Improving primary health care quality for refugees and asylum seekers: A systematic review of interventional approaches

Abstract

Background It has been widely acknowledged that refugees are at risk of poorer health outcomes, spanning mental health and general well‐being. A common point of access to health care for the migrant population is via the primary health care network in the country of resettlement. This review aims to synthesize the evidence of primary health care interventions to improve the quality of health care provided to refugees and asylum seekers. Methods A systematic review was undertaken, and 55 articles were included in the final review. The Preferred Reporting Items for Systematic Reviews was used to guide the reporting of the review, and articles were managed using a reference‐management software (Covidence). The findings were analysed using a narrative empirical synthesis. A quality assessment was conducted for all the studies included. Results The interventions within the broad primary care setting could be organized into four categories, that is, those that focused on developing the skills of individual refugees/asylum seekers and their families; skills of primary health care workers; system and/or service integration models and structures; and lastly, interventions enhancing communication services. Promoting effective health care delivery for refugees, asylum seekers and their families is a complex challenge faced by primary care professionals, the patients themselves and the communication between them. Conclusion This review highlights the innovative interventions in primary care promoting refugee health. Primary care interventions mostly focused on upskilling doctors, with a paucity of research exploring the involvement of other health care members. Further research can explore the involvement of interprofessional team members in providing effective refugee/migrant health. Patient or Public Contribution Patient and public involvement was explored in terms of interventions designed to improve health care delivery for the humanitarian migrant population, that is, specifically refugees and asylum seekers.

Covid-19 case management in a Greek migrant camp: The Hellenic Red Cross Mobile Health Unit intervention in Nea Malakasa temporary accommodation center

“…The challenging nature of such an approach entailed synergy from the various actors operating in the field: Red Cross and HRCMU offered medical services and personnel, NPHO provided technical expertise, while IOM and MMA resolved administrative and logistic issues. Collaboration and engagement of local and international actors has always been the cornerstone of successful healthcare interventions within the humanitarian context, ( Abbas et al, 2018 , Iqbal et al, 2022 ) thus the response described in our study could be considered as rather efficient, though it exhibited several limitations: Spatial subdivision for isolation of infectious individuals or even permanent abolition of R&M camps and relocation of their population are responses that have been proposed by researchers for the mitigation of Covid-19 spread within closed structures ( Gilman et al, 2020 , McKenzie and Mishori, 2020 ) but could not be implemented due to the center's poor layout as well as major logistical and administrative barriers. In addition, the lack of NPHO specific Covid-19 case management guidelines for migrant camps/accommodation centers during the pandemic, led to the use by HRCMU of guidelines that were addressed mostly to urban public primary care providers and which may not have been suitable for resource limited settings, although adjustments and modifications were attempted by the medical team on site.…”

The Impact of Global Health Disparities on Atopic Dermatitis in Displaced Populations: Narrowing the Health Equity Gap for Patients with Skin of Color

“…Access to healthcare is a significant issue within displaced populations. Difficulty navigating foreign healthcare systems, limited financial and transportation-related resources, and communication barriers are ways in which displaced people receive decreased quality of care [74,75]. Dermatologic care may be even more difficult to access for this population.…”

‘Corona is coming’: COVID‐19 vaccination perspectives and experiences amongst Culturally and Linguistically Diverse West Australians

“…Scholars and commentators recognize that even within high‐income countries, pockets of populations are at risk of being left behind in the globally inequitable COVID‐19 vaccine rollout 1 . Culturally and Linguistically Diverse (CALD) populations, which include refugees and migrants, are at particular risk due to inaccessible or suboptimal healthcare experiences, which may compound attitudinal factors, including vaccine hesitancy 2,3 . Unique local factors can also create barriers: in the case of Western Australia (WA), almost nonexistent levels of community transmission of COVID‐19 led some locals to ‘wait awhile’ before being vaccinated as state borders remained closed throughout 2021 4 .…”

“… 1 Culturally and Linguistically Diverse (CALD) populations, which include refugees and migrants, are at particular risk due to inaccessible or suboptimal healthcare experiences, which may compound attitudinal factors, including vaccine hesitancy. 2 , 3 Unique local factors can also create barriers: in the case of Western Australia (WA), almost nonexistent levels of community transmission of COVID‐19 led some locals to ‘wait awhile’ before being vaccinated as state borders remained closed throughout 2021. 4 Meanwhile, earlier large outbreaks in other Australian states disproportionately affected CALD communities, with significantly higher morbidity and mortality.…”