Access to healthcare

UNHCR’s public health strategy aims to foster the conditions, partnerships, collaboration and approaches that enable refugees to access healthcare and essential health services. Advocating for the inclusion of refugees into national health systems at affordable costs and sufficient quality is a priority. This strategy is in line with the Global Compact on Refugees and the 2030 Agenda for Sustainable Development.

How does UNHCR help refugees get healthcare?

Through UNHCR’s advocacy, funding and support, refugees benefit from increased access to healthcare in these areas:

Primary healthcare and referrals for secondary healthcare

Primary healthcare practitioners provide support in the areas of sexual and reproductive health, nutrition, child health including immunizations, mental health and the treatment of communicable and noncommunicable diseases. Primary healthcare practitioners also make referrals to secondary healthcare for a higher level of clinical care.

UNHCR improves primary healthcare for refugees by advocating for refugee inclusion into national health systems, strengthening health infrastructure (e.g. constructing or renovating facilities, providing medicines, medical equipment and laboratory diagnostics), funding and training health workers.

Community health

Whether in camps or urban settings, the overall health of host and refugee communities impacts each individual. Community health initiatives mostly take place outside of health facilities and focus on how community members can take action together to maintain or improve their health and prevent disease.

UNHCR trains community health workers to meet with refugees to diagnose, treat and make referrals for common illnesses (e.g., diarrhoea and malaria) and follow up with pregnant women, newborns and people living with chronic diseases (e.g., diabetes and hypertension). Fluent in refugee languages and cultures, community health workers teach refugees about health, hygiene and preventative health measures such as immunization from the same perspective more easily relatable.

Noncommunicable diseases (NCDs) prevention and treatment

Noncommunicable diseases, such as heart disease, cancers, diabetes, chronic respiratory disease and mental health conditions, are the greatest source of preventable illness, disability, and mortality worldwide. Displacement can disrupt refugees’ treatment for these diseases or delay diagnosis, putting them at even greater risk.

In 2014, UNHCR began improving access to noncommunicable diseases care by ensuring that it is effectively integrated into primary healthcare. Through a capacity-building project, procurement of evidenced-based and cost-effective essential medicines and data collection and monitoring via the iRHIS (Integrated Refugee Health Information System), access to healthcare for noncommunicable diseases is now more available to refugees. UNHCR trains health staff on noncommunicable diseases care including screening, diagnosing and managing patients using clinical protocols (aligned with host country protocols). Capacity building includes training of staff to provide advice on smoking cessation, monitoring of disease control and awareness of complications.

Communicable diseases prevention and treatment

Conflict and displacement that lead to refugee situations are a recognized public health risk. They increase the population’s vulnerability to communicable diseases because of weakened health systems, overcrowding, poor water and sanitation conditions, interrupted immunization activities and delayed diagnoses. The main cause of death in many conflict and displacement situations is not violence, but the spread of communicable diseases such as malaria, measles and diarrhea.

Immunization

When refugees flee their homes, healthcare gets put on hold, including immunizations. As a result, refugees, especially children, are at increased risk of contracting vaccine-preventable diseases including measles, polio, viral hepatitis, diphtheria and whooping cough. Refugee children are also at very high risk to be “zero-dose” (no immunization) or under-immunized. Adult refugees may face more severe forms of childhood diseases if they were not immunized as children.

Essential medicines, medical supplies and equipment

Essential medicines are the medications considered to be most effective and safe to meet the most important health needs in a country. The World Health Organization (WHO) maintains a list of essential medicines that serves as a guide for states and institutions. Every two years, UNHCR reviews and adapts the WHO list for refugee contexts (also available in French: Lignes directrices du HCR sur les médicaments essentiels et les fournitures médicales).

UNHCR then procures and imports medicines from the UNHCR Essential medicines and medical supplies list for emergency and ongoing refugee situations taking into account national essential medicine lists. These medicines are distributed for use with refugees by partners (including governments, national and international NGOs, and Red Cross/Red Crescent partners).