What makes people seeking asylum and refugees well? A qualitative scoping review using a salutogenic approach.

Abstract

People seeking asylum and with refugee status (ASR) often face worse health outcomes compared with host populations. Despite this, ASR are underserved in health care and research, resulting in a knowledge gap about what promotes their health and resilience. The aim of this review was to define what ASR communities express makes them well. This was a scoping review of peer-reviewed papers and grey literature documenting patient-centred holistic health, wellbeing, and social outcomes in community-based research with ASR. In total, 24 papers met the inclusion criteria. Findings were underpinned by the theory of salutogenesis, or asset-based approaches (what makes people well) and categorised into: on 'head' (for example, skills and knowledge), 'hands' (for example, meaningful activities), and 'heart' (for example, cultural and spiritual connections). Wellbeing was primarily defined by safety, empowerment, and a sense of purpose. The study demonstrates that wellbeing for ASR is multifaceted, encompassing psychological, social, and cultural dimensions. The salutogenesis framework provides a holistic approach to understanding these factors and this study shows that, to align with of 'no decision about me, without me' in health care, individual measures of health and wellbeing measures must encompass these factors.