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Improving Health Outcomes for Pacific Island Seasonal Workers in Regional Queensland

Forest of banana trees with bunches of green bananas
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As the number of seasonal workers from the Pacific Islands continues to grow in Australia, understanding how health systems can better meet the needs of this population is key to ensuring universal access to health services

  • Gaps exist in access to and utilisation of health services in Australia for Pacific Islander seasonal workers
  • A lack of universal health coverage, policy gaps, geographic location, under-resourced regional and rural health services and limited cultural healthcare resources pose barriers for seasonal workers to access care
  • Targeted interventions, culturally appropriate in-language health resources, and universal health coverage for seasonal workers are required for a more equitable health system, to ensure health needs are met
  • Our study aims to offer valuable insights for informing migration policy and healthcare program design for seasonal workers in Australia. 

About the project

This project aims to identify opportunities for improving Blood blood-borne virus (BBV) and sexual health care in the areas of public health policy, health system and service delivery and clinical health care for Pacific Australia Labour Mobility (PALM) workers in regional Queensland. This study is examining the experiences (including barriers and enablers) of both PALM workers access and health care providers provision of care for BBVs and sexual health in regional Queensland. 

Anthon Wasang smiling at the camera as they hold secateurs and wear a hat in an orchard
Image Source: PALM Scheme Website

Project update

This project is being conducted in 4 phases:

  1. PALM workers and care and service providers have been interviewed to understand experiences of accessing and providing care and to identify barriers and enablers to BBV and sexual health services in regional Queensland (completed).
  2. A survey will be conducted with both PALM workers and service providers based on the interview results in Phase 1. 
  3. A cost-benefit analysis for a hepatitis B intervention will be performed using Markov mathematical simulations.
  4. Convergence of data with key stakeholders will be conducted to develop a model of care that is tailored to the specific needs of PALM workers.

What we are learning

Significant challenges exist for PALM workers in accessing blood-borne virus and sexual health services

The Invisibility of Hepatitis B: Due to a lack of routine testing in PALM workers' home countries and Australia, there is often an unknown diagnosis of hepatitis B, making it difficult for clinicians to provide prevention, care and treatment.

System-level barriers and enablers: Immigration policy, inequitable healthcare resource distribution, out-of-pocket healthcare costs associated with private health insurance and Medicare ineligibility, alongside casual employment conditions are some of the main system-level drivers impacting access to BBV and sexual health services for PALM workers.

Public Health Policy Gaps: Despite acknowledging challenges for temporary visa holders, both Commonwealth and State public health BBV policies lack specific provisions for seasonal workers as a priority population group, which conflicts with principles of equity and universal health coverage.

Regional challenges: Due to the nature of seasonal work predominantly being in the horticultural sector, most PALM workers live and work in regional areas. Regional health services in Australia face challenges such as geographic isolation and the need for private transport, alongside a lack of GP and specialist health clinicians and services. 

Cultural challenges: Regional health services that provide care for the majority of PALM workers in Australia have not been appropriately resourced to provide culturally appropriate care to the growing population of seasonal workers from Pacific Island Countries and Territories. 

The goodwill of employers and health service providers: access to healthcare for PALM workers is often reliant on effective relationships developed inside and outside of the health system, alongside employers and health staff taking initiative and advocating for improved access to care.

Addressing these gaps is crucial for health equity and inclusive health systems.

Next steps

Phase 2 is currently underway, surveying both PALM workers and service providers.

Outputs

Presentations

Research publications

The Team

Dr Haylee Fox is a postdoctoral health system, services and policy researcher whose work has predominantly been in sexual and reproductive health, with a focus on improving access and quality of care for underserved population groups in Australia.

View Haylee's Profile.

Dr Robyn Preston (CQUniversity) is a social scientist and public health researcher. She is interested in health and community workforce issues in remote and rural communities and developing innovative models of care through health and community partnerships.

View Robyn's Profile.

Dr Geraldine Vaughan is a public health researcher and educator with a particular focus on improving health access and systems through an equity lens - particularly women's health and communicable diseases.

View Geraldine's Profile.

Dr Gary Jones is a researcher with global experience working in the field of migrant workers’ health and livelihoods, including in the South Pacific.

View Gary's Profile.

A/Professor Cathy O’Mullan is a public health researcher whose research program works through a health equity lens and uses participatory and community-based research approaches to address a range of contemporary public health issues, notably ‘Healthy and Safe Sexual Experiences’. A key theme in her work is amplifying the voices of marginalised or vulnerable communities.

View Cathy's Profile.

Professor Chris Doran is a Professor of Health Economics and leads the Cluster for Resilience and Wellbeing at Central Queensland University. Professor Doran is co-supervising PhD student Isaac Livai who is undertaking the projects economics analysis.

View Chris' Profile.

Prof Janya McCalman co-leads the Jawun Research Centre at CQUniversity. With a strong background in public health and infectious diseases, she has extensive experience working collaboratively with diverse communities and health service partners. Her research emphasises participatory approaches and the implementation of quality improvement strategies. Prof McCalman has been working with partner organisations in various regions to develop, implement, and evaluate intersectoral strategies to enhance the wellbeing of underserved populations.

View Janya's Profile.

Billingsley Kaambwa is an associate professor in health economics whose research focuses on economic evaluations of healthcare technologies. A/Prof Kaambwa is co-supervising PhD student Isaac Livai who is undertaking the projects economics analysis.

View Billingsley's Profile.

Isaac has over two decades of experience as a General Practitioner in Papua New Guinea. Isaac is a PhD candidate on this project, with his research focusing on the cost and benefit of chronic hepatitis b management in PALM scheme seasonal workers in Queensland.

Stakeholders and External Relationships

The project is guided by a steering committee and external stakeholders from the following organisations:

Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine (ASHM)

Hepatitis Queensland

Brisbane South Primary Health Network

Refugee Health Network Queensland

Ethnic Communities Council of Queensland (ECCQ)

Current grants

This project is funded by the Commonwealth Department of Health and Aged Care through their Blood Borne Viruses and Sexually Transmissible Infections Research Program (Grant ID 4-H3C9CZ2)

Contact Us

If you would like to learn more about our research, or if you are a seasonal worker or care provider interested in contributing to our project, please contact us.

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