Evidence map›Paper›PMID 41668135›Full record

SynthesisBMC health services research2026

Barriers and facilitators to healthcare access for refugee, immigrant, and migrant populations during the COVID-19 pandemic: an overview of reviews.

Thomas Mayers, Yuri Terunuma, Ryota Inokuchi, Fredah Guantai, Huijun Z Ring, Junichi Akashi

Abstract readSystematic Review
In one paragraph

Synthesis in BMC health services research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Thomas MayersDepartment of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan. mayers@md.tsukuba.ac.jp.ORCID http://orcid.org/0000-0003-2947-2805
Yuri TerunumaDepartment of Internal Medicine, University of Texas Medical Branch, Galveston, TX, USA.ORCID http://orcid.org/0000-0003-0837-3744
Ryota InokuchiDepartment of Health Services Research, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.ORCID http://orcid.org/0000-0001-6343-2298
Fredah GuantaiGraduate School of Systems and Information Engineering, University of Tsukuba, Tsukuba, Japan.ORCID http://orcid.org/0009-0007-3053-6956
Huijun Z RingDepartment of Medicine, Stanford University, California, USA.ORCID http://orcid.org/0000-0003-0605-0589
Junichi AkashiInstitute of Humanities and Social Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan.ORCID http://orcid.org/0000-0001-9031-625X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRefugee, immigrant, and migrant (RIM) populations experienced unique obstacles to healthcare during the COVID-19 pandemic. Already facing displacement, insecure legal status, and economic instability, RIM populations were further affected by service disruptions, discrimination, and systemic weaknesses. The objective of this overview of reviews was to synthesize evidence on barriers and facilitators to healthcare access for RIM populations during the COVID-19 pandemic.

methodsThis review followed the PRISMA 2020 guidelines and the protocol was registered in PROSPERO (CRD42024552590). Systematic searches of Embase, CINAHL, MEDLINE, PubMed, CENTRAL, Web of Science, and Google Scholar (January 2020 onward) identified systematic reviews addressing healthcare access for RIM during COVID-19. Two reviewers independently screened studies, extracted data, and assessed methodological quality using AMSTAR 2. Narrative synthesis was used to categorize barriers and facilitators into cross-cutting domains following a socio-ecological model framework.

resultsNine systematic reviews (published 2021–2024) met inclusion criteria, encompassing 14–256 primary studies each, and spanning low-, middle-, and high-income settings across the Americas, Europe, Africa, the Middle East, and Asia. Nine interacting domains of barriers and facilitators emerged involving legal constraints, economic concerns, service provision, physical and digital access, trust and confidence, information and communication, cultural and social influences, psychological and perceptual factors, and structural/systemic weaknesses. Common barriers included fear of deportation, exclusion from national health or social protection systems, job and income loss, high direct and indirect costs, service closures, overcrowded housing, discrimination, and misinformation. Facilitators included suspension of exclusionary policies, telemedicine and digital tools, mobile clinics, multilingual and culturally appropriate communication, messaging from trusted clinicians and community leaders, and civil society engagement.

conclusionsThis overview shows that the pandemic both intensified long-standing barriers and prompted innovative solutions for RIM healthcare access. Lessons from the pandemic can help guide future sustainable, inclusive health systems for displaced populations.

Indexed as

COVID-19Emigrants and ImmigrantsHealth Services AccessibilityRefugeesTransients and MigrantsHumansPandemicsSARS-CoV-2COVID-19Emigrants and immigrantsHealthcare disparitiesHealth policyHealth services accessibilityRefugeessystematic reviewUndocumented immigrants

Identifiers

PMID41668135
PMCPMC12990447

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.