NSW Refugee Health Plan: A policy-framework for improving the health of refugees and asylum-seekers in New South Wales
Discuss about the Analysis of the NSW Refugee Health Plan.
The NSW Refugee Health Plan is a policy-framework that the state government of New South Wales (NSW) came up with to help in addressing the health issues of the refugees as well as other people who have undergone refugee-like experiences at one point in their life. The plan was to be implemented between the year 20011 and 2016. According to the state government of NSW, the state has been receiving a large number of refugees. As a country, Australia has been receiving so many refugees who leave their mother land and relocate into the country because of war, political, or religious conflicts that cause instability and compel them to seek for refuge. There are also other people who come into the country as asylums-seekers because it provides a safe place that can accommodate them. However, when such refugees come into the country, a large number of them are deployed to NSW state (Mahimbo, Seale & Heywood, 2017). That is why the state government of NSW decided to come up with this plan. The purpose why this paper is to analyze this policy because it was a brilliant idea that the government had come up because it would help in providing a long-term solution to healthcare challenges faced by the refugees who come to the state whenever the circumstances force them to flee from their respective countries of origin (Ross, Harding, Seal & Duncan, 2016). The idea of providing safe and quality care to be commendable because it not only addresses the needs of the refugees and asylum-seekers, but also strives towards the realization of health equality and equity in the state and Australia at large.
The government decided to implement this policy because it was aimed at addressing the health needs of the refugees that immigrate into the country. According to official records, the refugees that come into the state often have poor state of health. When it comes to the matters of health, the refugees are worse-off as compared to the rest of the Australian citizens and residents. There are many reasons why the refugees are lagging behind when it comes to matters of health. Their social, economic, behavioral, and environment al determinants expose them to a wide range of health issues. Among the most significant factors that influence the health of the NSW-based refugees include cultural diversity (Botfield, Newman & Zwi, 2016). These people face cultural difficulties because they come from a cultural background that is quite different from that in Australia. Meaning, for them to receive quality care that satisfies their needs, they must have a special attention be given an opportunity to benefit from a culturally-competent care. Besides, these people have been exposed to lots of psychological trauma. Therefore, to meet their needs, they must have a well-organized team of practitioners who can attend to their unique situation and address it as expected (Chaves, Paxton, Biggs, Thambiran, Gardiner, Williams & Davis, 2017). Last, but not least, the refugees must be given a social consideration because their status makes it challenging for them to access healthcare services in the country. Meaning, it can be much better is there is a special program designed for them.
Background: Why the NSW state government implemented the plan
After classifying the refugees as a group that requires special attention, the state government of NSW came up with this plan because it would play a significant role in addressing the health needs of the newly-arrived refugees as well as their counterparts who have been in the country for up to five years. The government acknowledged that these refugees must be helped because if not empowered, there would be wide health disparities between them and the rest of the Australian population. Therefore, to achieve, this objective, the government set some goals that it was looking forward to accomplishing (Murray & Skull, 2005). These included the goals to do with the provision of immunization services, delivery of mental health services, reproductive health services, oral health services, nutritional health services, and preventive health services. These are the services that had been identified because they had to be regarded as priority areas that had to be addressed if the government was really concerned about the improvement of the health status of the refugees (Guajardo, Slewa-Younan, Kitchener, Mannan, Mohammad & Jorm, 2018). Nevertheless, to achieve all these, the government chose to apply a few models that were deemed appropriate for the addressing the needs of the refugees. The models included the commitments to the principles of social justice, gender equity, and human rights. Each of these principles was of great contribution towards the implementation of the plan. The government had demonstrated its commitments towards the elimination of any disparities in the health of the refugees because, despite their poor state, they had to be granted full rights to quality and safe medical care just like the rest of the Australian population.
The NSW Refugee Health Plan is a policy framework that the state government of SSW had come up with because it would help in addressing the health needs of the refugees and asylum-seekers in the state. For a very long time, the NSW state has been receiving a large portion of the refugees and asylum-seekers from different parts of the world. However, whenever they come into the country, these already disadvantaged immigrants find it quite challenging to fit into the country because they have a myriad of physical, mental, and psychological health problems that need an immediate redress (Riggs, Gibbs, Kilpatrick, Gussy, van Gemert, Ali & Waters, 2015). However, this might not happen because the poor status of these people in the Australian society deprives them of an opportunity to get access to healthcare services just like the rest of the people. In this regard, the state government felt that it was the right time to come up with this policy because it would help in providing an ultimate solution to this crisis. This paper acknowledges the policy as a good initiative that was rolled-out by the government because it would help in eliminating the disparities in the healthcare provision in NSW.
