Developing a profile of refugee primary care access and delivery needs in Pima County, Arizona

Refugees are resettled into Pima County at a rate of 600-800 annually, and an estimated 1,000 in 2009. Coming from every continent and diverse backgrounds, and speaking a range of languages, including Arabic, Kirundi, Somali, Mai Mai and Nepalese, they all hold in common a need to navigate an unfamiliar and complex primary care delivery system. The challenges some refugee groups face in this process, and those encountered by health and human service agencies in providing optimal services to them are documented qualitatively in this study. A Refugee Primary Care Work Group composed of faculty and graduate students from the University of Arizona schools of public health, nursing, library science, and health sciences library, community service providers from the county health department and public library, and representatives of refugee groups and of volunteer agencies responsible for refugee resettlement was convened specifically to guide and support the project. The study included a survey on service delivery challenges and training needs of primary care providers which identified a range of refugees' priority and unmet needs, and subsequently the group interviews with refugees regarding their experience in accessing primary care services, and their recommendations for optimizing the health care delivery system. The group interviews elicited health concerns, barriers to accessing services, and recommendations for improving outreach and services. Findings will contribute to policy recommendations for improving service outreach and delivery, developing orientations for providers serving refugee clients, and orientations for refugee clients in utilizing the health care system in Pima County.