Background:
Often new arrivals from refugee backgrounds have experienced poor health and limitedaccess to healthcare services. The maternal and child health (MCH) service in Victoria,Australia, is a joint local and state government operated, cost-free service available to allmothers of children aged 0-6 years. Although well-child healthcare visits are useful inidentifying health issues early, there has been limited investigation in the use of theseservices for families from refugee backgrounds. This study aims to explore experiences ofusing MCH services, from the perspective of families from refugee backgrounds and serviceproviders.
Methods:
We used a qualitative study design informed by the socioecological model of health and acultural competence approach. Two geographical areas of Melbourne were selected to inviteparticipants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi,Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived anaverage of 4.7 years in Australia (range one month-18 years). Participants had a total of 249children, of these 150 were born in Australia. Four focus groups and five interviews wereconducted with MCH nurses other healthcare providers and bicultural workers.
Results:
Four themes were identified: facilitating access to MCH services; promoting continuedengagement with the MCH service; language challenges; and what is working well and couldbe done better. Several processes were identified that facilitated initial access to the MCHservice but there were implications for continued use of the service. The MCH service wasnot formally notified of new parents arriving with young children. Pre-arranged groupappointments by MCH nurses for parents who attended playgroups worked well to increaseongoing service engagement. Barriers for parents in using MCH services included access totransportation, lack of confidence in speaking English and making phone bookings. Serviceusers and providers reported that continuity of nurse and interpreter is preferred forincreasing client-provider trust and ongoing engagement.
Conclusions:
Although participants who had children born in Melbourne had good initial access to, andexperience of, using MCH services, significant barriers remain. A systems-oriented,culturally competent approach to service provision would improve the service utilisationexperience for parents and providers, including formalising links and notifications betweensettlement services and MCH services.