Providing health services to migrants and refugees settling in Victoria, Australia: an analysis of the complexity, cost and policy implications for public health

The aim of the research was to identify factors related to the increased costs of providing health services to clients from a non-English speaking background (NESB), using a cross-sectional analysis of the administrative records of clients using community health services in the Northern Metropolitan region of Melbourne for the 2001/2002 financial year. The higher cost of providing services to NESB clients was influenced by four factors: increased consultation time, group attendance to an appointment, increased interpreting costs and the type of service provider. Family members and multilingual staff play a significant role in providing informal interpreting services or low-cost support for NESB consultants, and these activities should receive appropriate support. Additional funding is needed to support interpreting requirements when dealing with the health needs of NESB clients.

Illegal migrants, tourism and welfare : a trade theoretic approach

Many countries receive illegal migrants but are reluctant to accept them due to possible negative externalities. We provide a rationale for not policing illegal migration by linking it to the tourism industry. By paying illegal migrants less than local workers, the relative price of the non-traded goods is shown to be lower than it would be in the absence of such workers. An expansion in tourist trade, under certain intensity conditions, necessarily raises resident welfare and employment. This tourist boom necessarily lowers the welfare of the illegal migrants. It is established that an increase in tourism increases the supply of illegal migrants.

POSSIBLE MIGRATION ROUTES THROUGH MAINE BY VERNAL MIGRANTS

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Challenges of negotiating obesity-related findings with African migrants in Australia : lessons learnt from the African migrant capacity building and performance appraisal project

Aim: To document sub-Saharan African migrants' and teachers' reaction to and acceptance of findings from African Migrant Capacity Building and Performance Appraisal initiative, and to examine the implications for any community-based obesity prevention program.

Methods: Two community forums were organised to discuss the research findings: one with 45 African community leaders from various African communities in Melbourne; and the other with 17 primary and secondary teachers from English Language Schools and Centres across Victoria. The dissemination focused on highlighting the rapid weight gain and obesity risks observed among African migrant children.

Results: Sub-Saharan African migrants' reaction to the findings was that of pride and satisfaction with large body size, seeing it as a job well done, reflecting their perceptions that obesity is not a disease. In addition, they highlighted the intergenerational conflict related to body size ideals between parents and teenage offspring, with the latter preferring model-like Australian body sizes.

Conclusion: Further research is required to examine the association between shifting preferences in body ideals and obesity among traditional communities, such as sub-Saharan African migrants. The understanding of how changes in body image perceptions may influence eating and exercise behaviours among sub-Saharan African migrants would assist in the development of obesity-related preventive interventional programs for this at-risk population.

Having a baby in the new land : a qualitative exploration of the experiences of Asian migrants in rural Tasmania, Australia

Introduction: Australia is a land of cultural diversity. Cultural differences in maternity care may result in conflict between migrants and healthcare providers, especially when migrants have minimal English language knowledge. The aim of the study was to investigate Asian migrant women’s child-birth experiences in a rural Australian context.

Method: The study consisted of semi-structured interviews conducted with 10 Asian migrant women living in rural Tasmania to explore their childbirth experiences and the barriers they faced in accessing maternal care in the new land. The data were analysed using grounded theory and three main categories were identified: ‘migrants with traditional practices in the new land’, ‘support and postnatal experiences’ and ‘barriers to accessing maternal care’.

Results: The findings revealed that Asian migrants in Tasmania faced language and cultural barriers when dealing with the new healthcare system. Because some Asian migrants retain traditional views and practices for maternity care, confusion and conflicting expectations may occur. Family and community play an important role in supporting migrant women through their maternity care.

Conclusions: Providing interpreting services, social support for migrant women and improving the cross-cultural training for healthcare providers were recommended to improve available maternal care services.

Over the border and under the radar : can illegal migrants be active citizens?

