# A Scoping Review of Refugee Children’s Health Conditions, Outcomes, and Measures Used in Refugee-Serving Public Health Centres/Clinics in Canada

## TL;DR

This study reviews how health conditions and outcomes of refugee children under 5 are measured in Canadian clinics, highlighting gaps in standardized and culturally safe approaches.

## Contribution

The paper identifies the lack of standardized and culturally safe measurement tools for refugee children's health in Canadian clinics and emphasizes the need for equitable assessment strategies.

## Key findings

- Most studies focus on physical health conditions like infections and malnutrition, with limited attention to developmental and mental health.
- There is significant variability in health measures across provinces and a lack of longitudinal data.
- Current approaches show limited cultural adaptation and insufficient standardized tools for refugee children's health assessment.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Refugee children experience a disproportionate burden of infectious diseases, nutritional deficiencies, and developmental and mental health conditions. Current literature pays limited attention to social determinants of health, despite strong evidence that these factors significantly influence refugee child health outcomes.The lack of standardized, culturally safe measurement approaches for vulnerable populations, especially refugee children, makes their health needs invisible within the healthcare system, contributing to health inequities. Improving early and equitable assessment is essential to reducing preventable morbidity and enhancing long-term health outcomes.

Refugee children experience a disproportionate burden of infectious diseases, nutritional deficiencies, and developmental and mental health conditions. Current literature pays limited attention to social determinants of health, despite strong evidence that these factors significantly influence refugee child health outcomes.

The lack of standardized, culturally safe measurement approaches for vulnerable populations, especially refugee children, makes their health needs invisible within the healthcare system, contributing to health inequities. Improving early and equitable assessment is essential to reducing preventable morbidity and enhancing long-term health outcomes.

Public health significance—Why is this work of significance to public health?
Improving how refugee children’s health is measured strengthens the capacity of health systems to anticipate needs, plan services, and prevent future disease burdens. Improved measurement has the potential to act as a preventative strategy that supports population health, reduces long-term cost, and promotes equitable developmental trajectories.By revealing gaps in current systems, this study identifies opportunities where coordinated action can reduce avoidable disparities in a rapidly growing, vulnerable population.

Improving how refugee children’s health is measured strengthens the capacity of health systems to anticipate needs, plan services, and prevent future disease burdens. Improved measurement has the potential to act as a preventative strategy that supports population health, reduces long-term cost, and promotes equitable developmental trajectories.

By revealing gaps in current systems, this study identifies opportunities where coordinated action can reduce avoidable disparities in a rapidly growing, vulnerable population.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Standardized, culturally safe measurement approaches, including evidence-based tools informed by the lived experiences of refugee families, consistent data collection protocols, and shared definitions across jurisdictions, have the potential to improve the accuracy of diagnosis, early identification, surveillance, and equitable access to care for refugee children.Strengthened and coordinated data systems, both nationally and internationally, are essential to monitor health conditions and outcomes, understand the influence of social determinants, inform evidence-based policy, and design responsive, high-quality services that address the unique needs of refugee children.

Standardized, culturally safe measurement approaches, including evidence-based tools informed by the lived experiences of refugee families, consistent data collection protocols, and shared definitions across jurisdictions, have the potential to improve the accuracy of diagnosis, early identification, surveillance, and equitable access to care for refugee children.

Strengthened and coordinated data systems, both nationally and internationally, are essential to monitor health conditions and outcomes, understand the influence of social determinants, inform evidence-based policy, and design responsive, high-quality services that address the unique needs of refugee children.

Refugee-serving primary health centres/clinics (PHCs) provide culturally safe, integrated care for refugee children, yet little is known about how their health conditions and outcomes are assessed. This scoping review examines the current literature on the health conditions and outcomes of refugee children aged 0–5 years and how they are measured in refugee-serving PHCs in Canada. In partnership with the New Canadians Health Centre and guided by Joanna Briggs Institute methodological guidelines, we systematically searched Medline, CINAHL, Scopus, and Embase. Included studies focused on refugee children in Canada and reported health conditions, outcomes, and their measurements within PHCs. Twenty-five studies (2008–2024) met the inclusion criteria, most from Ontario (n = 11), followed by Alberta and Saskatchewan (n = 4 each). Reported health conditions or outcomes (n = 24) spanned the physical (n = 19), developmental, and mental health domains (n = 5). Communicable (e.g., gastrointestinal infections, hepatitis) and non-communicable conditions (e.g., malnutrition, vitamin D deficiency) were mostly reported. Although some standardized approaches were used, substantial variability exists across provinces and conditions or outcomes measured. Findings reveal a disproportionate focus on physical health and notable variability and gaps in child health measures, limited cultural adaptation, and lack of longitudinal data. Standardized, culturally responsive, and age-appropriate measurement approaches are needed to enhance health equity and inform evidence-based policy for refugee children in Canada.