Indigenous women’s access to maternal healthcare services in lower- and middle-income countries: a systematic integrative review

Abstract

Objectives Globally, Indigenous people have lower-health status compared to non-Indigenous people due to unequal access to health care. Barriers or enablers to accessing maternal health services by Indigenous women are not well researched. This review aims to determine accessibility and utilisation of maternal primary healthcare services among Indigenous women in lower-and middle-income countries. Methods We conducted a systematic integrative review of published and grey literature published between 2000 and 2017. Studies on maternal healthcare service utilisation by Indigenous women in lower-and middle-income countries were included. From 3092 articles identified, 10 met the eligibility criteria. ResultsThe most prominent barrier to accessing maternal primary healthcare services was the top-down nature of intervention programmes, which made programmes culturally unfriendly for Indigenous women. Distance, cost, transport, accommodation, language barriers and lack of knowledge about existing services also impacted access. Conclusions Findings provided insights into understanding the gaps in existing policies for Indigenous women and their access to maternal health services. Results suggested that efforts be made to ensure appropriate programmes for Indigenous women's maternal health right.

Traumatic brain injury and intimate partner violence: Addressing knowledge and service gaps among indigenous populations in Canada

“…The overarching theme found in this study acknowledging the critical need for a broad education campaign increasing awareness and understanding in service providers, survivors, families, and communities supports findings not only in previous studies of a similar nature (Keightley et al, 2011a(Keightley et al, , 2011bLinton & Kim, 2014), but also in the broader Indigenous health literature (Akter et al, 2019). In particular, issues of timely and effective screening, the absence of a culturally competent diagnostic tool, and the persistent lack of knowledge are raised as being of ongoing concern in a study looking at IPV-related TBI in Native Americans (Linton, 2015).…”

“…This lack of information presents a host of challenges including the difficulty of situating the findings of this consultation within existing knowledge. Findings, however, reflect a congruence with the existing literature on Indigenous people's engagement with a range of colonial structuresand the resultant experiences of structural and cultural violencewhich is a direct affront to community health, safety, and integrity (Akter, Davies, Rich & Inder, 2019;Kronfli et al, 2017;Patrick, 2016). It is this larger picture of colonial violence in which IPV, TBI, and their intersection are situated, which shapes Indigenous women's experiences of the injury and its aftermath.…”

“…Challenges stemming from reduced or non-existent cultural competency were discussed at length in this study, reflecting conversations found in the broader body of literature exploring Indigenous health (Akter et al, 2019;Kronfli et al, 2017;Patrick, 2016). Both Inuit and First Nations participants expressed concerns regarding language, literacy, and an absence of recognition for the unique qualities and varied implications of the Indigenous worldview.…”

“…More investigation exploring the lived experiences of women exposed to IPV is needed to develop TBI-sensitive services to address this unique group of survivors. Studies focused on other areas of Indigenous health have highlighted this knowledge gap (Akter et al, 2019;Kronfli et al, 2017), suggesting the issues are not unique to the IPV/TBI context, but reflect a larger, systemic concern. Engaging in further consultation in order to gain a better understanding of the Indigenous worldview and the ways in which existing traditional methods of healing can be fostered and supported within the community will have significant implications for policy and health care delivery, and can make strong advances in the reduction of shame and stigma, as all Canadians move forward in the process of reconciliation.…”

How the choice of ethnic indicator influences ethnicity-based inequities in maternal health care in four Latin American countries: who is indigenous?

“…Improving indigenous living conditions could not be enough because other sociocultural factors are also involved. Usually, indigenous women take care of their pregnancy and childbirth with midwives because of cultural and geographic proximity, they have the recovery of childbirth at home and the decisions about their care involve their partner or another family member [27][28][29][30][31].…”