Abstract
BackgrundMarginalized groups, such as nomadic populations across the world, have perhaps the least access to modern reproductive health (RH) services. This scoping review aims to identify barriers to access to RH services faced by nomadic populations from the existing literature and to highlight possible opportunities to address them.MethodsKey databases, including PubMed, Popline, Google Scholar, and Google Advanced were searched for relevant articles published between 2002 and 2019. A total 344 articles were identified through database online searches, and 31 were included in the review.ResultsNomadic people face complex barriers to healthcare access that can be broadly categorized as external (geographic isolation, socio-cultural dynamics, logistical and political factors) and internal (lifestyle, norms and practices, perceptions) factors. To effectively address the needs of nomadic populations, RH services must be available, accessible and acceptable through tailored and culturally sensitive approaches. A combination of fixed and mobile services has proven effective among mobile populations. Low awareness of modern RH services and their benefits is a major barrier to utilization. Partnership with communities through leveraging existing structures, networks and decision-making patterns can ensure that the programmes are effectively implemented.ConclusionFurther research is needed to better understand and address the RH needs of nomadic populations. Though existing evidence is limited, opportunities do exist and should be explored. Raising awareness and sensitization training among health providers about the specific needs of nomads is important. Improved education and access to information about the benefits of modern RH care among nomadic communities is needed. Ensuring community participation through involvement of nomadic women and girls, community leaders, male partners, and trained traditional birth attendants are key facilitators in reaching nomads. However, participatory programmes also need to be recognized and supported by governments and existing health systems.
Highlights
Despite the great progress towards improving reproductive health (RH) for global populations, outcomes such as maternal morbidity and mortality and a global unmet need for contraception remain large concerns in the international public health community [1, 2]
There are many other types of nomads such as hunter-gatherer populations who live in regions where they can rely on non-domesticated plants and animals for food, as well as sea nomads, and traders and craftworkers, who are commonly known as gypsies or Roma [5]
Much of the literature reviewed in this paper describes nomadic peoples in Africa [11, 12, 14, 17, 23,24,25,26,27,28,29,30,31, 33,34,35,36, 38,39,40,41,42]
Summary
Despite the great progress towards improving reproductive health (RH) for global populations, outcomes such as maternal morbidity and mortality and a global unmet need for contraception remain large concerns in the international public health community [1, 2]. Ali et al BMC Women's Health (2019) 19:161 mobility as they move from place to place, generally in traditional routes, in search of resources and food. Our paper focuses on pastoralist nomads, whose trajectories largely rely on grazing grounds for livestock. Pastoralists are defined as groups that move their homes according to grazing opportunities for their livestock and make up a large proportion of the global nomadic population. There are many other types of nomads such as hunter-gatherer populations who live in regions where they can rely on non-domesticated plants and animals for food, as well as sea nomads, and traders and craftworkers, who are commonly known as gypsies or Roma [5]
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