Preventive youth health professionals in the lead for the care of refugee and resettled children

Refugee and resettled children often face a wide range of health risks associated with refugee stress and inadequate healthcare, such as vaccinations. Research shows that refugee children often experience anemia, micronutrient deficiencies, infectious diseases, as well as psychosocial issues like trauma, depression, and anxiety disorders. However, these children receive less help for these problems. It is important to timely detect and treat these physical and mental health issues.

Currently, youth doctors play a significant role in providing care for refugee children in The Hague, but the correct tools for detecting the physical and mental issues in refugee children are not always used. Moreover, coordination with general practitioners, mental health services, youth welfare, and pediatricians for personalized referrals is currently insufficient. The Dutch Pediatric Society (NVK) has developed guidelines for medical and psychosocial examinations for refugee children. Additionally, Amsterdam UMC and the Academic Collaborative Centre for Youth & Health have designed a toolkit for early detection of psychosocial problems in refugee children within youth healthcare. However, these are not yet implemented on a wider scale.

Objectives

This research aims to: 

1. assess how physical and mental care for refugee children in The Hague can be optimized on the basis of these guidelines and tools
2. improve collaboration between youth healthcare and other professionals to enhance the care and support for refugee and resettled children and their parents

Methods

This study begins with a one-year observational study of refugee and resettled children, assessing the current situation upon arrival and during follow-up (with youth doctors, general practitioners, youth welfare, mental health services, and pediatricians). Routine care and registration data (via the Extramural Leiden Academic Network) and interviews will be used to determine the current care provided for these children, identify the needs and wishes of children, families, and professionals, and determine the requirements for implementing the recommendations from the NVK guidelines and toolkit in youth healthcare. An adjusted working method will be developed in collaboration with youth healthcare professionals, general practitioners, mental health services, and youth welfare professionals in the Haaglanden region after one year. This new approach will apply the NVK guidelines and the toolkit to all arriving refugee children within youth healthcare. The new method will be implemented for one year and evaluated using routine care and registration data, observations, and individual interviews with stakeholders. The execution of the new method and the subsequent follow-up care and support will be monitored. Furthermore, the implementation process of the new approach will be monitored using the Normalization Process Theory and the Consolidated Framework of Implementation Research.

Implications

The results of this research have implications for the care of refugee children. By using the appropriate tools to detect physical and psychosocial issues by youth healthcare professionals, the time required to initiate proper support and treatment can be reduced. If this approach is found to be feasible for refugee children and their parents, it could lead to more efficient and effective care for this vulnerable group.