Access to appropriate health care for non-English speaking migrant families with a newborn/young child: a systematic scoping literature review

Abstract

Background: Recently arrived culturally and linguistically diverse migrant mothers in Western Industrialised Nations are less likely to access health care and are more likely to report negative healthcare experiences than more established migrant or non-migrant populations. This is particularly an issue in Australia where nearly half of all Australians were born overseas or have at least one parent born overseas. Methods: A systematic scoping review was conducted to identify a) the main enablers and barriers to accessing appropriate health care for migrant families with a new baby/young child who speak a language other than English, and b) the effectiveness of interventions that have been tested to improve access to appropriate health care for this group. Three academic databases (CINAHL, Medline and ProQuest) were searched, with additional publications identified through expert knowledge and networks. Data was extracted and analysed according to the Access framework, which conceptualises access to health care as being generated by the interaction of dimensions of accessibility of services (supply side) and abilities of potential users (demand side).Results: A total of 1964 records were screened for eligibility, with nine of these included in the review. Seven studies only described barriers and enablers to health care access, one study reported on an evaluation of an intervention and one study described the barriers and enablers and the evaluation of an intervention. This review identified that the most significant barriers occurred on the supply side, within the 'appropriateness' domain. Overall, the most frequently cited barrier was a lack of cultural sensitivity/understanding of different cultural practices (five studies). The most significant enablers also occurred on the supply side, but within the 'acceptability' domain. The most frequently cited enabler was cultural sensitivity and understanding. (Continued on next page)Conclusions: There is a dearth of evaluated interventions in the peer reviewed literature to improve appropriate access to postnatal care for migrant families who speak a language other than English. The literature focuses on identifying barriers and enablers to access to healthcare for this population group. Interventions which aim to address barriers within the 'appropriateness' dimension may have the greatest impact on access.

Feasibility of a culturally adapted early childhood obesity prevention program among migrant mothers in Australia: a mixed methods evaluation

“…Consistent with our findings, mothers have reported doctors consultations to sometimes be rushed and lacking specialist infant advice [ 53 ]. Differences in language and cultural background of health professionals and recipients is also an important consideration for engagement [ 8 , 54 ]. Many mothers in this study felt they were given time for the interaction and were emotionally supported by the bi-cultural CFHNs.…”

“…We recruited a large sample for this feasibility study and had a high retention rate, indicating positive uptake from participants and greater representation from the target groups. Our qualitative interviews and acceptability analysis were a strength of this study, particularly as acceptability is a significant enabler for child and family health service access among linguistically diverse migrants [ 8 ] and participants’ experiences in early childhood obesity prevention studies are infrequently reported [ 69 ]. The qualitative follow-up interviews conducted allowed us to explore mothers’ program experiences in detail.…”

“…Reduced access to healthcare impacts the support mothers receive for their health and the health of their children in this critical early period of life. Yet, there is a lack of evaluated interventions to improve access to postnatal care for culturally and linguistically diverse migrant families [ 8 ].…”

Supporting Newly Arrived Migrant Mothers: A Pilot Health Literacy Intervention

“…A recent literature review has identified that there are a lack of evaluated interventions to improve health literacy and health care access for migrant families who speak a language other than English, with the majority of the literature focused on identifying enablers and barriers to health care access rather than testing interventions ( Dougherty et al, 2020 ). However, there is a clear need for these types of interventions given that migrant women have been found to experience lower levels of access to health care and poorer birth outcomes ( Almeida et al, 2013 ).…”

“…One potential avenue to address barriers to accessing health care is through interventions aiming to improve health literacy. Most research has tended to focus on identifying these barriers rather than trialing interventions to overcome these barriers ( Dougherty et al, 2020 ), and as such, this pilot study is an important contribution to the literature and to practice.…”