Objectives: To document the health needs of refugee children accessing comprehensive refugee health services in New South Wales (NSW), to match needs with available services and establish gaps in services. Methods: We collated clinical data on all children aged under 14 years attending the three refugee specific clinics seeing children in NSW in 2005. We compared these data to the number of refugee children settling in NSW in 2005. Results: NSW received 1,557 refugee children (<14 years) in 2005. Around one in five (n=331) was seen in a refugee specific clinic. Most were asymptomatic. Of those tested, 25% had anaemia, 27% were serology positive for schistosomiasis, 16% had evidence of current or recent malaria, 25% were tuberculin skin test positive, 69% were hepatitis B non-immune and 20% had low vitamin D levels. Most children needed catch up immunisation. Other problems included chronic health, developmental and behavioural problems. Screening tests varied across sites. Follow up was problematic for most. Conclusions: A small proportion of refugee children arriving in NSW have access to comprehensive screening and assessment, in spite of significant health needs. There is variation in screening practices, and follow up is poor. There is a high pick up rate for diseases of personal and public health significance. Implications: There is a strong moral and public health imperative to provide appropriately resourced, culturally competent and comprehensive health care to optimise refugee children's wellbeing. © 2009 The Authors.

Comprehensive health assessments Screening Refugee health Health needs of refugee children

refugee Australia mass screening health disparity Health Status Disparities human wellbeing Refugees statistics and numerical data health service Malaria comparative study Health Services Needs and Demand school child migrant anemia Humans Adolescent Infant, Newborn male Emigrants and Immigrants female preschool child Infant Child, Preschool newborn Child Welfare New South Wales vitamin D deficiency Article organization and management major clinical study tuberculin test schistosomiasis health care access child health care Health Services Accessibility Delivery of Health Care immunization health care availability health care need health care delivery Child