Perspectives of healthcare providers on healthcare engagement among unaccompanied migrants and stateless populations in Ghana

Abstract Introduction Unaccompanied migrants (UM) and persons prone to statelessness (SP) constitute a unique vulnerable group, yet their health needs and healthcare barriers remain poorly documented particularly in sub-Saharan Africa undermining realisation of global health initiatives. Informed by the health belief model, this study investigates the perspectives of healthcare providers on healthcare engagement among UM and SP across two regions of Ghana. Methods This study employed an exploratory qualitative design involving in-depth interviews with 65 healthcare providers across public and private facilities in the Greater Kumasi Metropolitan Area (GKMA) and Awutu Senya East Municipal Area (ASEMA). Participants included nurses, physicians, community health practitioners, pharmacists, dietitians, and physician assistants. Data were collected from March 2024 to June 2024 using a semi-structured interview guide. Data were analysed using a thematic analysis method. Results Healthcare utilisation among UM and SP was predominantly irregular and crisis driven. Providers most frequently described care-seeking as rare or occasional (UM: rare = 19, sometimes = 36; SP: rare = 23, sometimes = 36), with SP presenting less frequently overall. Perceived barriers, perceived severity, and perceived susceptibility emerged as influencing healthcare engagement of UM and SP. Succinctly, financial hardship was the most cited access barrier (UM = 58; SP = 54), followed by documentation constraints (UM = 27; SP = 41) and communication challenges (UM = 35; SP = 40). Providers reported a high burden of communicable diseases, particularly malaria (UM = 56; SP = 55) and typhoid fever (UM = 44; SP = 36) alongside non-communicable conditions including hypertension (UM = 35; SP = 35) and diabetes (UM = 26; SP = 25). Malnutrition was widely noted, driven primarily by financial constraints (UM = 51; SP = 29). Overcrowded and unsanitary living conditions (UM = 44; SP = 40) were perceived to exacerbate recurrent illness. Mental health needs were considered substantial but under-recognised. Conclusion Healthcare providers perceive UM and SP as populations navigating overlapping vulnerabilities that drive delayed care, recurrent illness, and unmet psychosocial needs. Addressing these inequities requires policy reforms, inclusive financing, strengthened community and provider sensitisation, and system-level investments that enable equitable, timely, and culturally attuned care.