Migration is a major social, political and public health challenge for the WHO European Region and policy-makers will need to develop specific and coherent policies addressing the health needs of all migrants, including asylum seekers and refugees. The lack of common strategies for the health care management of refugees is apparent in the fragmented nature of data described here. Health penalties are consistently found in terms of poorer mental health and perinatal outcomes, but the evidence is neither consistent nor generalizable. The variation in how countries define asylum seekers and refugees and in how health care is provided at point of entry and at final destination also make it harder to draw generalized evidence-based conclusions. However, even though evidence is limited, there are examples of successful intersectoral interventions that foster integration and promote communication between and beyond medical agencies.
Legal and structural impediments as well as uncertainties in communication, expectation and entitlement are described as the main barriers for this population to access health care. A lack of specialized maternal and mental health services is noted. Improving the collection of quality of data, prioritizing measurement and mapping of good practices and encouraging research to underpin the development of minimum standards in health and social care of refugees all actions that should be reinforced.
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