on behalf of all DHBs
.
Public Health Handbook (2003) Amendments: inserted into standard service specification template updating
Handbook content, added Purchase Unit tables, service linkages and quality requirements, linked to tier one Public Health
Services and tier two Social Environments and Health promoting
Schools service specifications.


Within three years
Note : Contact the Service Specification Programme Manager, National Health Board Business Unit,
Ministry of Health to discuss the process and guidance available in developing new or updating and revising existing service specifications. Web site address of the Nationwide Service Framework
Library: http://www.nsfl.health.govt.nz/.
Services Social Environments and Health Promoting Schools Refugees and Migrant Health Services Public
Health Services tier three service specification. February 2010.
Nationwide Service framework
1

SOCIAL ENVIRONMENTS AND HEALTH PROMOTING SCHOOLS -
REFUGEES AND MIGRANT HEALTH PROGRAMME
PUBLIC HEALTH SERVICES
TIER LEVELTHREE
SERVICE SPECIFICATION
This tier three service specification for Social Environments and Health Promoting Schools -
Refugee and Migrant Health Programme (the Service) must be used with the overarching tier one Public Health Service specification and the tier two Social Environments and Health
Promoting Schools service specifications.
Refer to the Public Health tier one service specification under the following headings for generic details on:

Service Objectives

Service Users

Access

Service Components

Service Linkages

Exclusions

Quality Requirements

Regulatory
The above heading sections are applicable to all service delivery.
1. Service Definition
The Refugees and Migrant Health Programme includes:
 improving health for refugee and migrant populations, in particularly screening for treatable disease an avoiding unnecessary emergency department visits and hospital admissions.
 protection of the New Zealand public from communicable disease borne by migrants e.g.
Tuberculosis (TB)
2. Service Objectives
The Service objectives are to:
 improve, promote and protect the health of refugees, asylum seekers and their families, and the wider community.
 assess both public and personal health and health service needs, health screening, follow-up and referral, including health promotion for Refugee and Asylum Seeker health.
 ensure a continuum of car approach is delivered, e.g. screening, through primary care and promoting health reducing avoidable emergency department presentations and hospitalisations.
Services Social Environments and Health Promoting Schools Refugees and Migrant Health Services Public
Health Services tier three service specification. February 2010.
Nationwide Service framework
2

2.1 M āori Health
Refer to the tier one Public Health Services service specification.
3. Service Users
Service users for this service specification are:

recent migrant and refugee arrivals to New Zealand as part of the United Nations High
Commissioner for Refugees (UNHCR) mandated quota system, New Zealand Immigration
Service (NZIS) humanitarian migrant intake or family reunification programme

asylum seekers (spontaneous refugees) and as identified in the Eligibility criteria (see www.moh.govt.nz,)
4. Access
Public Health Communicable Disease Services will be provided throughout New Zealand.
Access to the Service will be managed ethically and equitably such that priority is based on acuteness of need and capacity to benefit.
5. Service Components
Refugees and Migrant Health
Components of
Service
Service Descriptions/Activities
1. Assess Health and
Health Service
Needs (Public And
Personal Health)
1. Assess health and health service needs of refugees, asylum seekers and their families, for example, by using research information, conducting surveys, reviewing surveillance information, assessing the adequacy of existing and new services for meeting the needs of refugees and asylum seekers
(e.g. availability of trained interpreters).
2. Use assessments to plan services.
2 Health Screening,
Follow-Up, Referral
(Public and
Personal Health)
1. Health screening, referral and follow-up for refugees, asylum seekers and their families to level similar to the Mangere
Refugee Resettlement Centre clinic.
2. Public health follow-up, including contact tracing, assistance with
Directly Observed Therapy (DOT), Laboratory tests.
3. Health Promotion
(Public and
Personal Health)
1. Develop health promotion programmes for refugees, based on assessed needs. Topics could include:

Tuberculosis, HIV/AIDS and other infectious diseases

Nutrition

Cervical and breast screening

Diabetes

Mental health
 Women’s health

Child health

Oral health
3 Services Social Environments and Health Promoting Schools Refugees and Migrant Health Services Public
Health Services tier three service specification. February 2010.
Nationwide Service framework

Components of
Service
Service Descriptions/Activities

Vision and hearing.
2. Work with refugee communities to improve access to social and economic resources to influence their overall health status.
Service Provider Nature of
Linkage

