The countries included in this study were Belgium, Canada, Finland, France, Germany, Norway, Sweden, Switzerland, the UK, and the US. While the US resettled the highest total number of UNHCR refugees, Sweden and Norway resettled the highest number per capita (see supplementary Table 1). These 10 countries resettled 94% of all refugees resettled by UNHCR in 2021.

We found important similarities and differences across all categories of structural and social supports and services offered to resettled refugees by host country governments (see Table 1).

In European countries and in Canada, resettled refugees are eligible to register for the same public healthcare as citizens upon arrival or after a transition period of a few weeks. During the transition period, governments provide temporary healthcare coverage. While public healthcare is tax-financed by either the provinces in Canada, Finland, Norway, and Sweden or the federal government in the UK, a monthly fee is charged for health insurance in France, Belgium, Germany, and Switzerland where refugees without income are eligible for governmental assistance to cover fees. In Canada, prescription medications, vision, dental and mental healthcare expenses are funded by the federal government for one year after arrival (otherwise these are typically covered by low-income provincial programs [variable coverage], employer insurance programs or are out-of-pocket expenses). In the US, resettled refugee children are eligible for free health insurance coverage (i.e., Medicaid) upon arrival, while adult Medicaid eligibility varies by state. In states where low-income adults have limited eligibility for Medicaid, refugee adults typically receive less than one year of Refugee Medical Assistance to cover healthcare costs before they either need to obtain private insurance or rely on sliding scale charity programs for the uninsured.

All countries offer resettled refugees pre-departure orientation training in collaboration with the International Organization for Migration (IOM) and, upon arrival, offer language courses in the national language(s). Language and integration courses are typically government-financed and free (e.g., Canada, US); in some countries (e.g., Germany, UK), refugees pay a fee that can be waived in case of financial need. Course attendance may be mandatory in some countries as part of a personal integration plan/contract (e.g., Finland, France, Germany) and failure to comply may result in the withdrawal of certain support benefits. In Norway and Sweden, introduction programs - including language classes - are mandatory for working-age refugees and entitle participants to financial support. Within all countries, there is regional heterogeneity in the delivery of language and educational support. Children and young people (5–16 years old) are generally eligible for free schooling and subject to the same mandatory education regulations as children who are citizens of the host country.

In all countries, resettled refugees are legally allowed to work immediately after arrival, but there are differences in terms of employment training support [59]. Typically, refugees receive a skill assessment, labor market information, employment counseling, and job search workshops. In some countries (e.g., Belgium, Germany) these are a part of the standard support program available to all unemployed citizens, while in other countries (e.g., Finland, Canada, Switzerland, UK, US) these are offered during the first 1–2 years via specialized (mentoring) programs for newcomers or refugees. Resettled refugees and their families are entitled to the same amount of financial assistance as non-refugee citizens who receive government social assistance in Belgium, Canada, the UK, Switzerland, and Germany, typically composed of a basic benefit plus potentially additional benefits for child support, housing/heating and special needs. In Canada, Belgium, Norway, and the US, they receive additional financial support compared to the typical unemployed population, e.g., in Canada and Belgium, a one-time fund is paid to cover costs of establishing a new home. In Sweden, refugee-specific furnishing and equipment loans are available. Upon arrival, housing is typically provided by host countries. In Belgium, Germany, and Switzerland, UNHCR resettled refugees are accommodated in central reception centres for the first weeks, while in Finland, Canada, France, Norway, Sweden [60,61,62], the UK, and the US, they are usually directly distributed to the receiving municipalities.

A total of 63 studies were included in our scoping review (see Supplementary Fig. 1: PRISMA diagram) (US: 34 [54%] [63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96], Canada: 25 [40%] [97,98,99,100,101,102,103,104,105,106,107,108,109,110,111,112,113,114,115,116,117,118,119,120,121], UK: 4 [6%] [122,123,124,125]). Table 2 summarizes the study characteristics and populations across countries while Figs. 1a and b illustrate the geographic distribution of the studies. The American states of Texas (n = 4 [65, 66, 89,90,91]) and Michigan (n = 4 [66, 78, 89, 93]) had the largest number of studies of any state in the US, with 13 other states being covered by at least one included study and 14 studies covering the whole US or where the state was not specified. Fourteen of the 25 Canadian studies were conducted in Ontario, the most populous province of Canada, (n = 14) with most other provinces but no territories represented (see Fig. 1a). Apart from 4 studies from the UK (Fig. 1b), no other European studies met the inclusion criteria.

Geographic distribution of the included studies by country and region

Of the 63 studies included, most included only the refugee perspective (US n = 26 (76%), Canada n = 15 (60%), UK n = 2 (50%)). Studies across all countries most frequently used qualitative research methodology (n = 47, 75%) and focused on the experiences of adult refugees (n = 36, 57%) as well as refugees from the Middle East and North Africa (n = 22, 35%) and Africa (n = 10, 16%).

In a minority of studies originating from the US and Canada, healthcare access was noted as fulfilled (n = 12 each, US (35%) [63, 65, 68, 74, 75, 79, 80, 85, 86, 90, 92, 93], Canada (48%) [97, 98, 101, 102, 105, 106, 109, 111, 113, 117,