Abstract
Cultural competence is widely recognized as a core component of equity in healthcare. However, little is known about how healthcare professionals in Greece, a frontline country for displaced populations, develop and implement cultural competence in refugee healthcare. This study explores the experiences, training needs, challenges, and strategies of Greek healthcare professionals for delivering culturally competent care to refugees and asylum seekers. Twelve healthcare professionals from various Greek healthcare settings participated in semi-structured interviews. Data were analysed using reflexive thematic analysis within an interpretive description framework, appropriate for applied health research. Three themes were developed: (i) developing cultural competence through cross-cultural engagement; (ii) finding a balance: dilemmas and complexity in refugee healthcare; and (iii) caring in isolation: refugee care in unsupportive environments. Systemic constraints and patient-provider challenges limited participants' efforts, despite their demonstrated adaptability and commitment, which sometimes resulted in emotional exhaustion or disengagement. Findings highlight the need for multilevel interventions, combining structural competence, advocacy, and reflective supervision, to support uninterrupted, culturally responsive care and promote healthcare providers' well-being.