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Inequitable pregnancy care experiences and outcomes disproportionately affect refugee background women in Australia. Culturally safe care is essential for achieving health equity, however, cultural safety can only be determined by the person receiving care. To our knowledge, women of refugee background in Australia are yet to be asked what culturally safe pregnancy care is to them. Specifically, this study aimed to explore what culturally safe pregnancy care is to Karen women (from Burma) of refugee background. A photovoice study founded on community-based participatory research principles was undertaken with a Karen community of refugee background living in Victoria, Australia. A community advisory group was established, guiding study design and conduct. Five S'gaw Karen-speaking women with experience of pregnancy care in Australia were invited to take photos within their community. Participants shared their photos and stories with each other in four online discussion groups. Reflexive thematic analysis guided by a critical constructionist lens developed three themes: Building foundations for belonging; cultivating reciprocal curiosity; and storytelling as an expression of self and shared power. These themes sit within the overarching theme When I can be my whole authentic self, I feel safe and know that I belong. When Karen women can embrace their cultural and spiritual identity without fear of discrimination, including racism, culturally safe pregnancy care is possible. This study contributes to the design and delivery of maternity services by providing insights that can enhance equitable and culturally safe pregnancy care for Karen women of refugee background. [ABSTRACT FROM AUTHOR]

The importance of English language acquisition for resettlement of refugees is well established, particularly as a pathway to education, employment, health and social connections. A qualitative study was conducted in 2011 in Melbourne, Australia utilising focus groups with 87 refugee background women from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese refugee backgrounds. Focus groups and interviews were also conducted with 18 service providers and five bicultural and community workers. Several barriers were identified that prevented refugee mothers from learning English; however, some innovative and flexible models appear promising. The development, implementation and evaluation of innovative models and settings for refugee background women with young children to learn English in a culturally appropriate way are essential.

This study describes the extent, quality and cultural appropriateness of current research on the health conditions of refugee children aged 0–6 years settled in high-income countries. A systematic review was conducted, including original articles published on the health conditions experienced by refugee children. A total of 71 papers were included. The studies varied considerably in their research design, population characteristics and health conditions. Studies included information on 37 different health conditions, with the majority non-communicable diseases, in particular growth, malnutrition and bone density. Although the studies identified a wide range of health issues, a coordinated effort to prioritise research on particular health topics was lacking, and health conditions studied do not align with the global burden of disease for this population. Additionally, despite being rated medium–high quality, most studies did not describe measures taken to ensure cultural competency and community involvement in their research. We suggest a coordinated research effort for this cohort, with greater emphasis on community engagement to improve the evidence-base of the health needs of refugee children after settlement. [ABSTRACT FROM AUTHOR]

In a context of increasing numbers of refugees and asylum seekers globally, recognition of the importance of the school environment for promoting successful settlement outcomes and inclusion for refugee-background young people is growing. Yet schools may be poorly equipped to recognise and respond to the multiple challenges faced by children and young people who must learn a new language while grappling with unfamiliar educational and social systems. Refugee-background students often have minimal or significantly disrupted formal education prior to arrival in their new country. Young people, and sometimes their families, may lack literacy in first languages and many are coping with the impacts of trauma associated with forced displacement. Evidence for effective interventions in schools that promote an inclusive learning environment is scarce. This paper presents the results of an evaluation of the "School Support Programme" operating in schools in Victoria, Australia. The programme is provided to networks of schools in a region and facilitates partnerships between schools and agencies and provides a holistic model for a whole-school approach focused on the learning, social and emotional needs of refugee-background students. The evaluation concluded that the programme provides an appropriate and feasible model that supports the capacity of schools to provide an inclusive education for this group.

South Sudanese families have faced many hardships in the process of acculturation to Australian society. This has led to rapid family breakdown amongst refugees from South Sudan who live in Melbourne, Australia, and has created tension between families, the wider South Sudanese community, and authorities. This qualitative study explores how shifting dynamics of religious faith, the concept of family and cultural values impacts South Sudanese families and young people. The study consisted of 23 semi-structured interviews, three focus groups and two feedback forums, gathering data from South Sudanese youth aged 14 to 21 years, social workers, elders and parents from the South Sudanese community. Several themes were identified including the impact of intergenerational conflict, coping with new freedoms in Australia, the associated tensions these freedoms create within the South Sudanese community, and young people's conflict with religion. The patriarchal system that underpins the family structure of the South Sudanese culture is under significant strain as women and children are becoming aware of their rights, resulting in friction between men and women, parents and children. Male elders believed the embracing of freedom by women and children was at the core of family breakdown, leading to cultural erosion, and was the root of the problems experienced by the youth. The church as a traditional meeting place and a centre point for social inclusion within the South Sudanese community remains relevant as an important factor in social networking for parents and elders but lacks relevance for many South Sudanese youth. [ABSTRACT FROM AUTHOR]

There is growing recognition of the critical role that refugee fathers have in helping their children and families adjust to starting life in a new country, and the contribution of their mental and physical health to settlement and family health outcomes. The aims of this systematic review were to summarize and critically appraise the quality of research reporting on estimates of mental and physical health conditions among refugee fathers. Electronic databases were systematically searched to identify peer-reviewed studies reporting on the mental and/or physical health of refugee fathers of children aged 0–18 years, who had settled in a host country. Study details and estimates of mental and/or physical health conditions were extracted, and a critical appraisal of study quality conducted. Ten studies reporting estimates of post-traumatic stress (2–86%) and general psychological distress, anxiety, depression, stress and prolonged grief (25–50%) were identified. Only one study reported on physical health. Study quality and variability in recruitment, samples, data collection methods and outcomes across studies made it difficult to estimate the overall prevalence of mental and physical health difficulties. Despite marked heterogeneity across studies, this review highlights that mental health difficulties among refugee fathers are common, identifying them as a specific cohort of socially and culturally diverse fathers at risk of poor health. The findings underscore the need for health and social policy and service delivery specifically focussed on promoting the mental health of refugee fathers and their families. [ABSTRACT FROM AUTHOR]

Objectives: To conduct a critical and systematic analysis of descriptive studies regarding the health, development and wellbeing status of Indigenous children in Australia and to map them according to 1) Reported Indigenous involvement in the research process; 2) Domains of the life-course model of health; and 3) Geographical location of the Indigenous child population sample. Methods: A search of electronic databases, targeted websites and reference lists of relevant papers. Studies from 1958 to 2005 with clear methods and results were included. Data were extracted, mapped and analysed according to domains of the life-course model of health and development, study location, and reported level of Indigenous involvement. Results: 217 studies were eligible. Research predominantly addressed physical health (75.1%) with few studies addressing mental health and wellbeing (2.8%) or health determinants (27.6%). Indigenous involvement in the research process was not apparent in 71.4% of studies, although it appears to be increasing. Compared with 10.6% in metropolitan locations, 67.2% of the studies were conducted in very remote areas. Remaining studies were conducted in remote or regional areas or were national. Conclusions: More work is needed to establish an evidence base of Australian Indigenous child health and wellbeing that is founded on Indigenous values, knowledge and participation. Not withstanding the significant need to address issues of core morbidity and physical health for Indigenous children, more research addressing emotional and social health and wellbeing is required, as are research questions of importance to Indigenous children living in urban settings. Key words: child health, Indigenous population, systematic review