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‘Fragmented care’

Asylum seekers’ experience of accessing health care in NSW

Bibliographic Data

ID22944145
AuthorsZelalem Mengesha (0000-0003-1599-0951, Centre for Health Equity Training, Research & Evaluation (CHETRE); UNSW Australia Research Centre for Primary Health Care & Equity; A Unit of Population Health; member of the Ingham Institute , Sydney, NSW , Australia, corresponding author), Danielle Weber (0009-0008-7527-239X, NSW Refugee Health Service, South Western Sydney Local Health District , Sydney, NSW , Australia), Mitchell Smith (NSW Refugee Health Service, South Western Sydney Local Health District , Sydney, NSW , Australia), Patrick Harris (0000-0002-4649-4013, Centre for Health Equity Training, Research & Evaluation (CHETRE); UNSW Australia Research Centre for Primary Health Care & Equity; A Unit of Population Health; member of the Ingham Institute , Sydney, NSW , Australia), Fiona Haigh (0000-0002-5706-5118, Health Equity Research Development Unit, UNSW Sydney; A unit of Clinical Services Integration and Population Health , Sydney Local Health District, Sydney, NSW , Australia)
Year2023
Volume38
Issue5
Publication date2023-10-01
Open AccessYes
TypeARTICLE
VenueHealth Promotion International (JOURNAL)
Journal identifiersISSN: 0957-4824 • E-ISSN: 1460-2245
PublisherOxford University Press (OUP) (PUBLISHER)
DOI10.1093/heapro/daad123
PMID37864803
OpenAlexW4387844236
LanguageEN
Citations received3
References cited26

Medicare is central to accessing health care in Australia, yet many asylum seekers are ineligible for this scheme. In NSW, Medicare ineligible asylum seekers have some access to public health care under the Medicare Ineligible Asylum Seekers - Provision of Specified Public Health Services policy. This policy was updated in November 2020 to clarify services where a fee waiver applies for asylum seekers without Medicare. We examined the experiences of Medicare ineligible asylum seekers in accessing health care in New South Wales (NSW) in light of the revised policy. Employing qualitative methods, we conducted semi-structured interviews with asylum seekers (n = 7) and service providers (n = 6) in South Western Sydney. The interviews were analysed using thematic analysis and the socio-ecological model was used to interpret the data. Participants identified that chronic and mental health conditions are the main health issues for asylum seekers. Factors across the four levels of the socio-ecological model were identified as influencing the health care of asylum seekers, including a lack of awareness about health care rights at the individual level, support from relatives and friends at the interpersonal level, providers’ lack of awareness of fee waivers at the organizational level and limited access to primary health care at the policy level. The results imply that Medicare ineligible asylum seekers in NSW do not have optimal access to health care which may worsen existing health disparities. Educational initiatives that improve service providers’ and asylum seekers’ awareness of the revised policy are needed to improve asylum seeker health equity in NSW.

Asylum seeker · Equity (law) · Health care · Health equity · Mental health · Political science · Psychiatry · Public health · Public relations · Qualitative research · Refugee · Sociology · Thematic analysis · Employment and Welfare Studies · Global Health Workforce Issues · Law · Medicine · Migration, Health and Trauma · Nursing

  • Fragmented reproduction

    Open Access•Laura Perler, Milena Wegelin et al.•Geographica Helvetica•2026

  • Barriers to and Enablers of Preventive Sexual and Reproductive Health Care Among Women Seeking Asylum in Melbourne, Victoria

    Open Access•Natasha Davidson, Karin Hammarberg et al.•International Journal of…•2025

  • Comparing Australian Refugee‐Related Health Policies With the World Health Organization's Framework for Improving Refugee Integration and Health Outcomes

    Open Access•Mahan Mohammadi, Najmeh Bahmanziari et al.•Australian Journal of Social Issues•2025

  • Meeting the health literacy needs of immigrant populations

    Open Access•Gary L Kreps, Lisa Sparks•Patient Education and Counseling•2008

  • The Social Determinants of Refugee Mental Health in the Post-Migration Context

    Open Access•Michaela Hynie•The Canadian Journal of Psychiatry•2018

  • A systematic review of socio-ecological factors contributing to risk and protection of the mental health of refugee children and adolescents

    Open Access•Florian Scharpf, Elisa Kaltenbach et al.•Clinical Psychology Review•2021

  • An Ecological Perspective on Health Promotion Programs

    Open Access•Kenneth R McLeroy, Daniel L Bibeau et al.•Health Education Quarterly•1988

  • Patient-centred access to health care

    Open Access•Jean-Frédéric Levesque, Mark F Harris et al.•International Journal for Equity…•2013

  • Improving asylum seekers’ health awareness in a Hungarian refugee reception centre

    Open Access•Erika Marek, Gibson D’Cruz et al.•Health Promotion International•2019

  • Do access, quality and cost of general practice affect emergency department use

    Open Access•Anton Pak, Brenda Gannon•Health Policy•2021

  • A model explaining refugee experiences of the Australian healthcare system

    Open Access•Michael Au, Athire Debbie Anandakumar et al.•BMC International Health and…•2019

  • Preparedness of Health Care Professionals for Delivering Sexual and Reproductive Health Care to Refugee and Migrant Women

    Open Access•Zelalem Mengesha, Janette Perz et al.•International Journal of…•2018

Citations per year3
Citation span2025 - 2026 (2)
Highly citedNo

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