Access to sexual and reproductive healthcare for refugees transiting through Europe: a scoping review.

Objectives: To map and synthesise the existing evidence on access to sexual and reproductive health (SRH) services among refugees transiting across the European Region and to identify key barriers, facilitators and emerging strategies for equitable care. Design: Scoping review. Data sources: Peer-reviewed (Embase, Medline and Web of Science) and grey literature. Eligibility criteria: Quantitative, qualitative and mixed-methods publications from 2012 onwards reporting on access to SRH services among refugees transiting through WHO European Region member states. Data extraction and synthesis: From 1951 screened records, 41 publications across 12 countries were included. Data were extracted using standardised templates and charted using qualitative content analysis. Barriers and facilitators were mapped onto Levesque's healthcare access framework. Results: Predominantly, on the supply-side of Levesque's framework, 72 barriers and 19 facilitators were identified. Refugees in transit face multiple, intersecting barriers to SRH care, including limited availability of gender-sensitive services, staff shortages, language barriers and weak coordination across providers. Health is often deprioritised during migration journeys, while low trust in health systems-compounded by limited health literacy and lack of culturally appropriate care-further constrains access. Findings highlight the need for provider training in cultural sensitivity, gender-based violence and female genital mutilation/cutting. At the same time, several promising interventions were identified. Safe, gender-sensitive spaces and community-based partnerships facilitate trust-building and more responsive service delivery and digital tools show potential to address language, continuity and literacy challenges, particularly in fragmented or overstretched systems. Conclusions: SRH responses for refugees in transit across the European Region must move beyond short-term, emergency-oriented approaches towards sustained, inclusive and community-driven models of care. An adapted version of Levesque's framework, adapted to account for displacement and linguistic exclusion, may be better suited for this population.