REFUGEE HEALTH PROMOTION IN CANADA: A SYSTEMATIC REVIEW OF THE EVIDENCE ON THE IMPLEMENTATION OF THE IHR IN CANADA REGARDING REFUGEE HEALTH PROMOTION WITHIN THE CONTEXT OF A PHEIC

Abstract

Refugees remain the most vulnerable members of society and face several health risks for adaptation to a host country. These include an increased risk of developing communicable diseases that are exacerbated during a PHEIC . The purpose of this systematic review is to evaluate the reported implementation of the IHR in Canada, specifically in refugee health promotion, during PHEICs. The chosen method is a systematic review which locates and synthesizes evidence from as many relevant studies as possible. 9 electronic databases were searched and screening was conducted on Covidence. Articles that were included contained IHR policies on PHEICs, quantitative and/or qualitative methodologies of analysis, systematic reviews, published in English, provided a Canadian context, involved at least 1 of the refugee health outcomes from the following: access to health services and quality health care provision, improved health security, improved health literacy and published between 2005 and 2022 Risk of Bias was assessed using the ROBIS tool. Thematic Synthesis was used to code textual data on MAXQDA to extract descriptive themes and analytical themes. 19 studies were selected for the systematic review. 10 descriptive themes were found and analyzed to determine 2 analytical themes. Findings exhibit lack of effective policy/legislation translation as well as inappropriate applications of public health restrictions and safety protocols as barriers to promoting positive refugee health outcomes during a PHEIC. The findings may also reflect a lack of consistency in implementing some of the IHR core capacities and PHAC core competencies for refugee health promotion in Canada. Thus, it is essential that future research focus on appropriate needs-assessment tools, the use of legal frameworks that can inform the capacity- building of health systems for refugee populations as well as ongoing consultation amongst governing entities, health care administration, health care providers and refugee populations for strengthening Canada’s implementation of the IHR for refugee health promotion.