Access to primary healthcare for asylum seekers and refugees: an umbrella review of key factors

Abstract Background In 2019, 79.5 million individuals were forcibly displaced, with 38.8 million seeking refuge beyond their home countries. Access to healthcare is a fundamental human right and a priority for the United Nations High Commissioner for Refugees (UNHCR), as outlined in the 1951 Refugee Convention. This umbrella review identifies evidence reporting barriers and facilitators to Primary Health Care (PHC) access for asylum seekers and refugees. Methods A comprehensive search of systematic reviews on refugee and asylum seekers in primary or community healthcare settings, published from 2013 to 2025, was conducted on February 27, 2025. Databases searched included Academic Search Ultimate, CINAHL, Cochrane Library, LILACS, PsycINFO, PubMed, Scopus, SocINDEX, and Web of Science. Primary studies, non-systematic reviews, hospital or tertiary care settings, and gray literature were excluded. Results Out of 404 records screened by title and abstract, 95 full-text articles were assessed, and 18 systematic reviews met the inclusion criteria. Of these, 83.3% (15/18) were conducted in high-income countries. Reported regions of origin for asylum seekers and refugees included South and Southeast Asia, Africa, the Middle East, and South America. 27.8% (5/18) of reviews focused exclusively on women, 72.2% (13/18) assessed access to physical healthcare (i.e., preventive, maternal, dental, cancer, medication, and pharmacy services), and 27.8% (5/18) assessed access to mental healthcare. No reviews focused exclusively on children, nor did they report barriers and facilitators to vaccinations. Conclusions Preliminary findings highlight evidence gaps in PHC access for asylum seeker and refugee children and women, particularly regarding communicable disease prevention and mental health. Future research can identify evidence-based practices to reduce health disparities and improve PHC access for marginalized populations, aligning with UNHCR priorities Key messages • Access to primary healthcare remains a critical gap for asylum seekers and refugees, especially for women and children, highlighting urgent global health equity needs. • This umbrella review reveals significant evidence gaps in preventive care and mental health access needed to support UNHCR goals and protect displaced populations.