Health literacy as a determinant of healthcare access in refugees: a systematic review

Abstract Background Refugees and asylum seekers often face unique challenges in navigating healthcare systems, including potential gaps in health literacy. Health literacy - the ability to access, understand, appraise, and apply health information - is a critical determinant of healthcare access and health outcomes. Methods This systematic review utilized the PRISMA 2020 framework for structured data collection from PubMed, Scopus, and EBSCOhost databases, synthesizing peer-reviewed studies that assessed health literacy among refugee and asylum-seeking populations using standardized measures to examine how it impacts access to healthcare. Following a systematic selection procedure, 9 studies met inclusion criteria, representing refugees/asylum seekers from diverse regions (Europe, North America, Middle East). Results This review identified a consistent pattern of limited health literacy among refugees/asylum seekers Individuals with lower health literacy are more likely to have reduced use of healthcare services, face greater challenges in communicating with health care providers, and generally report worse health outcomes. Conclusions The findings underscore the necessity to promote equitable healthcare access for refugees and asylum seekers, through targeted health literacy interventions that are culturally and linguistically tailored to improve access to healthcare and relevant outcomes for refugees. This review contributes to the growing body of evidence that supports enhancing health literacy as a pivotal factor in mitigating health disparities among displaced populations. Key messages • Limited health literacy hinders healthcare access for refugees/asylum seekers. Targeted, culturally tailored interventions are essential to reduce disparities and improve health outcomes. • Refugees with low health literacy face care barriers and poorer outcomes. Tailored education is key to improving healthcare access and equity for these vulnerable, displaced populations.