Beyond coverage: reviewing barriers and facilitators to healthcare access among Ukrainian refugees

Background

The 2022 war in Ukraine led to a large-scale population displacement. Refugees represent a particularly vulnerable population due to disrupted continuity of care, trauma, and chronic diseases. Although many host countries ensured formal healthcare coverage for refugees from Ukraine through temporary protection mechanisms, access remains unequal and is influenced by barriers and facilitators at both individual and system levels. This study synthesizes available evidence on barriers and facilitators to healthcare access among Ukrainian refugees.

Methods

A scoping review was conducted, identifying 227 studies that collected data beginning in 2022; 161 were included in the final analysis. Evidence from multiple countries, mainly in Europe, was mapped into predefined domains of barriers and facilitators to accessing care among refugees from Ukraine.

Results

Most studies used quantitative methodology (53%). Geographically, they mostly focused on refugee populations residing in Poland (25%), Germany (12%), and Czechia (8%). The most frequently reported barriers were communication challenges; lacking or incomplete medical records; socioeconomic constraints (finances, housing, transportation); health system differences (organizational structures, wait times, accessibility, medication availability); system navigation challenges, and unfamiliarity with where to seek information. The most common facilitators were healthcare coverage, access to specialized services, availability of multilingual communication (interpreters and digital tools), and positive perceptions of care.

Conclusions

Healthcare access for Ukrainian refugees remains constrained by structural and communications barriers, despite formal coverage and existing facilitators. Strengthening interpreter services, improving medical record integration, and simplifying system navigation are essential to enhance equitable access, continuity of care, and overall health system responsiveness.

Key messages

• Communication barriers, fragmented medical records, and system complexity remain the main barriers in accessing healthcare for refugees from Ukraine despite broad entitlement to services.

• Facilitators such as interpreter services, insurance coverage, and simplifying system navigation are essential to improve equitable healthcare access.