Barriers and facilitators to digital primary health care access in immigrant and refugee populations: a scoping review

Refugees and immigrants face individual and structural barriers in accessing primary health care (PHC). Digital health technologies have been proposed as a way to improve access to primary health care services, yet our understanding of the unique barriers and facilitators to accessing this form of care among immigrants and refugees remains limited. A scoping review was conducted to (1) identify the barriers and facilitators to digital PHC access as experienced by immigrants and refugees, and (2) to characterize which primary health care needs are being addressed, and through which digital modalities.

We searched CINAHL, Embase, Global Health, Medline, PsychInfo, Scopus and Web of Science databases for qualitative studies, according to the Arksey and O’Malley (Int J Soc Res Methodol 8(1):19–32, 2005) framework.

The screening process yielded 25 articles included in the review. Results were analyzed according to Levesque’s (2013) framework of access to healthcare. Access to digital PHC is facilitated by the flexibility afforded by digital technologies. Digital technologies also provide an opportunity to form new social connections through peer support groups and/or check-ins with service providers. Structural barriers to access include concerns about privacy and data security.

This review provides an overview of the barriers and facilitators to digital PHC access in immigrant and refugee populations in both high-income and low- and middle-income countries. Our findings can guide the development of digital interventions that consider the social and political factors shaping access to care for this population.