Barriers to health access for women during forced migration: An exploratory study

Abstract

Abstract Background Mass migration is a global crisis that has a number of significant public health implications for Europe. With more than a billion migrants worldwide, Europe receives a significant proportion of those, many of whom are forced migrants, possessing particular health and social vulnerabilities. Many forced migrants transit through, or settle within Europe. Despite this, there is a dearth of literature examining the experiences and perspectives of forced migrants or the barriers they may face in accessing health services. Understanding these barriers is integral to developing an effective international response. Methods Using purposive sampling, 8 female key informants from displacement backgrounds were recruited for in-depth interviews from Queensland, Australia. The interview questions focused on past experiences of accessing healthcare during displacement and were formulated around the 5 dimensions of health access described by Levesque, Harris and Russell (2013). Data was analysed using qualitative content analysis. Results Under the five dimensions of health access (approachability, acceptability, availability, affordability and appropriateness) twelve sub-themes were identified that were specific to the displacement context. Common sub-themes included mistrust of health services, irregularity in access, focus on acute health conditions, limited healthcare capacity, self-treatment; with pharmacies often the first point of contact, and the neglected health needs of vulnerable populations, such as women. Conclusions The current global mass population flows, display a need to consider the long-term health effects of displacement and how these experiences shape migrants’ future health-seeking behaviours. A significant number of forced migrants transit or settle within Europe and therefore there is a demonstrable need to understand the perspectives and experiences of those individuals, if equitable health access is to be attained. Key messages This is the first study to the authors’ knowledge that applies a structured framework to the displacement experience, providing novel insights of an under-researched population. It is essential to understand the perceived barriers to health access of forced migrants in order to reduce morbidity, mortality, inequity and associated healthcare costs.