The PATHS project aims to improve equitable access to healthcare for Ukrainian refugee women and other migrant groups in the Nordic-Baltic region. Led by the Norwegian University of Science and Technology (NTNU), the project investigates how refugees experience healthcare systems in Norway, Sweden and Estonia, with particular attention to the barriers that influence healthcare seeking, navigation and trust.

Refugees may face multiple, interconnected challenges when accessing healthcare, including language and communication difficulties, limited knowledge of how healthcare systems work, uncertainty about eligibility and referral pathways, and challenges navigating increasingly digital services. These barriers can be particularly significant for preventive and sensitive services, including mental health support, reproductive healthcare, vaccinations and cancer screening. Healthcare professionals also report challenges related to interpretation, limited consultation time, continuity of care and the repeated sharing of sensitive medical histories.

PATHS uses a user-centred and participatory design approach, placing refugees and healthcare professionals at the centre of the research and development process. Through qualitative research, cross-country collaboration and co-design activities, the project identifies users’ needs, experiences and priorities and translates these insights into requirements for future digital health interventions.  

A key outcome of the project will be a user-centred digital health platform designed to help refugees understand and navigate healthcare systems step by step. The platform will provide clear, reliable and multilingual information about healthcare services and pathways. It will also support healthcare professionals by providing contextual information about the Ukrainian healthcare system and refugees’ previous experiences of healthcare.

The project seeks to move beyond technology-focused solutions by developing tools that are practical, accessible and responsive to real-life needs. Initial development will focus on Ukrainian refugee women in Norway, with the ambition to adapt the approach to other countries and migrant populations. Ultimately, PATHS aims to strengthen health literacy, improve healthcare navigation, inform health policy and contribute to more equitable and socially sustainable healthcare systems across the Nordic-Baltic region.  

Project number: 196420

Funder: Nordic-Baltic initiative for migration and integration research, NordForsk

Research area: Nordic initiative on Migration and Integration Research

Peer-Reviewed Journal Articles

• Porras Elizo, A., & Jalote-Parmar, A. (2026). Refugee-centered framework for design of digital health interventions: A qualitative study with Ukrainian refugee women in Norway. Frontiers in Digital Health, 8, 1886871.

Media

• Porras Elizo, A., & Jalote‑Parmar, A. (2026). Your Voice Matters: Co‑Designing Future Health Solutions Together (PATHS Study 2) [Audio podcast; narrated and translated in Ukrainian by Olena Ivashkina]. NTNU Panopto.
• Porras Elizo, A. (2026). Hacia una salud digital más accesible: Un nuevo framework de diseño para mujeres refugiadas [Article in Spanish, based on Porras Elizo & Jalote-Parmar, 2026]. Extremadura Design.
• Jalote-Parmar, A. (2026, June 30). Advancing health equity: Making healthcare accessible through user-centred design for refugees  NordForsk. Feature article based on an interview with Ashis Jalote-Parmar, conducted by Sofia Grünwald, NordForsk Communications Manager. 

International research cooperation with Ukraine and for Ukraine, 18 March 2026, Tartu, Lydia Hotel Event center

Presentation on PATHS project by Anneli Uusküla, Professor, Institute of Family Medicine, University of Tartu.

Conference of the Norwegian Research School in Global Health for Sustainable Futures, Bergen 3-4  November, 2025. 

Nord Baltic Migration and Integration Research, Kick off seminar, 17th June Malmö 2025.

Promoting Access Through Health System Navigation for Ukrainian Refugee Women

During the first year (2025), the PATHS project made progress toward improving Ukrainian refugee women’s access to healthcare in the Nordic–Baltic region.
Project research started from August 2025.

Shared Study Protocol and Cross‑Country Collaboration

Led by NTNU (Norway), the project developed a joint study protocol across Norway, Estonia, and Sweden through collaboration between design researchers, epidemiologists, migration specialists, and public‑health teams.
Recruitment criteria, topic guides, data‑collection routines, and ethics procedures were harmonised across all sites. NTNU also provided access  to secure digital tools (Nettskjema and Educloud) for GDPR‑compliant handling of consent forms, audio recordings, and transcripts for all consortium partners.
This shared framework ensures comparable data across countries and establishes a strong foundation for joint analysis and the development of future digital‑health interventions.

Phase 1 Data Collection and Analysis, December 2025 to June 2026

Across all three countries, the PATHS project has assembled a rich comparative dataset on how Ukrainian refugee women understand, navigate, and experience Nordic–Baltic healthcare systems, as well as how their prior experiences in Ukraine shape expectations, decision‑making, and help‑seeking behaviour.
This dataset also includes healthcare‑worker perspectives on needs, barriers, and support practices.

Phase 1 focuses on generating comparative insights into health‑seeking behaviour, frontline professional experiences, and user‑centred requirements for a future digital health navigation tool. Data collection and analysis are ongoing, and the first scientific publications are in preparation.
In Norway, Phase 1 is completed, with five focus groups conducted with Ukrainian refugee women and one with healthcare workers, all fully transcribed, translated, and verified and data analysis ongoing.
In Estonia, Phase 1 is progressing well, with three focus groups with Ukrainian women and one with healthcare professionals completed, and transcription and analysis underway.
In Sweden, Phase 1 is ongoing, with ethics approval in process and focus‑group data collection already initiated.

Phase 2 Co-Designing Future Health Solutions With Ukrainian Refugee Women

In its second phase (Fall 2026), the PATHS project is building on insights from earlier research to explore how digital solutions can better support Ukrainian refugee women in navigating healthcare systems across the Nordic-Baltic region.

Using a co-design approach, researchers and participants work together to identify priorities, generate ideas, and shape concepts for future health-support solutions. Through collaborative workshops and creative activities, Ukrainian refugee women contribute their experiences, perspectives, and needs, helping ensure that future interventions are relevant, accessible, and user-centred.

Study 2 focuses on understanding what features, information, and forms of support would be most valuable in a future digital health navigation tool. Findings from this phase will inform the design of solutions that can strengthen access to healthcare, improve health literacy, and support informed decision-making among refugee communities.

The study is being conducted collaboratively across Norway and there is a possibility that it will also be followed in Estonia in next year creating opportunities to develop solutions that respond to both shared and country-specific healthcare navigation challenges.