Maternal Healthcare in Migrants: A Systematic Review

Abstract

Pregnancy is a period of increased vulnerability for migrant women, and access to healthcare, use and quality of care provided during this period are important aspects to characterize the support provided to this population. A systematic review of the scientific literature contained in the MEDLINE and SCOPUS databases was carried out, searching for population based studies published between 1990 and 2012 and reporting on maternal healthcare in immigrant populations. A total of 854 articles were retrieved and 30 publications met the inclusion criteria, being included in the final evaluation. The majority of studies point to a higher health risk profile in immigrants, with an increased incidence of co-morbidity in some populations, reduced access to health facilities particularly in illegal immigrants, poor communication between women and caregivers, a lower rate of obstetrical interventions, a higher incidence of stillbirth and early neonatal death, an increased risk of maternal death, and a higher incidence of postpartum depression. Incidences vary widely among different population groups. Some migrant populations are at a higher risk of serious complications during pregnancy, for reasons that include reduced access and use of healthcare facilities, as well as less optimal care, resulting in a higher incidence of adverse outcomes. Tackling these problems and achieving equality of care for all is a challenging aim for public healthcare services.

Brechas de desigualdad en salud en niños migrantes versus locales en Chile

“…Se ha estimado que 37 millones de estos migrantes son menores de 20 años, de los cuales la mayoría reside en países en vías de desarrollo 2 . Recientemente se ha reconocido que la condición migratoria puede ser un indicador de vulnerabilidad social o de desigualdad social en salud al interior de un país 1-4,9,10 y que variables migratorias específicas, posibles de modificar o prevenir, pueden ser determinantes en este proceso 8 . Los principales factores que afectan a la salud de los migrantes internacionales son condiciones laborales, barreras culturales, acceso y uso a servicios de salud, condiciones previas en el país de origen, tiempo de residencia en el país de destino (asociados a fenómenos de asimilación y aculturación), procesos sociales de integración/exclusión y experiencias de estigma y discriminación 11,12,13 .…”

“…Las razones para ello son diversas e incluyen, por ejemplo, diferentes patrones de enfermedad, diferentes comportamientos de acceso al sistema de salud, variabilidad económica y social, así como la disposición de cobertura de seguros de salud parcial o total. De hecho, revisiones sistemáticas han documentado el reducido uso de servicios de salud prenatal entre inmigrantes embarazadas 8,17 . Hay pocos estudios acerca del uso de servicios de los niños migrantes internacionales.…”

“…Estos factores de riesgo se traducen en resultados adversos para la salud de los niños migrantes internacionales. De acuerdo a lo reportado en la literatura internacional, niños nacidos de madres con antecedentes de inmigración tienen una mayor incidencia de muerte fetal, muerte neonatal, parto prematuro y bajo peso al nacer 8,9,10,11 . El estado de salud física de los niños migrantes después del nacimiento se ha estudiado con menos rigor, pero hay indicios de mayor prevalencia de caries dentales, algunas enfermedades infecciosas 10,12 y obesidad 13 .…”

The Rise of Pregnancy Apps and the Implications for Culturally and Linguistically Diverse Women: Narrative Review (Preprint)

“…While around half of those who did not or rarely engaged with health-management practices indicated an interest in doing so in the future, several indicated a need for support or training in order to be able to manage existing digital resources. These findings highlight a key concern then, for CALD women, who are known to have lower health literacy levels compared to women in general [11,35,36].…”

“…These groups require particular consideration given the lower levels of health literacy [9] health care access [10], and concomitant poorer perinatal outcomes in comparison to non-CALD women [11]. Thus, it is crucial to ascertain whether digital technologies improve outcomes for CALD and other disadvantaged groups or simply perpetuate the status quo [12].…”