Objectives of the NSW Refugee Health Plan
The government did not just outline its intention, but came up with an implementation plan that it was looking forward to adopt in order to put the plan into practice. The most important thing to note here is that, in its implementation, the government sought to adopt a multi-disciplinary approach. Meaning, it decided to seek for the contributions of different stakeholders each of which had important contributions to make towards the success of the policy (Guajardo, Slewa-Younan, Santalucia & Jorm, 2016). However, the activities of the stakeholders was spearheaded by a central and supreme steering committee that had been established to coordinate, supervise, organize, and plan all the activities to be done during the implementation of the plan. The steering committee was, therefore, made up of representatives from different organizations including, but not limited to Primary Health and Community Partnerships Branch, Sydney South West Area Health Service, Asylum Seekers Centre, NSW Refugee Health Service, NSW Refugee Health Service, Multicultural Communications Service, Sydney South West Area Health Service, Service for the Treatment & Rehabilitation of Torture and Trauma, Survivors (Startts), Migrant Resource Centre Coordinators’ Forum, Transcultural Mental Health Centre, Multicultural Hiv and Hep C Service, Sydney West Area Health Service, Greater Southern Area Health Service, and Refugee Council of Australia.
The implementation of the plan was spearheaded by the steering committee which had powers ensure that everything is done as planned. However, the efforts of the committee were boosted by the contribution of many stakeholders that had been directly involved into its implementation. These included the Sydney Children’s Hospital (SCH), SESLHD Multicultural Health Service (MHS), Services, St George Migrant Resource Centre, and Gymea Community Aid and Information Service), Settlement services (Settlement Services International, Sydney Multicultural Community, NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Child Youth Women Family Health, Health Language Services (HLS), Health Promotion Service, Diversity Health Coordinators in SESLHD hospital facilities, Eastern Sydney and South Eastern Sydney Medicare Locals, Local Government as applicable, Asylum Seeker Centre (ASC), and the NSW Refugee Health Service (RHS). These are the partner whose participation led to the success of the plan because if it were not for them, nothing would be accomplished.
The NSW Refugee Health Plan was not only put into paper, but implemented because, right from the beginning, the government had identified the refugees and asylum-seekers as a special group that needed to be treated as apriority because its health status was worse-off and had to be redeemed (Correa-Velez, Gifford, McMichael & Sampson, 2017). After the installation of the steering committee, a well-outlined implementation plan was drawn and put in place for adoption during the 2011-2016 periods when the policy was to be in force. The overall monitoring and supervision of the plan was, however, bestowed on the Department of Health. Under the leadership of the department, various Local Health Networks would be empowered and given an opportunity to implement the identified strategic priority areas as well as the strategic actions that had been agreed upon.
Multi-stakeholder approach to the implementation of the NSW Refugee Health Plan
The implementation was to be done strictly on the following eight priority strategic priorities. First, there was to be a development and prioritization of the refugee health policies and plans. Here, the SESLHD Executive, SESLHD Planning Unit, and MHS were to collaborate and develop an implementation plan by December 2012. Two, there was to be a collaboration between the GPs and other healthcare providers to provide a universal health assessment and follow-up of all the newly-arrived refugees and asylum-seekers into the state (Guajardo, Slewa-Younan, Santalucia & Jorm, 2016). The settlement services, Medicare Locals, ASC, SCH, MHS, and RHS were to implement this action by September 2013. Three, the settlement services, Medicare Locals, ASC, SCH, MHS, and RHS were supposed to take up the necessary steps to promote the well-being of the refugees and asylum-seekers. This was supposed to be an on-going activity that had no specific time-frame. Four, the STARTTS, MHS, ASC, RHCG, MHS, and RHS were supposed to deliver high-quality specialized healthcare services to the refugees and asylum-seekers. This was to be an on-going process that had no time-frame.