Active citizens can become a powerful driver of development by holding to popular account those who traditionally wield decision-making power at the local and national levels. Active citizenship draws from a long history of understanding the importance of community participation and ownership of development interventions. However, in spite of its inherent strengths, active citizenship may not be a possible (or optimal) outcome in all circumstances. This article argues for the realistic expectation of active citizenship (and indeed participation) of one specific sub-population in Thailand, where the overwhelming majority of illegal migrants (of an estimated total of 800,000-1.5 million) are Burmese. Their precarious existence as illegal migrants compounds the development needs that confront any poor community. This in turn hinders their ability to engage actively in the development process. This article reviews the lessons learned by a Thai-based NGO that has worked with illegal Burmese migrants for more than 15 years. It discusses the unique strengths and weakness of these illegal communities, whether or not it is appropriate to seek to engage them as active citizens, and the implications for NGOs working with such communities. It suggests that the unique role that NGOs must play, in cases where public participation could endanger the lives of community members, is that of advocate-guardians, whereby they assume the role of active citizen on behalf of the community in question and simultaneously provide development interventions and advocate on its behalf.

Applying socio-cultural lenses to childhood obesity prevention among African migrants to high-income western countries : the role of acculturation, parenting and family functioning

Migration from third-world and low-income countries to high-income Western countries presents significant challenges for individuals and families, and for health service providers in the receiving societies. Cultural conflicts related to preferred body size/shape and parenting practices, together with differential inter generational rates and styles of acculturation, can affect nutritional and lifestyle choices and be associated with high rates of childhood obesity. Using African cultures as an example, this paper examines these issues. It concludes that, in designing and implementating obesity prevention programmes, health service providers need to understand these factors and how they play out.

Parenting, family functioning and lifestyle in a new culture : the case of African migrants in Melbourne, Victoria, Australia

This study documented the parenting styles among African migrants now living in Melbourne, Victoria, Australia, and assessed how intergenerational issues related to parenting in a new culture impact on family functioning and the modification of lifestyles. A total of 10 focus group discussions (five with parents and five with 13–17-year-old children; N = 85 participants) of 1.5–2 hours duration were conducted with Sudanese, Somali and Ethiopian migrant families. The analysis identified three discrete themes: (i) parenting-related issues; (ii) family functioning and family relations; and (iii) lifestyle changes and health. African migrant parents were restrictive in their parenting; controlled children's behaviours and social development through strict boundary-setting and close monitoring of interests, activities, and friends; and adopted a hierarchical approach to decision-making while discouraging autonomy among their offspring. Programmes seeking to improve the health and welfare of African migrants in their host countries need to accommodate the cultural and social dimensions that shape their lives. Such programmes may need to be so broad as to apply an acculturation lens to planning, and to assist young people, parents and families in addressing intergenerational issues related to raising children and growing up in a different social and cultural milieu.

Parenting, family functioning and lifestyle in a new culture : the case of African migrants in Melbourne, Victoria, Australia

This study documented the parenting styles among African migrants now living in Melbourne, Victoria, Australia, and assessed how intergenerational issues related to parenting in a new culture impact on family functioning and the modification of lifestyles. A total of 10 focus group discussions (five with parents and five with 13–17-year-old children; N = 85 participants) of 1.5–2 hours duration were conducted with Sudanese, Somali and Ethiopian migrant families. The analysis identified three discrete themes: (i) parenting-related issues; (ii) family functioning and family relations; and (iii) lifestyle changes and health. African migrant parents were restrictive in their parenting; controlled children's behaviours and social development through strict boundary-setting and close monitoring of interests, activities, and friends; and adopted a hierarchical approach to decision-making while discouraging autonomy among their offspring. Programmes seeking to improve the health and welfare of African migrants in their host countries need to accommodate the cultural and social dimensions that shape their lives. Such programmes may need to be so broad as to apply an acculturation lens to planning, and to assist young people, parents and families in addressing intergenerational issues related to raising children and growing up in a different social and cultural milieu.