Care of refugee children and adolescents with chronic diseases and disabilities Entitlement and possibilities in Germany

Refugee children and adolescents with chronic diseases and disabilities are among the most vulnerable persons as their health and developmental chances are considerably at risk. This article describes the challenges and opportunities in the care of this group of patients from the perspective of different care sectors: initial reception center, public health service, pediatricians in private practice, social pediatric centers and patient organizations. The starting point is a presentation of the rights to optimal healthcare that can be derived from the United Nations (UN) Convention on the Rights of Persons with Disabilities and the UN Convention on the Rights of the Child. It becomes clear that for children and adolescents in the status of asylum seekers there are systematic gaps in the recognition and care of chronic diseases, disabilities and support needs. An expansion of the health examination after arrival, which has so far focused on the detection of communicable diseases, is important and necessary in order to identify individual needs and improve the data situation for this group. A strengthening of the school entry screening by the public health service, especially for older children entering school as lateral entrants, could also significantly improve the nationwide coverage. In contrast to these deficits, which require changes at the political level, there are innovative models of care, especially in local contexts, such as pediatric consultation clinics in initial reception centers, diverse examples of voluntary commitment or the use of social media in patient organizations, which are presented as examples.