Pathways to Refugee Health - Northern Adelaide

Background: Refugees may experience poorer health outcomes due to a combination of factors including high disease burden, limited access to quality healthcare, poverty, social exclusion and exposure to health hazards during their migration journey (1). These challenges are compounded by systemic barriers within health systems that may lack the cultural responsiveness needed to effectively support refugee communities. To address these concerns, and increasing support requests received from primary care providers, Adelaide Primary Health Network (PHN), Australia initiated the Refugee Health Project in partnership with Survivors of Torture and Trauma Assistance and Rehabilitation Services (STTARS) and general practices across Northern Adelaide.

 

The project, delivered between January 2024 - June 2024, aimed to identify barriers within the primary health care system and upskill general practices to deliver culturally appropriate services for refugee communities.

 

Approach: A participatory approach, involving stakeholder engagement, education and networking sessions, was undertaken to understand the barriers to providing quality health care to refugees in primary care settings. A purpose-built Quality Improvement Toolkit was then developed and implemented to upskill five general practices in Northern Adelaide, enhancing the recording, screening, and treatment of refugee patients, including immunisations and ongoing health services.

 

Results: The discourses with stakeholders revealed a noticeable lack of culturally safe and appropriate primary care accessible for refugee communities. Further gaps were revealed in catch-up immunisation schedules and data recording for this population. Following implementation of the purpose-built Quality Improvement Toolkit, the 5 general practice collectively identified an additional 196 refugee patients on their database, provided 186 refugee health assessments and 1,569 immunisations to the refugee community over the 6 months. The toolkit also assisted practices in developing Structured Query Language (SQL’s) to retrieve data related to refugee patients through their clinical software, which historically could not be accessed due to reporting field limitations.

Implications: Implementation of the Quality Improvement Toolkit improved the accessibility of culturally safe, and appropriate healthcare for refugee communities. Participating general practices now have a better understanding of the number of refugee patients they provide healthcare to, what care they are providing, and an increased understanding of the cohort. The success of this initiative has informed resource allocation and funding decisions to support future refugee health initiatives across Metropolitan Adelaide.

 

In April 2025, Adelaide PHN commissioned an expansion of the Refugee Health Program across nine general practices over a 12-month period, to continue building capacity across the primary care sector for culturally responsive refugee health care.

 

References: International Organization for Migration. Social determinants of migrant health. 2020. Accessed September 15, 2020. https://www.iom.int/social-determinants-migrant-health