Barriers to Health Care Access among Refugee Asylum Seekers

Abstract

Significant inter-related barriers exist at the individual, provider, and system levels. Strategies to improve access include targeting social programs and mental health services, expanding Medicaid eligibility/enrollment, promoting community-based organizations, enforcing the use of trained medical interpreters, and improving cultural competency.

The physical health status, service utilisation and barriers to accessing care for asylum seekers residing in the community: a systematic review of the literature

“…8,49,55,56 Aside from consultation fees, there appear to be other costs that serve as barriers, including the cost of transportation to appointments, difficulties paying for pharmaceuticals and other health-related expenses, 8 …”

“…The participants in the majority of the studies found navigating the healthcare system to be problematic due to inadequate knowledge of the availability of, and their eligibility for, health services. 49,50,[52][53][54][55][56] Problems cited were a lack of provision of health service information on arrival in the country, poor understanding of the concept of primary healthcare and referral pathways, and logistical difficulties in accessing a service. Social and community supports were seen as integral for providing information and resources to facilitate service access.…”

“…Social and community supports were seen as integral for providing information and resources to facilitate service access. 49,51,52 Perceived effectiveness and quality of health services Participants complained of long waiting times for all types of services and a lack of continuity of care, which served as deterrents for future help-seeking. 49,50,53,54 Continuity of care was perceived to be a facilitator to service access because it improved asylum seekers' trust and confidence in health professionals.…”

“…They felt that GPs were not specialised enough or did not have sufficient knowledge about refugee health issues to be able to provide adequate care. 49,53,54 …”

“…This appeared to be linked to the perception that the immigration and health systems were interconnected, and that their health information, lack of documentation or inability to pay would have an effect on the asylum process, or increase their risk of deportation or detention. 49 The participants of other studies expressed issues of trust relating to the presence of interpreters during consultations, as they could not be assured of the accuracy and quality of translation and whether confidentiality was upheld. 50,51,53,54 Discrimination and health professionals' attitudes Themes of discrimination were highlighted in multiple qualitative studies.…”