Access to Primary Health Care for Asylum Seekers and Refugees: An Umbrella Review of Key Factors

Abstract

BACKGROUND: In 2019, 79.5 million individuals were forcibly displaced, with 38.8 million seeking refuge beyond their home countries. Access to healthcare is a fundamental human right and a priority for the United Nations High Commissioner for Refugees (UNHCR), as outlined in the 1951 Refugee Convention. This umbrella review identifies evidence reporting barriers and facilitators to Primary Health Care (PHC) access for asylum seekers and refugees. METHODS: A comprehensive search of previously published systematic reviews focusing on refugee and asylum seeker populations in primary or community health care settings from 2012 to 2025 was conducted on February 27, 2025. Ten databases were searched [ xxxx - add names of some if wording permits]. Exclusion criteria included primary studies, non-systematic reviews, hospital or tertiary care-based studies, and gray literature. RESULTS: Out of 404 records screened by title and abstract, 95 full-text articles were assessed, and 18 systematic reviews met the inclusion criteria. Of these, 83.3% (15/18) were conducted in high-income countries. Reported regions of origin for asylum seekers and refugees included South and Southeast Asia, Africa, the Middle East, and South America. 27.8% (5/18) reviews focused exclusively on women; 72.2% (13/18) assessed access to physical healthcare (preventive, maternal, dental, cancer, medication, pharmacy services), and 27.8% (5/18) assessed access to mental healthcare. No reviews focused exclusively on children or reported barriers and facilitators to vaccinations. CONCLUSIONS: Preliminary findings highlight evidence gaps in PHC access for asylum seeker and refugee children and women, particularly regarding communicable disease prevention and mental health. Future research can identify evidence-based practices to reduce health disparities and improve PHC access for marginalized populations, aligning with UNHCR priorities.