‘Excuse me, do any of you ladies speak English?’ Perspectives of refugee women living in South Australia: barriers to accessing primary health care and achieving the Quality Use of Medicines

Abstract

Abstract. Reforms to the Australian health system aim to ensure that services are accessible, clinically and culturally appropriate, timely and affordable. During the reform consultation process there were urgent calls from stakeholders to specifically consider the health needs of the thousands of refugees who settle here each year, but little is known about what is needed from the refugee perspective. Access to health services is a basic requirement of achieving the quality use of medicines, as outlined in Australia's National Medicines Policy. This study aimed to identify the barriers to accessing primary health care services and explore medicine-related issues as experienced by refugee women in South Australia. Thirty-six women participated in focus groups with accredited and community interpreters and participants were from Sudan, Burundi, Congo, Burma, Afghanistan and Bhutan who spoke English (as a second language), Chin, Matu, Dari and Nepali. The main barrier to accessing primary health care and understanding GPs and pharmacists was not being able to speak or comprehend English. Interpreter services were used inconsistently or not at all. To implement the health reforms and achieve the quality use of medicines, refugees, support organisations, GPs, pharmacists and their staff require education, training and support.

Understanding quality use of medicines in refugee communities in Australian primary care: a qualitative study

“…The results also resonate strongly with previous health research on refugees. 27,28,30,34 Comparison with existing literature This study confirmed the need for clear communication when prescribing, recognising the vital role that interpreters play. 32 Communication enables adherence and improves the identification of adverse effects that could compromise patient safety.…”

“…This study provides further support for delivering cross-cultural awareness training for health practitioners. 27,41 Powerful narratives captured in this study illustrate the potentially serious health, social, and financial consequences that can result when health providers fail to identify and manage cultural dissonance. Although common cultural practices, such as the sharing of medicines and the simultaneous use of traditional medicines, have been reported previously, they may not be recognised by providers.…”

“…23,41 Poor health literacy is common in refugee communities 28,32 and community education can address this. 27 Refugee health leaders clearly described how community leaders should be engaged as trusted sources of information to facilitate education to optimise medicines use. Although written information is useful, poor literacy in a person's first language can limit the effectiveness of translated resources.…”

“…25,26 One study of medicines use with members of different refugee communities in South Australia reported barriers encountered by refugees when seeking and engaging with health services. 27 The authors made 11 systemic recommendations that broadly focused on enabling health access, addressing cultural and (especially) linguistic barriers, and enhancing health literacy in refugee communities, rather than addressing issues specific to quality use of medicines.…”

Refugee health and rehabilitation: Challenges and response

“…Since 1945, Australia legitimately settled over 75,000 refugees, mainly from Africa, Asia-Pacific and Middle Eastern regions (5)(6)(7). In 2014-2015, a total of 13,756 visas were granted for the Humanitarian Program (11,009 visas for the offshore component and 2747 for the onshore component) (8).…”