Challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries: a systematic review and thematic synthesis of qualitative research

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Twenty-six articles were included in a thematic analysis of challenges and facilitators for healthcare professionals providing primary healthcare for refugees and asylum-seekers in high-income countries. Three analytical constructs (healthcare encounter, healthcare system, and asylum and resettlement) were able to describe various challenges and facilitators.

Primary healthcare providers often encounter difficulties in providing culturally sensitive and effective healthcare for refugees and asylum-seekers in resettled countries. This systematic review aimed to identify challenges and facilitators for healthcare providers through thematically analyzing twenty-six articles involving 357 participants. Three analytical constructs were determined to encompass challenges and facilitators for effective healthcare: healthcare encounter, healthcare system, and asylum and resettlement. Within the context of the healthcare encounter, identified factors included the presence of a trusting relationship, communication, cultural understanding, social conditions, and time of the encounter. On the level of the healthcare system, identified factors included training and guidance, professional support, community services, resourcing, and capacity. Further challenges and facilitators were also associated with factors related to asylum and resettlement, such as policy restrictions, immigration status, and perception of resource abuse. The authors conclude their systematic review with recommendations related to clinical practice as well as health policy.