Post-Arrival Health Assessment (PAHA)
As a primary care provider, especially physicians/family doctors, your first point of contact with a refugee or refugee family will be within the scope of a Post-Arrival Health Assessment (PAHA). The assessment is expected to take longer than a regular patient-doctor visit, as it will be the first time you will be meeting with your new patients, and it is likely you might be meeting with an entire refugee family. In addition, the PAHA can take place over several visits, as there are several items that should be covered.
For a more detailed look at recommendations for the PAHA, visit the CCIRH’s website: Evidence-Based Preventative Care Checklist For New Immigrants and Refugees.
(Please note that KFL&A Public Health will be involved with any newcomer to Canada with a history of active TB infection or an abnormal chest X-ray suggestive of TB as part of mandatory post-immigration surveillance within seven or 30 days of entering Canada. Completion of this medical surveillance is required by Citizenship and Immigration Canada for Canadian citizenship. Please contact KFL&A Public Health at 613-549-1232 or 1-800-267-7875 with any questions.)
Some important things that should be covered during the PAHA are the following:
- Making introductions between refugee patients and physicians; often translators/translation services might be required
- Explaining how the physician’s office and booking of appointments works
- Working through and addressing any cultural differences in health care about which the refugee patients might be concerned
- Advising newcomers briefly about the Canadian health-care system, expectations regarding appointments and patient-doctor confidentiality
- Addressing urgent health-care issues and a standard physical
- baseline blood tests (e.g.: complete blood count, serology for Hep B and C, etc.)
- age-based preventative screening
- vital signs, growth of children and targeted examination based on complaints
- identifying any allergies
- Walking through the patient’s complete medical and surgical history
- it can be difficult, as most refugees will likely NOT have past medical records
- interview patient(s) to discover any neglected diseases, injuries, disabilities, pregnancies, visual/hearing impairments, etc.
- Discussing restart of previously discontinued medications (finding appropriate substitutions if original medication is not available in Canada)
- Booking for more specific appointments (e.g., female-specific session for a PAP smear) and referrals to specialists, if needed
- Addressing need of immunization and setting up appointments to go through immunization records/begin vaccination schedule