Models of health care for responding to the complex health needs of refugee and asylum-seeking children: a scoping review

Refugee and asylum-seeking children can have complex health needs arising from displacement, psychological trauma, legal uncertainty, inadequate housing and nutrition, and barriers to health-care access. In this scoping review, we aimed to synthesise the evidence on models of health care for refugee and asylum-seeking children, including their core components, facilitators, barriers to uptake, and impact on health outcomes. Seven overarching themes of impactful models of health care for refugee and asylum-seeking children were identified: holistic and family-centred approaches, multi-tiered models of care with outreach and community partnerships, community-based and home-based settings, cultural sensitivity, creative initiatives, workforce competency and capacity, and funding and sustainability. The evidence base remains constrained by its heterogeneity in terms of service delivery, evaluation, and reporting of health and other outcomes. Paucity of sustainable commissioning of and funding for these services, and the stigma associated with accessing health services for mental health and infectious diseases, are limitations that can affect the provision of sustainable models of care. Future research needs to focus on identifying outcomes prioritised by refugee and asylum-seeking children themselves and exploring mechanisms to support scale-up and continued investment.