Mapping Refugee Health Services: Understanding the Roles Played By Refugee Support Organizations

Background and Purpose

Approximately 3.6 million refugees have been resettled in the United States (U.S.) over the past forty years. As of June 2024, the U.S. had received more than 100,000 refugees, with the highest number coming from the Democratic Republic of Congo (22.3%), Afghanistan (14.6%), and Syria (12.7%). Refugees resettling in the U.S. face several challenges shaped by trauma, limited health literacy, and fragmented systems of care. The 2023 Annual Survey of Refugees shows that only 76% of refugees had continuous medical coverage over the previous 12 months. This study examines the role of refugee-serving organizations in supporting newly resettled African refugees in the U.S.

Methods

This study employed a qualitative design with a grounded theory approach to examine the health-related services and best practices of refugee-serving agencies for newly resettled refugees in the U.S. Participants were recruited using purposive and snowball sampling. In-depth interviews were conducted with 13 professionals from refugee-serving agencies in Florida and Missouri. Interviews were conducted via Zoom, audio-recorded, and transcribed verbatim. Transcripts were double-checked for accuracy, de-identified, and uploaded to NVivo 14. The research team developed a comprehensive codebook to guide the thematic analysis of the data.

Results

Thematic analysis revealed five areas of service: 1) service provision such as background checks for needs assessment, 2) care coordination and referrals including working with appropriate service providers to ensure refugees access health care, 3) refugee advocacy that involves speaking up for refugees’ needs and rights, 4) financial and material support to meet refugee needs like housing, and 5) cultural mediation to ensure both refugees and host communities understand each other’s cultures to enhance culturally appropriate services. Additional support included a range of health‑related services, such as health education and interpretation services. Recommendations included the continuity of advocacy to ensure access to healthcare and health-related services; the development of mechanisms that build trust between newly arrived refugees and healthcare service providers; and mental health support to improve healthcare access for newly arrived refugees. Overall, the findings highlight the vital role of refugee support organizations in promoting the health and well‑being of newly resettled refugees in the U.S.

Conclusions and Implications

This study highlighted the importance of refugee-serving organizations in supporting newly arrived refugees’ access to services, especially health care. These organizations serve as critical intermediaries for refugees who may lack the required knowledge and resources to successfully navigate the complex U.S. healthcare system. This research can improve refugee well-being by enhancing access to healthcare services.