INTRODUCTION:
Public health systems particularly in high-income western countries increasingly rely on digital health strategies to support access, efficiency, and sustainability. At the same time, migration has increased population diversity within these systems. Migrants often encounter healthcare environments shaped by dominant languages, digital interfaces, and institutional assumptions that do not reflect diverse social and cultural contexts. This paper examines how equity and inclusion are shaped in everyday healthcare use among migrants within digitalized public health systems.

METHODS:
This paper synthesizes findings from two qualitative studies based on semi structured interviews with 27 working age Nepali migrants living in Finland. The interviews explored healthcare access, communication with providers, use of digital health services, and reliance on informal and transnational support. An inductive thematic analysis was used to examine how structural and experiential factors influence healthcare use.

RESULTS:
The findings show that digital first service models can reproduce inequities when linguistic and digital capacities are unevenly distributed. Limited proficiency in the host country language restricted access to health information and digital platforms, leading many participants to depend on family members, employers, or community networks. This reliance often reduced autonomy and limited meaningful participation in healthcare decisions. Digital services were frequently experienced as exclusionary rather than enabling. In person care was perceived as more inclusive and culturally appropriate, particularly for communication and trust.

CONCLUSIONS:
Equity in migrant healthcare requires more than formal access to services. It depends on inclusive system design that recognizes linguistic diversity, varied digital capacities, and culturally shaped care expectations. Public health strategies that prioritize digital delivery without addressing these factors risk reinforcing exclusion. An equity oriented approach that supports inclusive communication, flexible service models, and meaningful participation is essential for migrant inclusive public health systems.