A critical interpretive synthesis of migrants’ experiences of the Australian health system

Abstract

While the health of and healthcare use by migrants has received significant scholarly and policy attention in Australia, current debates highlight that a critical examination of the theoretical underpinnings of these inquiries and responses is needed. We conducted a systematic review and critical interpretive synthesis (CIS) to critically examine how the policy and scholarly literature conceptualises migrants’ interactions with and experiences of the Australian health system. Guided by PRISMA, we searched for literature without imposing any limits. We also searched key State and Federal Government websites for relevant policy documents. Our initially broad inclusion criteria became refined as the CIS progressed. We prioritised the likely relevance and theoretical contribution of the papers to our inquiry over methodological quality. The CIS of 104 papers revealed that the Australian scholarly literature and policy documents consistently homogenise and reduce migrants according to an assumed, (1) cultural identity, (2) linguistic affiliation, and/or (3) broad geographic origin. Based on these three critiques and drawing on the theoretical literature, we propose a synthesising argument on how the Australian literature could better conceptualise migrants’ experiences of the Australian health system. We contend that both research and policy should explicitly recognise and engage with the multifaceted and shifting ways that migrants define themselves, generally, and during their encounters with destination country health systems. Engagement with this notion is necessary for also understanding how aspects of migrants’ identities are dynamically co-constructed during their interactions with the health system. These understandings have implications for improving the design and implementation of policies and programs directed at improving the responsiveness of Australia’s health system to the needs and expectations of migrant communities specifically, and destination countries broadly.

“It Is Definitely a Good Program for Everyone from Every Community”: A Qualitative Study of Community Partner Perspectives on the Culturally and Linguistically Diverse (CALD) Mindfulness Program

“…For Australians from CALD backgrounds, understanding of community is often tied to shared experiences, practices, language, beliefs and history, rather than a suburb or set of postcodes [ 29 ]. However, this approach can lead to homogenisation of what is an extremely diverse population [ 55 ]. An approach that recognises and responds to intersectionality (the range of shifting identities that people may embody and mobilise and structural power differentials) is required [ 55 , 56 ].…”

“…However, this approach can lead to homogenisation of what is an extremely diverse population [ 55 ]. An approach that recognises and responds to intersectionality (the range of shifting identities that people may embody and mobilise and structural power differentials) is required [ 55 , 56 ].…”

Green Hydrogen Production and Its Land Tenure Consequences in Africa: An Interpretive Review

“…Of note regarding our use of this method is that it adopts typical steps used in systematic reviews, following a qualitative communicative inquiry. In adopting this approach, it was important to clearly delineate how the literature data were sourced, but we did not seek to draw conclusions from all the relevant sources, or to identify what they suggest, as in a critical traditional literature or synthesis [16,17]. This is why we refer to our general approach as interpretative or interpretive.…”