Health Screening and Post‐Arrival Services for Refugee Children From Afghanistan

AIM: To examine refugee health screening and services for Afghan children in the unique context of emergency expedited humanitarian resettlement in Melbourne, Australia. METHODS: Retrospective audit of Afghan children who attended a specialist child refugee health service between August 2021-April 2024. RESULTS: Participants included 218 children aged 2 months-18 years, 57.8% male. Most (82.6%) were part of an intact family unit, 11.5% were unaccompanied minors. At first clinic visit, more than half held a temporary humanitarian visa with variable medicare access, and 51.4% were in hotel quarantine or short-term accommodation due to the Covid-19 pandemic. Only 17.4% children reported offshore healthcare related to travel. While 65.1% children were linked with a general practitioner, 90.8% still required refugee health screening and 92.7% required catch-up vaccinations. The most common health issues were dental caries (28.4%), sleep concerns (17.0%), infections (14.2%) and developmental concerns (15.1%). Twenty children (9.2%) required hospital admission in the early post-arrival period, 10.1% had intellectual disability and 8.7% had complex physical disability. Refugee health screening identified high prevalence of vitamin D deficiency (64.7%), B12 deficiency (44.7%), iron deficiency (29.5%) and anaemia (25.5%), and a range of rare diagnoses and communicable diseases. CONCLUSIONS: Refugee health screening remains essential in post-arrival healthcare, allowing early identification and treatment of infections and micronutrient deficiencies and support for complex cases. Fragmented systems for refugee health screening in Melbourne are not meeting this need, and there is a strong case for specialist paediatric screening given the range of medical, developmental, disability, educational and social needs identified.