444 Health care system accommodation of forcibly displaced migrants in Poland - challenges and adaptations

The full-scale invasion of Ukraine by Russia led to one million individuals being forcibly displaced to Poland. The health care system represents an important place of contact with the refugee population. As such, it is critical to understand how these patients navigate through the health system and what facilitators and barriers are experienced throughout this process.

To address this, semi-structured interviews were conducted between October and December of 2024. Our purposive sample included 72 participants from nine large and small cities across Poland, including 30 refugees, 26 individuals in management roles (system planners, health care sector officials, leads in governmental and non-governmental organizations), and 16 individuals working in frontline roles (health care professionals, officers in governmental and non-governmental settings), representing different system areas and varied roles in the humanitarian crisis response. We analyzed the interviews in the context of the facilitators and barriers to accessing the health care system, as well as the system challenges and resulting adaptations from the perspectives of health care professionals and system planners.

During the presentation, we will shed light on the main facilitators to accessing care that were identified by the participants. Nonetheless, barriers also persisted, including the ease of communication, the availability of medical records, and health care system differences that affected navigation through it. The participants described health care system pressures, which impacted its resilience, and the resulting adaptations.

Our research highlights areas of focus for improving access to care and alleviating the barriers. Implications for health system planners are suggested, such as the need for the continued assessment of the health status of refugees from Ukraine, the establishment of procedures and policies at the local and national levels with regular re-evaluations, and strong collaboration between all levels of government and with health care professionals and non-governmental organizations.