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Helping refugee children thrive: what we know and where to next
  1. Karen Zwi1,2,
  2. Lisa Woodland3,
  3. Sarah Mares4,
  4. Santuri Rungan2,
  5. Pamela Palasanthiran1,2,
  6. Katrina Williams5,
  7. Susan Woolfenden2,
  8. Adam Jaffe1,2
  1. 1 University of New South Wales, Sydney, New South Wales, Australia
  2. 2 Sydney Children’s Hospitals Network, Sydney, New South Wales, Australia
  3. 3 District Executive Unit, South Eastern Sydney Local Health District, Sydney, New South Wales, Australia
  4. 4 School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
  5. 5 Royal Children’s Hospital, Melbourne, Victoria, Australia
  1. Correspondence to Dr Karen Zwi, University of New South Wales and Sydney Children’s Hospitals Network, Randwick, Sydney, NSW 2031, Australia; Karen.zwi{at}

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Australia offers a small but well-regarded refugee programme offering extensive support to the 13 750 refugees settled in the country each year, after the processing of their protection claims by the United Nations. Since 2015, a further 12 000 resettlement places have been allocated to Syrian and Iraqi refugees.1 Globally, there are an estimated 65 million people around the world currently displaced, half of whom are children under 18 years of age.2 These children are exposed to cumulative risks associated with poor developmental and social–emotional health outcomes.3–6

Successful settlement of refugee children and their families is of global importance and presents a challenge to health professionals in implementing known evidence to optimise development and social–emotional health in childhood and to produce a better chance of lifetime good health and success, including mental health, employment and socioeconomic status.7–9 With a well-coordinated and evidence-based response, there is potential to produce excellent outcomes for displaced children. Presented here is a summary of findings from a body of evidence developed in our local setting in regional Australia to inform future service development for displaced children. We argue that there is an urgent need for further investment in long-term outcomes and make recommendations on how we can continue to develop the evidence base to support optimal well-being for displaced children in Australia and other high-income settings.

What is known

For health professionals to provide safe, high quality, culturally responsive care to refugee populations, an understanding of the multiple barriers to care is required. Specific strategies and tools to empower families can improve clinician–patient relationships, service delivery and health outcomes.10

We have shown that accessible healthcare for refugees is achievable through community-based models that include primary care, refugee health nurses and specialised paediatric refugee referral services and has the added value of integrating the whole family …

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  • Contributors KZ takes public responsibility for the entire work, from idea to complete manuscript. All authors meet the following criteria for authorship: substantial involvement and contribution to the idea or the study question, or to the study design, or to the fieldwork component, or to the analysis, or to the interpretation of study findings; writing drafts of the manuscript, or reviewing drafts or revisions critically with substantial input and approval of the final version of the manuscript.

  • Funding This study was funded by Foundation Markets Foundation for Children.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Ethics approval for the community sample in these studies was granted by the Human Research Ethics Committee Northern Hospitals Network, South Eastern Sydney Illawarra Area Health Service (HREC Reference Numbers 08/084 and 09/163), including approval to compare this sample with the detention sample on 21/6/2017. The research involving the detention sample in this study was assessed by the South Western Sydney Local Health District Human Research Ethics Committee (HREC/15/LPOOL/556), which was satisfied with provisions to protect the rights of participants. All participants gave their informed consent prior to their inclusion in the study.

  • Provenance and peer review Not commissioned; internally peer reviewed.