Access Without Borders: A Scoping Review to Identify Solutions to Creating Portable Identity, Education and Health Records for Refugee Children

Abstract Review objective: The focus of this scoping review is to identify studies, reports, and other relevant sources from the peer-reviewed and grey literature that reports on refugee children’s access and barriers to portable identity, education, and health records at different stages during the migration process. Introduction: The child refugee crisis has become a global concern as many individuals risk their lives to escape the political violence, persecution, and war. Forcibly displaced children face the genuine challenge of being unable to acquire documents pre-migration or having documents lost, stolen, or destroyed during transit. Still, little is known about refugee children's challenges when accessing and maintaining personal records while moving within and across borders. We will consolidate existing information and analyze the barriers that limit access to identity, education, and health records at different stages of migration and the policies and practices to address record portability and interoperability problems. This work is part of a program of study that seeks to understand the institutional, social, and political aspects of a refugee child’s environment that potentiate their resilience under conditions of extreme stress. Inclusion criteria: The study included academic literature focused on the production, preservation, or transmission of records pertaining to identification, education, or health of refugee children, adolescents, and young adults. The review process was limited to documents written in the English language. Methods: We employed the framework proposed by Arksey and O’Malley 1 for the methodological synthesis of research, as well as the modifications recommended by Levac and colleagues.2 Results of the search strategy were compiled and presented using the extended reporting guidelines for scoping reviews, as suggested by the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA).3 Several bibliographic and grey literature databases, including PubMed, CINAHL, Embase, Tandfonline, Proquest, Cochrane Database of Systematic Reviews, Scopus, Google Scholar, Google search engine, and UN agency websites, were searched to identify relevant studies. Results: Using electronic literature searches, 87 articles were identified, of which 8 were deemed eligible for inclusion in this study. In addition, we identified 7 news articles and 10 reports from international organizations, most of which were focused on issues related to education record portability, as well as initiatives aimed at recognizing digital credentials for refugee young people. All eligible documents were categorized into three themes based on the analysis targets: (1) examining the challenges faced by refugees in utilizing humanitarian identity systems; (2) highlighting the need for digital credentials for refugees; and (3) exploring the potential benefits of digital health interventions for refugees. Specifically, our search showed that digital identity systems need to be more flexible and tailored to individual refugee needs. With regard to education records, the retrieved grey literature prioritizes adults' needs, but adopting digital credentials and blockchain technology may solve traditional recognition systems' constraints, ensuring that refugee children's education is also supported. In contrast, digital health interventions, including EHRs and mobile health applications, have be better studied and shown to positively impact healthcare access, patient outcomes, and chronic disease management for refugees in high-resource host countries. Despite this potential for positive outcomes, the portability of health records remains an under-researched and under-resourced area of a refugee child’s life. Conclusion: The increasing number of refugee children globally necessitates urgent solutions to address their need for portable identity, education, and health records. This review highlights the potential of digital interventions to improve refugee children’s lives, including their resettlement outcomes. Furthermore, recent innovations like blockchain technology and digital credentials offer promising solutions for advancing equity for refugee children. Developing adaptable digital solutions and resources can enhance refugee children's access to health and education services, while also enabling them to obtain necessary documentation and identity verification for accessing basic rights and services.

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