259 Continuity of care for forcibly displaced persons with chronic diseases: a conceptual framework for research, analysis, and action

Abstract OP 30: Refugees and Asylum Seekers 5, B308 (FCSH), September 4, 2025, 16:00 - 17:12 Aim Forcibly displaced persons with chronic diseases face challenges in maintaining continuity of care due to instability, mobility, and systemic barriers across different phases of displacement. We present a conceptual framework that visually maps the interrelated factors influencing care continuity, providing a structured approach for future research, analysis, and action. Methods We draw on a Delphi-exercise analysis of cross-cutting findings from the CONTINUITY project, a multi-country study exploring continuity of care among forcibly displaced persons living with diabetes and/or hypertension in Uganda and South Sudan. Five primary researchers presented findings from different research contexts in a workshop, which were iteratively discussed by the research team (n = 10). This resulted in a synthesis of key spheres of influence to be included in the framework. Results The framework identifies three critical and interdependent dimensions of continuity of care. First, clinical management, which involves engagement with health services along the care cascade, including diagnosis, treatment, follow-up, and disease control; second, medication adherence, ensuring consistent access to and use of treatments, including both biomedical and traditional herbal medicines; and three, a strict diet and healthy lifestyle, essential for disease management. Multiple factors shape the ability of forcibly displaced persons to maintain continuity of care, including individual and host country characteristics, the disease context, socio-cultural influences, community support structures, and the quality of the health system. The framework also highlights mobility and the different phases of displacement—flight, arrival, settlement, and ongoing back and forth movements – as mediators or disruptors of continuity of care. Conclusions The framework provides a comprehensive tool for analysing both barriers and facilitators to care continuity. It can be used to identify opportunities for refugee/health policy reforms and multi-level, community-driven interventions to create health-enabling environments that support continuity of care among forcibly displaced persons living with chronic diseases.