working to strengthen partnerships between Afghan individuals, communities and health services. Enhanced community engagement has the potential to improve the delivery of primary health care to the Afghan community in Australia.

Understanding oral health help‐seeking among Middle Eastern refugees and asylum seekers in Australia: An exploratory study

“…Help‐seeking behaviours were also attributed to norms from participants' countries of origin, mirroring previous research concerning the knowledge, attitudes and practices of migrants towards oral health . Acculturation is a relatively novel addition to Andersen's Model relevant for this population and reflects previous research concerning the relevance of acculturation in promoting positive oral health beliefs and outcomes . Results also suggested combining oral health beliefs and behaviours (see also) to capture the interactions between beliefs—such as those associated with adherence to Islamic customs—and resulting oral health behaviours.…”

A Scoping Review and Conceptual Model of Social Participation and Mental Health among Refugees and Asylum Seekers

“…For example, communication between health care service providers and patients is of key importance for building trust in health care institutions, where insufficient health literacy and language issues may specifically constitute important barriers in this regard [69]. Additional refugee-related factors such as socio-economic position in the host society, gender roles, lack of adequate information, difficulties in navigating organization of the health care services, and cultural beliefs and practices in regard to health and illness may potentially hamper access to health care utilization [57,65,69,70,71,72,73]. Engagement of the refugee communities in the development of health care policy and delivery, as well as participatory health care research, are suggested to be viable for addressing such barriers to care [69,71,72,74,75].…”

Community-Based Healthcare for Migrants and Refugees: A Scoping Literature Review of Best Practices

“…Publications in this area of action were conducted mainly between 2012 and 2018 (7/9) in Australia (2/9), the USA (2/9), Canada (2/9), and the Middle East (1/9) (+2/9 not specified), and populations addressed included refugees and asylum-seekers, immigrants of various descents, and vulnerable migrants [113][114][115][116][117][118][119][120][121]. Aspects of the interventions in primary healthcare discussed are engagement with the migrant community through partnerships [113,114], stronger focus on ancillary services [121], interdisciplinary collaboration between public health and primary care institutions [116][117][118], culturally and linguistically trained interpreters [118,119], evidence-based guidelines [118,119], outreach activities by nurses [120], training of staff in cultural competency [114,121], health promotion education among migrants, and advocacy [117,121].…”