Refugee and ethnic community associations

Immigration New Zealand (INZ)

Mangere Refugee Resettlement Centre (MRRC)

Refugee Migrant Service (RMS)

Refugees As Survivors (RAS)

Refugee Resettlement Support (RRS)

Refugee Council of New Zealand

Refugee Health Education Programme

Refugee Health Co-ordinators

Refugee Community Health Workers

NZ AIDS Foundation (NZAF) and Community
AIDS Resource Team (CART)

Sexual Health Clinics

Education Sector (Ministry of Education Refugee
Education Unit)

District Health Board Personal and Public Health
Services

Community, Child and Family Health services

Needs Assessment Services and Disability
Support services

Well Child/Tamariki Ora services

Regional Dental services
 Well Women’s Nursing Service (WONS)

Lead maternity carers (LMCs)

Primary Care Sector (including Union and
Peoples health centres)

Community Mental Health services

Social services provided by City missions and the Salvation Army

English As A Second Language (ESOL)
Courses and Co-ordinators

City Councils

Work and Income

Child Youth and Family Service (CYF)

Other relevant organisations and community groups, as necessary.
Facilitate Service access and participation
Accountabilities
Liaise with local communities to ensure culturally appropriateness and accessibility to services.
Services Social Environments and Health Promoting Schools Refugees and Migrant Health Services Public
Health Services tier three service specification. February 2010.
Nationwide Service framework
4

7. Exclusions
Refer to the tier one Public Health Services service specification.
8. Quality Requirements
The Service must comply with the Provider Quality Standards described in the Operational
Policy Framework or, as applicable, Crown Funding Agreement Variations, contracts or service level agreements.
9. Purchase Units and Reporting Requirements
Purchase Units are defined in the joi nt DHB and Ministry’s Nationwide Service Framework
Purchase Unit Data Dictionary. The following Purchase Units apply to this Service:
PU Code PU
Description
RM00101 Communicable
Disease
PU Definition
Communicable disease control, communicable disease surveillance and imported diseases control;
Immunisation promotion;
Refugees and asylum seekers;
Needle exchange programme.
PU
Measure
Service
PU Measure
Definition
Service purchased in a block arrangement uniquely agreed at a local level.
National collections or payment systems
As per National
Non-admitted
Patient
Collection
(NNPAC) –
Optional
Where reporting requirements are not part of National Collections list the data elements required to be reported and frequency of reporting by the service provider, and requirements regarding frequency of reporting.
The Service must comply with the requirements of national data collections where available.
10. Service Planning Information
1. Migrants face social and educational barriers to health and health services, including language and literacy barriers, cultural differences, discrimination, isolation, and unemployment.
2. Migrants coming to New Zealand may have a range of physical, mental and social health problems. Areas where public health interventions can be beneficial include:






 lack of information about accessing the health system in New Zealand communicable diseases, such as tuberculosis, schistosomiasis, HIV/AIDS, viral hepatitis low immunisation uptake rates or incomplete immunisation mental health, including post-traumatic stress disorders and adjustment difficulties nutritional status disabilities women’s health
5 Services Social Environments and Health Promoting Schools Refugees and Migrant Health Services Public
Health Services tier three service specification. February 2010.
Nationwide Service framework


 child health oral health.
3. Health screening services for refugees, asylum seekers, and their families coming to
New Zealand under Family Reunification should be of a similar extent to that provided by the Mangere Refugee Resettlement Centre (MRRC) for Quota Refugees.
4. Migrants coming from other countries or situations where there is a high risk of communicable and other diseases may also need increased levels of service during the initial period of residence.
Services Social Environments and Health Promoting Schools Refugees and Migrant Health Services Public
Health Services tier three service specification. February 2010.
Nationwide Service framework
6

Appendix One References for Refugees and Migrant Health


Ministry of Health. 2001. Refugee Health Care: A Handbook for Health Professionals.
Wellington: Ministry of Health.
Ministry of Health, 2003. Achieving Health for All People: Whakatutuki te oranga hauora mo nga tangata katoa . A framework for public health action for the New
Zealand Health Strategy
Services Social Environments and Health Promoting Schools Refugees and Migrant Health Services Public
Health Services tier three service specification. February 2010.
Nationwide Service framework
7