Sri Lankan-born women who have given birth in Victoria: a survey of their primary postpartum health-care needs Irosha Nilaweera A,B,D , Heather Rowe A , Hau Nguyen A , Joanna Burns A , Frances Doran C and Jane Fisher A A Jean Hailes Research Unit, School of Public Health and Preventive Medicine, Monash University, Ground Floor, 89 Commercial Road, Prahran, Melbourne, Vic. 3004, Australia. B Ministry of Health, Sri Lanka, 385, Reverend Baddegama Wimalawansa Thero Mawatha, Colombo 10, Sri Lanka. C School of Health and Human Sciences, Southern Cross University, PO Box 157, Lismore, NSW 2480, Australia. D Corresponding author. Email: irosha.nilaweera@monash.edu Abstract. Women who migrate are vulnerable after giving birth. Normal postpartum adaptive challenges are heightened by separation from family and lack of familiarity with local services. The aim was to investigate primary care needs among Sri Lankan-born women with at least one Victorian-born child aged under 2 years. Health care, information and support needs and unmet needs were assessed in a structured Sinhala or English survey offered in print, online or by telephone. Fifty women provided data. Most (80%) had at least one relative from Sri Lanka to stay for postpartum support. Despite this, many had difficulties settling (62%), feeding (58%) and soothing (42%) their babies. They used significantly fewer health services on average (2.3) than mothers in the general community (2.8) (P < 0.004). Only 32% of primiparous women attended at least one First-Time Parents’ group session. Of women experiencing infant care difficulties, only two-thirds accessed care from a Maternal and Child Health Nurse and only one-third from a General Practitioner. Sri Lankan-born mothers have significant unmet needs for primary care, which are not reduced by informal support. A two-pronged approach is indicated in which women are informed about primary care availability, and the cultural competence and client friendliness of services is strengthened. Additional keywords: Australia, postpartum primary care, Sri Lankan-born mothers. Received 16 January 2014, accepted 3 November 2014, published online 23 February 2015 Background Women face the significant adaptive challenges of acquiring infant care skills and adjusting to changed roles, responsibilities and workload after giving birth. Vulnerability to physical and psychological morbidities, which can have flow-on consequences for the mother–infant relationship, is increased in the postpartum year (Agampodi et al. 2011). Primary care and support can increase confidence in infant care and strengthen mother–infant relationships (McCallum et al. 2011). Migration of Sri Lankans to Australia has increased in recent years. In 2011, there were ~90 000 Sri Lankan-born Australian residents, constituting 1.6% of the overseas-born and 0.5% of the general population. Sri Lanka is a multi-ethnic country with 75% Sinhalese, 11.2% Sri Lankan Tamil, 9.2% Moor and 4.2% Indian Tamil people (Department of Census and Statistics Sri Lanka 2009). In the 2011 Australian Census, ethnicity or heritage was not ascertained, but in the 2006 Australian Census, the top three ethnicities that Sri Lanka-born people identified were: Sinhalese (69.5%), Tamil (8%) and English (5.3%). More of them live in Victoria than in other Australian states (Australian Government: Department of Immigration and Border Protection 2013). There is no single data source from which subgroups of the Sri Lankan population in the community can be identified. However, in 2012–13, nearly 6000 permanent residence visas were granted to more than 8000 applicants for asylum, and more than 20 000 Sri Lankans were given temporary visitor visas for Australia. All Australian citizens have access to health care under the national Medicare scheme and ~40% also hold private health insurance, which permits access to private hospital treatment. All women with babies and young children are entitled to community-based primary Maternal and Child Health (MCH) care and to medical care from a general practitioner (GP). Standard Maternal and Child Health care comprises 10 fee-free consultations to review a child’s health, growth and development between birth and 3.5 years (the Key Ages and Stages assessments). These include: the first Maternal and Child Health nurse (MCHN) visit, which is usually completed at home and consultations at 2, 4 and 8 weeks, and 4, 8 and 12 months of age. New parent groups are run by MCHNs to help first-time parents adjust to early parenting and build local social connections. Journal compilation Ó La Trobe University 2016 www.publish.csiro.au/journals/py CSIRO PUBLISHING Australian Journal of Primary Health, 2016, 22, 133–139 Research http://dx.doi.org/10.1071/PY14067