Original Title: Gesundheitslots:innen für Migrant:innen/Flüchtlinge

Authors' objectives: Migrants and refugees frequently experience substantial barriers when accessing healthcare services, including language difficulties, limited knowledge of healthcare structures and administrative complexity due to cultural differences and low health literacy. These barriers may contribute to delayed care, poorer health outcomes, and increased healthcare costs. Health navigators have emerged as a community-based support model intended to address these challenges by providing culturally sensitive guidance, orientation, and peer-to-peer support. This mixed-method review aimed to examine the role and impact of health navigators for migrants and refugees. The report synthesises evidence from international literature and practical experiences from Germany to identify key implementation factors, effects, and lessons learned.

Authors' results and conclusions: The review included five (scoping, realist) reviews and three primary studies on peer-supported navigation interventions for migrants and refugees. Additionally, 12 active health navigator projects in Germany were identified through web searches. Interviews and a survey were conducted to collect project information. The available evidence is heterogeneous and predominantly European, with most projects and studies emerging after the 2015 refugee movement. Most interventions are publicly funded and implemented at municipal or regional levels. The programs rely heavily on trust, cultural proximity, and multilingual communication. The literature and project evaluations suggest positive effects on navigational health literacy, knowledge of available services, empowerment and resilience, confidence in accessing healthcare, satisfaction with support services, and on patient-reported outcomes and experiences. However, the evidence remains methodologically limited. Most studies are small, heterogeneous, and rely on qualitative methods or self-reported outcomes. Standardised evaluation instruments are rarely used. Successful implementation depends on community-based and low-threshold access, cultural and linguistic competence, extensive training, trust-building within migrant communities, clear role definitions, quality assurance and supervision, sustainable funding structures, and integration with local health and social services. Challenges include short-term financing, limited standardisation, varying training concepts, and insufficient long-term evaluation.

Authors' recommendations: Health navigator initiatives for migrants and refugees appear to be a promising strategy to improve healthcare orientation, health literacy, and equitable access to healthcare services. Peer-based and culturally sensitive approaches are particularly valuable for reaching vulnerable populations and reducing structural barriers. Nevertheless, the current evidence base remains limited and heterogeneous. More robust evaluations, standardised outcome measures, and long-term implementation studies are required to better assess effectiveness, sustainability, and transferability to healthcare systems such as Austria's.

Authors' methods: A systematic literature search was conducted between January and February 2026 in six scientific databases, supplemented by grey literature searches, hand searches, and web-based project identification. The included evidence was narratively synthesised, with particular attention to organisational endpoints and implementation factors, and effects on target groups.

Project Status: Completed

URL for project: https://aihta.at/page/gesundheitslots-innen/en

Year Published: 2026

URL for published report: https://eprints.aihta.at/1613/1/HTA-Projektbericht_Nr.180.pdf

URL for additional information: https://eprints.aihta.at/1613/

English language abstract: An English language summary is available

Publication Type: Full HTA

Country: Austria

Organisation Name: Austrian Institute for Health Technology Assessment

Contact Address: Josefstaedter Strasse 39, A-1080 Vienna, Austria

Contact Name: office@aihta.at

Contact Email: office@aihta.at