I don't think general practice should be the front line: Experiences of general practitioners working with refugees in South Australia

Introduction Many refugees arrive in Australia with complex health needs. In South Australia (SA), providing initial health care to refugees is the responsibility of General Practitioners (GPs) in private practice. Their capacity to perform this work effectively for current newly arrived refugees is uncertain. The aim of this study was to document the challenges faced by GPs in private practice in SA when providing initial care to refugees and to discuss the implications of this for policy relating to optimising health care services for refugees. Methods Semi-structured interviews with twelve GPs in private practice and three Medical Directors of Divisions of General Practice. Using a template analysis approach the interviews were coded and analysed thematically. Results Multiple challenges providing care to refugees were found including those related to: (1) refugee health issues; (2) the GP-refugee interaction; and (3) the structure of general practice. The Divisions also reported challenges assisting GPs to provide effective care related to a lack of funding and awareness of which GPs required support. Although respondents suggested a number of ways that GPs could be assisted to provide better initial care to refugees, strong support was voiced for the initial care of refugees to be provided via a specialist refugee health service. Conclusion GPs in this study were under-resourced, at both an individual GP level as well as a structural level, to provide effective initial care for refugees. In SA, there are likely to be a number of challenges attempting to increase the capacity of GPs in private practice to provide initial care. An alternative model is for refugees with multiple and complex health care needs as well as those with significant resettlement challenges to receive initial health care via the existing specialist refugee health service in Adelaide.David R Johnson, Anna M Ziersch, Teresa Burges

Becoming Australian: a review of southern Sudanese students’ educational experiences

This research presents a review of the literature around meeting students’ learning needs in Australian schools. It is referenced to one group of students with refugee experience who have been in Australian schools for over 15 years; students with a background of oracy from Southern Sudan. The development of psychological health and literacy competencies are two of the most critical and complex responsibilities undertaken by education, and, in the case of these students two of the most significant when considered in relation to successful settlement, acculturation and assimilation. In presenting this literature, the bigger picture of how schools can fail, not only these students, but for any number of students from diverse backgrounds, becomes startlingly obvious, as do the ways in which the current political agenda inherent in the public education system in Australia privileges students of specific class and culture. Finally, recommendations are made regarding the development of policy and the concentration on pedagogical practices which acknowledge and respect the strengths and capabilities of this group of students

Hard to reach communities or hard to access services? Migrant mothers' experiences of dental services

Background Good oral health is an important component of overall health which can help migrants settle in a new country. Infant oral health is intimately associated with maternal oral health knowledge and behaviours and therefore, encounters with dental services. This study aimed to explore the experiences of dental service use from the perspective of migrant mothers living in Melbourne, Australia. Methods A participatory research approach utilizing qualitative methods was adopted. Women from Iraq, Lebanon and Pakistan participated. Semi‐structured focus groups and interviews were conducted and thematic analysis of the data was completed. Results Focus groups (n = 11) and interviews (n = 7) were conducted with 115 women. Despite an understanding that visiting the dentist was important for promoting oral health, the first dental contact for both the women and their children was typically for emergency care. Accessibility, cost and waiting lists were identified as significant barriers to attendance. Problematic interpreter encounters often led to negative experiences which were compounded by a perception that public services provided poorer quality of care. Conclusions Despite evidence of poorer oral health, migrant women face significant barriers in accessing mainstream dental services. Reorientation of such services, to address the accessibility and experience for migrant communities may help reduce oral health inequalities

Gains and losses: African Australian women and higher education

This article argues that African women migrants in Australia are increasingly enrolling in and successfully completing tertiary study, usually at high emotional and financial cost. While this qualitative study has shown that both refugee-background and non-refugee African Australian women's enrolment in higher education is enabling new forms of participation and belonging in resettlement, it continues to challenge the women's more traditional cultural roles and identities. This article argues that these gendered negotiations are noted only cursorily (if at all) within education and health contexts, and, importantly, form a primary obstacle facing African Australian women in migration and refugee resettlement transition