Health needs assessment is a ‘systematic public health process for identifying the unmet health and care needs of a population, making changes to meet those unmet needs and creating health gain’ 3. In public health ‘need’ is defined as the ‘ability to benefit’4. There were four main approaches used in this needs assessment.
A review of relevant literature was undertaken by searching both published and grey literature. Whilst there is a wealth of literature on migrant health, it is often difficult to disaggregate findings to AS specifically5. The findings from the literature are incorporated alongside the findings of the stakeholder consultation throughout this document.
Epidemiological Data Analysis
Epidemiological data was obtained from Home Office statistics6. Although further data was available from the accommodation provider, Ready Homes (via the SE Migration Partnership), and from local services and voluntary agencies, this was considered sensitive as could potentially disclose information about individuals so was not included in this publicly available report.
Comparative Needs Assessment
A comparative needs assessment approach has also been used to establish models of good practice from elsewhere that could be applied in Southampton and Portsmouth. The “comparative approach” contrasts the services received by the population in one area with those received in other areas7. In order to make the most appropriate comparisons, there has been an attempt to focus primarily on areas considered ‘most similar’ to Southampton and Portsmouth (such as Bristol, Norwich and Plymouth).
Corporate Needs Assessment
This assessment of needs has largely been done through a ‘corporate’ approach which involves collecting the views of stakeholders, including professionals and AS themselves, on what the needs are, what services are available and whether there are any gaps in services4
In order to ascertain which stakeholders to consult, a stakeholder analysis was carried out. This involved drawing up a list of all the people and groups involved with the health and wellbeing of AS and other vulnerable migrants in Southampton and/or Portsmouth. The level of interest and influence of each of the stakeholders was then assessed and mapped onto a chart (see Figure 1).
Figure 1: Stakeholder map
Over 35 face-to-face or telephone meetings were conducted with stakeholders. The conversations were not audio-recorded but substantial notes taken plus written reflections were made immediately after each conversation to assist with the identification of themes. The consultations were an iterative process involving continuous review of notes in order to identify themes as well as to identify additional stakeholders to consult. This report includes the predominant themes identified which were based on majority views.
Stakeholders were asked about the health needs of AS and other vulnerable migrants. They were also asked about the services provided to this population group, about any gaps in services and for their views on potential improvements.
Additionally, four focus groups were conducted with AS. Two were conducted at the Avenue Multi-Cultural Centre in Southampton and two at the All Saints drop-in in Portsmouth. There were separate focus groups for men and women. All focus groups were conducted in English so participants were selected on the basis of being able to understand and speak a reasonably good level of English. The limitation of this in terms of gathering the views of non-English speakers is acknowledged and the findings from the focus groups are considered with this bias in mind.
The focus groups were held in private rooms at each venue and were audio-recorded. Key themes were identified from the discussions but the whole conversation was not transcribed verbatim. Quotes were transcribed from the recordings to illustrate the themes. The audio-recordings were then deleted. Names and other key details of the participants were not recorded so there is no risk of disclosure of participants’ identity. Two facilitators were present at all focus groups and the themes were identified by one of the facilitators and then verified by the other facilitator.