Exploring the perspectives of professionals involved in refugee and asylum seekers’ reception and integration on access and utilization of healthcare: a qualitative study

In recent years, the number of displaced persons due to conflict, persecution, and environmental crises has significantly increased, leading to a large influx of refugees and asylum seekers in European countries, including Portugal. While the Portuguese National Health Service guarantees universal access to healthcare, numerous barriers still hinder the effective access and use of health services by refugee populations, particularly for the prevention and management of non-communicable diseases. This qualitative study aimed to explore the perspectives of professionals involved in refugee reception and integration regarding barriers to accessing and utilizing healthcare, with a particular focus on non-communicable diseases. A qualitative study informed by phenomenological principles was conducted. Semi-structured interviews were conducted with individual participants from December 2022 to March 2023, transcribed verbatim, and analysed using reflexive thematic analysis, informed by phenomenological principles. Thirteen professionals from healthcare, reception, and integration sectors participated. Participants described a high burden of non-communicable diseases, particularly mental health conditions, alongside common risk factors such as unhealthy diets, sedentary lifestyles, and psychosocial distress. Barriers to healthcare access included cultural and linguistic challenges, bureaucratic complexity, and socioeconomic constraints. Facilitators - though less mentioned - included the involvement of cultural mediators, flexible service delivery, and intersectoral collaboration. Both refugees and professionals were described as adopting informal strategies to navigate systemic barriers. This study provides insight into how professionals perceive refugees and asylum seekers’ health needs and their access to healthcare in Portugal. Findings highlight the interplay of structural, linguistic, cultural, and socioeconomic factors shaping healthcare utilisation, informing the development of more equitable and culturally responsive health strategies.