The fifth priority action stipulated that the team had to develop specific action plans to meet various health needs of the refugees and the asylum-seekers. Here, the groups like the Aged Care services, STARTTS, RHS, RHCG, HLS, Trans-Cultural Mental Health, and Mental Health Service were to implement specific programs to address different aspects of the refugees’ health like mental and physical health (Smith & Harris, 2018). The sixth priority action focused on the delivery of accessible and quality mainstream care to the refugees and asylum-seekers. Entities like RHS, Medicare Locals, RHCG, DHCs, and the MHS were to implement different plans such as research, professional development, and refugee education because they would contribute towards the success of this plan. The seventh strategic priority was to enhance evaluation and research. Here, the Longitudinal Study Partners, IEC Project Partners, RHS, SHC, and the MHS were supposed to engage in research by collecting reliable data that could provide adequate information on how the health of the refugees could be improved (Mace, Mulheron, Jones & Cherian, 2014). According to the plan, this activity was to be completed by December 2013. The eighth strategic priority was supposed to be an evaluation. Here, the RHCG was to conduct yearly evaluation and be ready to avail the annual progress reports to the SESLHD Executive.
The implementation of the NSW Refugee Health Plan was properly done because the steering committee had taken the necessary steps to collaborate with all the stakeholders to ensure that the plan was a success. The alignment of the plan to the principles of Evidence-Based Practice (EBP) was a brilliant idea that was to be supported by all the other stakeholders (Slewa-Younan, Mond, Bussion, Mohammad, Guajardo, Smith & Jorm, 2014). Through such initiatives, it was possible to engage in a number of best practices like health promotion, health improvement, use of supportive infrastructure, and high-quality healthcare delivery. However, despite all these, the plan would not realize its full potential because it failed in accomplishing all its goals (Savic, Chur-Hansen, Mahmood & Moore, 2016). Some of the weak areas that were identified in its implementation include the failure of the team to actively involve the refugees in the decision-making processes regarding the design, planning, implementation, and evaluation of the entire action plan. The involvement of the stakeholders without seeking for the contributions of the refugees and asylum-seekers was inappropriate because it deprived the plan of accomplishing its full potential.
Strategic priority areas for the implementation of the plan
Conclusion
The NSW Refugee Health Plan was a good strategic plan that had the refugees and asylum-seekers at heart. The government of NSW was justified for coming up with such a plan because it would help in providing a permanent solution to the problem of health that had been affecting this category of immigrants. From the analysis, it was observed that the refugees and asylum-seekers forma special category of people in the country, who despite having lots of health-related problems, are naturally limited chances of accessing quality and safe healthcare services that they direly need. As a one of the states which accommodate the highest number of refugees, NSW felt that it was a time it organized for a steering committee and bring together all the relevant stakeholders to outline and implement the plan as expected (Masters, Lanfranco, Sneath, Wade, Huffam, Pollard & Friedman, 2018). Everything to do with the organization and the formulation of the strategic priorities and action plans was done to the perfection. However, the implementation process was not all that successful because of the few were areas or loopholes that were identified. These touch on the areas to do with the participation of the refugees, active involvement of the local community organizations, and the choice of priority areas to address during the implementation. Because of this, this paper suggests the following:
First, the implementation of the plan would have addressed the issue of the participation of the refugee communities in the state. Since the whole plan was about the refugees, it would not be justifiable to come up with such a plan and execute everything without seeking for the contribution of the new and old refugees. This was supposed to be done because each of the refugees have specific and unique problem that had to be addressed (Botfield, Newman & Zwi, 2018). However, such problems would be best addressed if the refugees themselves were involved in identifying and coming up with the most appropriate intervention strategies for them. Secondly, the paper suggests that the implementation of the plan would have encompassed a strong collaborative approach between the government agencies and local community organizations within NSW. Such collaboration was appropriate because if there were strong partnerships, everything would be implemented as planned. Each of these stakeholders is important because they could have brought some ideas that would be relied upon to address the health needs of the refugees as required (Mahimbo, Seale, Smith & Heywood, 2017). Last, but by no means the least, this paper suggests that in its implementation plan, the team would have focused on the availability of health practitioners who have special training on the delivery of refugee care. As a matter of fact, refugees are not Australians, but immigrants who come from different backgrounds. This might make it a bit challenging for the Australian medics to attend to their needs to the perfection. Therefore, to ensure that this problem is resolved, emphasis could have been put on the availability of staff that has a special training particularly on the refugees (Masters, Lanfranco, Sneath, Wade, Huffam, Pollard & Friedman, 2018). During their training, these personnel should be adequately prepared and given the skills to prepare them to operate in such a multicultural setting.
Conclusion: The NSW Refugee Health Plan as a step towards healthcare equity in New South Wales
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