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Cited by 282Migration, Health and TraumaMigration, Racism, and Human RightsMigration, Identity, and Health

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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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Robertshaw, Luke, Dhesi, Surindar, Jones, Laura L·2017·BMJ Open
DOI 10.1136/bmjopen-2017-015981PMC PMC5629684
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Abstract

Objectives: To thematically synthesise primary qualitative studies that explore challenges and facilitators for health professionals providing primary healthcare for refugees and asylum seekers in high-income countries. Design: Systematic review and qualitative thematic synthesis. Methods: Searches of MEDLINE, EMBASE, PsycINFO, CINAHL and Web of Science. Search terms were combined for qualitative research, primary healthcare professionals, refugees and asylum seekers, and were supplemented by searches of reference lists and citations. Study selection was conducted by two researchers using prespecified selection criteria. Data extraction and quality assessment using the Critical Appraisal Skills Programme tool was conducted by the first author. A thematic synthesis was undertaken to develop descriptive themes and analytical constructs. Results: Twenty-six articles reporting on 21 studies and involving 357 participants were included. Eleven descriptive themes were interpreted, embedded within three analytical constructs: healthcare encounter (trusting relationship, communication, cultural understanding, health and social conditions, time); healthcare system (training and guidance, professional support, connecting with other services, organisation, resources and capacity); asylum and resettlement. Challenges and facilitators were described within these themes. Conclusions: A range of challenges and facilitators have been identified for health professionals providing primary healthcare for refugees and asylum seekers that are experienced in the dimensions of the healthcare encounter, the healthcare system and wider asylum and resettlement situation. Comprehensive understanding of these challenges and facilitators is important to shape policy, improve the quality of services and provide more equitable health services for this vulnerable group.

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  • Professionals frequently report feeling unprepared to deal with mental health issues in refugees and asylum seekers due to cultural and language barriers.

    “Studies suggest they frequently report feeling unprepared to deal with mental health issues in refugees and asylum seekers due to factors such as cultural and language barriers [5-7].”

    From A Digital Tool for Culturally Responsive Reflection and Case Conceptualization in First-Line Services to Support Children With a Refugee Background: Development and Usability Study (2026) · cites this paper as [7]

    In Results > The healthcare encounter (page unavailable), the review reports that professionals found psychological conditions challenging and felt they lacked the skills, knowledge and support to meet refugees’ complex psychological needs. The Discussion and Results > Thematic synthesis findings identify language and cultural barriers to care, but do not specifically say those barriers caused professionals to feel unprepared for mental-health issues. (LLM, conf=0.82)

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Metadata

Authors
Robertshaw, L., Dhesi, S., & Jones, L. L.
Affiliations
University of Birmingham (GB)
Corresponding author
Jones, Laura L
ORCID
Venue
BMJ Open
Publisher
BMJ
Published
2017-08
Volume
7
Issue
8
Pages
e015981
ISSN
2044-6055 (ISSN-L)
DOI
10.1136/bmjopen-2017-015981
PMC
PMC5629684
OpenAlex
W2746142087
Cited by
282
References
7
Citations by year
2026: 26 · 2025: 40 · 2024: 28 · 2023: 29 · 2022: 40 · 2021: 39 · 2020: 49 · 2019: 26 · 2018: 4
FWCI
2.87
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMJ Open (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Migration, Health and Trauma
  • Social Sciences › Law › Migration, Racism, and Human Rights
  • Social Sciences › Sociology and Political Science › Migration, Identity, and Health
Keywords
refugees, asylum seekers, primary care, healthcare workers, professional support, cultural understanding, health equity, high-income countries
MeSH terms
Attitude of Health Personnel, Communication Barriers, Health Services Accessibility, Humans, Health Knowledge, Attitudes, Practice, Physician-Patient Relations, Primary Health Care, Refugees, Translating, Qualitative Research

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