Common health needs of refugees and migrants: Literature review

Refugees and migrants may have health needs that differ from those of the host population, requiring effective and culturally responsive care that recognizes the impact of migration on physical and mental health. Refugee and migrant populations may also face a number of challenges to accessing health care that can shape their interactions with the host country’s health system and health workforce, including language and cultural differences, low levels of health literacy, discrimination and restricted access to mainstream health services. Communication is recognized as critical in the provision of culturally responsive care to refugees and migrants. However, inadequate use of interpreting services in various countries undermines access to and quality of health care for these populations. Notwithstanding communication barriers, health professionals can play an important role in educating refugees and migrants on the health system of the host country, thereby increasing their health literacy and engagement with health services. This literature review explores the common health needs of refugee and migrant populations across the life course and is designed to complement the development of the Global Competency Standards for the effective provision of health services to refugees and migrants. Health professionals providing care to refugees and migrants should be aware of how the migration experience – which can involve poor transit conditions, restrictive entry and integration policies, exclusion and acculturation stress – influences the health status of individuals and their health needs. For example, refugee and migrant children may have worse health outcomes related to infectious diseases and chronic diseases, as well as mental health, compared with local children in high-income host countries. Traumatic or stressful experiences in their country of origin, during migration process or while settling in their host country can lead to the poorer mental health outcomes experienced by refugees and migrants. Screening for sexually transmitted infections is essential for refugees and migrants, particularly for women who have come from environments that carry a high risk for sexual violence. While access to contraception is critical, knowledge of contraceptive methods, including emergency contraception, within some migrant groups may be quite limited. Unwanted fertility is a key concern for refugee and migrant women, who may experience higher rates of unwanted pregnancy as well as increased risks of adverse pregnancy outcomes. Communicable diseases are another serious health concern for refugee and migrant populations. Refugees and migrants are more likely to be susceptible to childhood vaccinepreventable diseases, in particular rubella, tetanus and diphtheria, due to under-immunization. The process of migrating can also expose individuals to significantly greater risks of contracting infectious diseases such as HIV and tuberculosis, and now SARS-CoV-2 (COVID-19), through issues such as overcrowding, poor living conditions and inadequate hygiene services. A number of gaps in the literature were also identified, emphasizing the need for more data and research on specific health needs of refugee and migrant populations. In particular, further research is needed to strengthen the evidence base for provision of care for mental, oral, hearing and vision health, and for older refugees and migrants and those with disabilities.