Health Needs Assessment of Children and Young Adults Seeking Asylum in Berlin, Germany

Background: Recently, unprecedented numbers of refugees have arrived in Europe, many of them being children and young adults. Government institutions, non-governmental and civil organisations are striving to provide shelter and medical care, but little is known about the migrants’ own views of their health needs.

Methods: A pre-validated survey instrument was converted to a mobile application for tablet computers and used to interview refugee children and adolescents arriving at the campus of the Regional Office for Health and Social Affairs in Berlin, Germany, between 7 October, 2015 and 15 March 2016. The health survey covers questions about migration and displacement, schooling, and self-reported health status. Participation in the survey was voluntary, anonymous and confidential.

Results: Data were obtained for 405 children and young adults (median age 19 years, range: 1-24 years), of whom 80.7% were male. The majority had come from Syria (62.5%), Afghanistan (9.1%) and Iraq (8.2%); overall, 55% reported having no family in Germany.; 53% had seen doctor since arrival, 64% reported being registered asylum seekers in Germany, allowing basic access to healthcare. Cold and respiratory symptoms were common (37.5 and 13.6%), followed by pain (26.7%) gastrointestinal (12.4%) and skin problems (11.1%). Underlying conditions were reported in 15.6% (predominantly asthma) with worsening of the condition during and after migration in 46 and 36%, respectively. The majority (73%) reported being up-to date on immunisations according to recommendations in the home country, but only 22% held a vaccination record, in 46.4% it was lost during migration. Top self-reported priorities were education (33%), followed by housing (19%) and health (16%).

Conclusion: Health appears to be one of the top priorities in this population. Access to basic healthcare, immunisations and medicines for chronic conditions will be key. The loss of immunisation records in a majority of refugee youth should trigger coordinated programs for catch-up immunisations and standardised documentation.