Promoting healthy development

Young refugee children and their families may experience problems with their health in the UK and barriers to receiving appropriate treatment and care. Some threats to good health may be linked to other concerns such as housing and financial problems. Refugees may also experience health problems related to human rights abuses, including torture, in their countries of origin.

Major difficulties experienced by refugee families include:

• Not knowing about healthcare entitlements and how to access information about health services
• Finding and registering with general practitioners (GPs) and dentists
• Not understanding healthcare information or letters from doctors and hospitals
• Worries about confidentiality and talking about issues such as sexual health, family relationships and child protection
• Finding specialised care and support if a survivor of torture and political violence
• Family stress caused by dislocation, family separation, overcrowding and poor housing.

Healthcare practitioners and others may not always understand the diverse cultural and religious needs of refugee families and communities. Particular health difficulties that affect refugee women and girls may be not identified and understood. Refugee women and girls from some communities may have undergone female genital mutilation (FGM), which can affect sexual health and childbirth.

Early years settings play a key role in the vision set out in Every Child Matters: Change for Children . One of the five outcomes for children is Being healthy: Enjoying good physical and mental health and living a healthy lifestyle. The Birth to three matters framework also recognises the interrelationship between children’s growth, learning and development. One of the four key ‘Aspects’ of the framework is A Healthy Child. The four ‘Components’ that make up A Healthy Child are:

• Emotional Well-being
• Growing and Developing
• Keeping Safe
• Healthy Choices

Good practice

Early years settings are well placed to contribute to the health, development and well-being of young refugee children and their families and ensure that they access the services and support they need.

Refugees’ entitlements to healthcare

Ensure practitioners are aware of refugees’ entitlements to healthcare. Refugees with refugee status, as well as those with humanitarian protection or discretionary leave, are entitled to free NHS medical treatment and can register with a GP. Guidance is provided on the Department of Health (DH) website.

Health needs of refugees

Raise awareness of the particular health needs of refugees.

HARPWEB – the health for asylum seekers and refugees portal provides a range of useful information and resources on the health needs of refugees.

Meeting the health needs of refugees and asylum seekers in the UK: an information and resource pack for health workers, published by the NHS and the DH, contains practical information, details of useful contacts and resources and includes examples of good practice from around the United Kingdom.

Support refugee families to access healthcare

Early years settings can help refugee families find GPs and access health services. When new children and families arrive, practitioners can check whether they are registered with a GP. Leaflets and translated information can also be made available. The NHS in England website allows users to search for health services in their local area including doctors, dentists, opticians, pharmacies and walk-in centres. NHS Direct provides information on local services and also operates a 24-hour nurse advice and health information service. A free, confidential translation service is also available.

Provide health checks and monitor health and development

Early years settings can ensure that children’s health is checked on or soon after entry. Support can then be provided and referrals made if appropriate. Nursery nurses work in a variety of early years settings, including nurseries run by local authorities and those that are privately owned. Their duties cover many aspects of health, physical care and safety. Nursery nurses are also responsible for observing and monitoring children and work closely with parents.

Develop links with midwives, health visitors and other services

Early years practitioners will find it helpful to make links with midwives, health visitors and other professionals working with refugee families. They may be the first contact point for families expecting babies, with new babies or with young families moving into the area. Some local health authorities and NHS trusts have developed refugee health initiatives and health advocacy services aimed at refugee communities. Early years practitioners in children's centres will also be working closely with other healthcare professionals.

The Sure Start website provides guidance on developing effective partnerships with health professionals. The multi-agency working area of this site also provides guidance on how early years settings can work with other services to meet the needs of refugee children and families.

Encourage healthy eating

The importance of good nourishment for babies and young children, and their parents, is well recognised. Most Sure Start local programmes and many early years settings provide advice and information on healthy eating and nutrition for families on low incomes, placing emphasis on the importance of the consumption of fruit and vegetables.

Promote healthy physical development

Physical development is one of the six areas of learning in the foundation stage curriculum. The importance of encouraging physical activity is also recognised within Sure Start programmes. Physical development in early years settings is about improving skills of coordination, control, manipulation and movement. It also helps children gain confidence in what they can do and enables them to feel the positive benefits of being healthy and active. Effective physical development helps children develop a positive sense of well-being.

Early years settings can help refugee families understand the importance of physical activity. They can encourage families to access and use local leisure and play facilities, and help them overcome any worries or barriers they have to participating in activities in the community that promote early movement skills. Refugee families may not be aware of programmes such as TOP Tots and TOP Start .

Promote emotional well-being

The foundation stage curriculum also has a major part to play in ensuring that the social and emotional needs of young children are met. One of the six areas of learning is personal, social and emotional development. Through play, safe and enjoyable activities and pastoral care, early years educational settings can promote the emotional well-being of refugee children. Further information and guidance is provided in the promoting emotional well-being area of this site

Case study

Enfield Temporary Accommodation Play Project (.PDF)

Many refugee children and families in the London Borough of Enfield occupy temporary accommodation and may experience difficulties with health and development. The case study describes how Enfield Temporary Accommodation Play Project provides a range of activities for children and parents that promote healthy development and well-being.