The physical health status, service utilisation and barriers to accessing care for asylum seekers residing in the community: a systematic review of the literature

Hadgkiss, Emily; Renzaho, Andre Μ Ν

doi:10.1071/ah13113

Cited by 140 publications

(142 citation statements)

References 44 publications

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“…This echoes findings from O’Donnell et al [21] and MacFarlane et al [46] that the provision of interpretation services in Ireland is inadequate. The perceived poor attitudes of primary care professionals towards patients from marginalised groups in this study resonates with findings from many other studies on this topic [32, 33, 37–39, 41, 43, 80–82]. These adverse experiences seem to deter participants in this study from attending for primary care in the community.…”

Section: Discussionsupporting

confidence: 84%

Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study

O’Donnell

Tierney

O'Carroll³

et al. 2016

Int J Equity Health

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BackgroundThe involvement of patients and the public in healthcare has grown significantly in recent decades and is documented in health policy documents internationally. Many benefits of involving these groups in primary care planning have been reported. However, these benefits are rarely felt by those considered marginalised in society and they are often excluded from participating in the process of planning primary care. It has been recommended to employ suitable approaches, such as co-operative and participatory initiatives, to enable marginalised groups to highlight their priorities for care.MethodsThis Participatory Learning and Action (PLA) research study involved 21 members of various marginalised groups who contributed their views about access to primary care. Using a series of PLA techniques for data generation and co-analysis, we explored barriers and facilitators to primary healthcare access from the perspective of migrants, Irish Travellers, homeless people, drug users, sex workers and people living in deprivation, and identified their priorities for action with regard to primary care provision.ResultsFour overarching themes were identified: the home environment, the effects of the ‘two-tier’ healthcare system on engagement, healthcare encounters, and the complex health needs of many in those groups. The study demonstrates that there are many complicated personal and structural barriers to accessing primary healthcare for marginalised groups. There were shared and differential experiences across the groups. Participants also expressed shared priorities for action in the planning and running of primary care services.ConclusionsMembers of marginalised groups have shared priorities for action to improve their access to primary care. If steps are taken to address these, there is scope to impact on more than one marginalised group and to address the existing health inequities.Electronic supplementary materialThe online version of this article (doi:10.1186/s12939-016-0487-5) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 84%

Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study

O’Donnell

Tierney

O'Carroll³

et al. 2016

Int J Equity Health

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“…Refugees on the other hand often arrive in poorer general health status than their immigrant counterparts [10] and often present with ill physical and mental health status [11]. Contributing to their likelihood for poor health is a difficult migration journey that may include migration from countries experiencing violent conflicts, forced migration at short notice, and living in refugee camps, along with unfavorable social determinants of health [3, 12–18].…”

Section: Introductionmentioning

confidence: 99%

A qualitative study on African immigrant and refugee families’ experiences of accessing primary health care services in Manitoba, Canada: it’s not easy!

Woodgate

Busolo

Crockett

et al. 2017

Int J Equity Health

100

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BackgroundImmigrant and refugee families form a growing proportion of the Canadian population and experience barriers in accessing primary health care services. The aim of this study was to examine the experiences of access to primary health care by African immigrant and refugee families.MethodsEighty-three families originating from 15 African countries took part in multiple open ended interviews in western Canada. Qualitative data was collected in six different languages between 2013 and 2015. Data analysis involved delineating units of meaning from the data, clustering units of meaning to form thematic statements, and extracting themes.ResultsAfrican immigrant and refugee families experienced challenges in their quest to access primary health care that were represented by three themes: Expectations not quite met, facing a new life, and let’s buddy up to improve access. On the theme of expectations not quite met, families struggled to understand and become familiar with a new health system that presented with a number of barriers including lengthy wait times, a shortage of health care providers, high cost of medication and non-basic health care, and less than ideal care. On the theme of facing a new life, immigrant and refugee families talked of the difficulties of getting used to their new and unfamiliar environments and the barriers that impact their access to health care services. They talked of challenges related to transportation, weather, employment, language and cultural differences, and lack of social support in their quest to access health care services. Additionally, families expressed their lack of social support in accessing care. Privately sponsored families and families with children experienced even less social support. Importantly, in the theme of let’s buddy up to improve access, families recommended utilizing networking approaches to engage and improve their access to primary health care services.ConclusionsAfrican immigrant and refugee families experience barriers to accessing primary health care. To improve access, culturally relevant programs, collaborative networking approaches, and policies that focus on addressing social determinants of health are needed.

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“…Given the substantial rates of mental illness in refugees, the high use of primary health care and hospitalization rates is not surprising – however, access to mental health services is very low (Bell & Zech, 2009; Hadgkiss & Renzaho, 2014). This is partly due to legal restrictions in the use of health services and barriers such as communication problems, poor health literacy, limited available care, and stigmatization associated with the use of mental health services (Kluge et al, 2012; Norredam, Mygind, & Krasnik, 2005).…”

Section: Introductionmentioning

confidence: 99%

Efficient identification of mental health problems in refugees in Germany: the Refugee Health Screener

Kaltenbach

Härdtner

Hermenau

et al. 2017

European Journal of Psychotraumatology

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Background: A substantial number of refugees present with mental disorders. This appears particularly acute in the currently increasing refugee populations in Europe. Although EU guidelines demand the identification and support of vulnerable individuals such as survivors of trauma, no adequately validated and comprehensive mental health screening instruments for refugees residing in Europe currently exist. Objective: We studied the feasibility, validity, and reliability of the Refugee Health Screener-15 (RHS-15) – a time-efficient and easy-to-implement screening developed by Hollifield et al. (2013) – as a self-rating and interview instrument. Methods: A sample of refugees from different countries (N = 86), representative of those who had arrived around the turn of the year 2015/2016 in Germany, filled in the RHS-15 on their own. A semi-structured clinical interview was later conducted with a random subsample (n = 56). Results: Fifty-two percent of the refugees examined screened positive in the RHS-15, thus indicating current mental health problems. The RHS-15 showed a good feasibility, reliability, and validity in both the self-rating and the interview version. It detected clinically relevant mental health problems when PTSD, depression, anxiety, or somatization problems were present. A shorter 13-item version proved to be equally valid. Conclusions: Together with previous research on the RHS in refugees living in the US, this suggests that the RHS is a time-efficient and accurate instrument that is able to detect common mental health problems in a wide range of refugees. Prospectively, the RHS could be used as an instrument for identifying vulnerable refugees, for example, by integrating it in the initial medical examination in the host community, thereby initiating support.

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The physical health status, service utilisation and barriers to accessing care for asylum seekers residing in the community: a systematic review of the literature

Cited by 140 publications

References 44 publications

Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study

Exploring levers and barriers to accessing primary care for marginalised groups and identifying their priorities for primary care provision: a participatory learning and action research study

A qualitative study on African immigrant and refugee families’ experiences of accessing primary health care services in Manitoba, Canada: it’s not easy!

Efficient identification of mental health problems in refugees in Germany: the Refugee Health Screener

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