Health care access in times of COVID-19: The experiences of refugees in Lisbon

Background and Objective: To address the health needs of refugees it is essential that health services are culturally competent and facilitate the access of this population to health care, especially in a context prone to the amplification of social inequities as the COVID-19 pandemic. However, no studies exist in Portugal exploring refugees’ access to health during COVID-19 pandemic. The Objective of this study is to describe socioeconomic and demographic characteristics of refugees living in Lisbon and to identify their health care patterns during the COVID-19 pandemic. Methods: A cross sectional descriptive study was conducted from May to November 2022. A 38-item questionnaire was applied to 36 refugees living in Lisbon through face-to-face interviews. Descriptive statistics were used to characterize sociodemographic and healthcare access profile during COVID-19. Results: The majority of participants were male (56%), with a mean age of 35 years, 72% were married, most had at least a secondary education (69%), but more than half were unemployed; the respondents came from seven countries and all had been integrated in the Refugee Reception Program; the median length of stay was 17 months. All were registered in a primary care center and during the pandemic, 94% used healthcare services. The majority tested negative for the coronavirus (58%), one was admitted to hospital due to severe COVID-19; most participants were compliant with preventive measures and 97% received COVID-19 vaccination; 69% had an incomplete schedule. More than half didn’t seek health care because of structural and cultural barriers and most had difficulty getting medical advice by phone or email (57.7%) during the pandemic. Conclusions: This is the first study exploring health care access among refugees in Portugal during the COVID-19 pandemic. Identified population characteristics and barriers signal the need to devise strategies necessary to the improvement of access to health care.