A scoping review of global primary healthcare models for refugees and asylum seekers

Abstract

The escalating global refugee crisis necessitates robust primary healthcare (PHC) models to address the complex health needs of displaced populations, who frequently encounter linguistic, legal, and cultural barriers to equitable care. This scoping review synthesizes global evidence on PHC service delivery models for refugees and asylum seekers to identify core structural elements, implementation strategies, and factors influencing their effectiveness. Guided by the Arksey and O’Malley framework and PRISMA-ScR guidelines, we systematically searched PubMed, Web of Science, Scopus, ProQuest, and Google Scholar for literature published between 2014 and 2024. Study selection and data extraction utilized the Population–Concept–Context (PCC) framework, followed by thematic analysis using NVivo 15 and methodological quality appraisal of included primary studies via Joanna Briggs Institute (JBI) checklists. From 2,087 retrieved records, 32 studies spanning 15 countries met the inclusion criteria. Thematic analysis revealed eight key areas: access barriers, provider roles, system reforms, refugee-specific needs, service delivery challenges, policy constraints, evaluation mechanisms, and technological interventions. While integrated care, cultural mediation, and digital health innovations demonstrate substantial promise, persistent challenges including language barriers, restrictive legal entitlements, and weak evaluation frameworks continue to impede effective service delivery. Notably, high-income countries primarily face bureaucratic and sociocultural obstacles, whereas low- and middle-income countries contend with severe resource limitations and reliance on non-governmental organizations. Ultimately, strengthening health system integration, building workforce capacity, and establishing standardized evaluation metrics are essential. The proposed Refugee-Integrated PHC Model offers a context-responsive pathway toward equitable, sustainable primary healthcare.