Gypsy, Roma and Traveller access to and engagement with health services: a systematic review

Abstract

This review provides evidence that Gypsy, Roma and Traveller populations across Europe struggle to exercise their right to healthcare on account of multiple barriers; and related to other determinants of disadvantage such as low literacy levels and experiences of discrimination. Some promising strategies to overcome barriers were reported but the evidence is weak; therefore, rigorous evaluations of interventions to improve access to and engagement with health services for Gypsy, Roma and Traveller people are needed.

Improving equity and cultural responsiveness with marginalised communities: Understanding competing worldviews

“…This makes it very hard when accessing health care as many Gypsy Roma Travellers women and their husbands would be uncomfortable if a male practitioner treated a female, especially if the health problem was gynaecological or gastric in nature. Discussing bowels, bowel movements or menstruation will be very difficult as they are considered very private (Heaslip, ; McFadden et al., ).…”

“…Whilst the disparities evident in health care and health outcomes can be attributed to a variety of things, some groups of people experience persistent, avoidable and unjust health inequities that in part can be attributed to the access to and quality of care they receive (Braveman, ; Marmot, ). We will draw on two different marginalised communities to illustrate impacts of healthcare delivery on health for two groups who have ongoing inequities (McFadden et al., ; Ministry of Health, ): New Zealand Māori and Gypsy Roma Travellers with alternative worldviews of health and illness. They have worldviews that are at odds with the biomedical worldview that is prevalent in many Western healthcare services—that is, they have collective, holistic worldviews that are wellness and relationship focused, contrasting with the individual, illness or disease focus of biomedical approaches.…”

“…Whilst the disparities evident in health care and health outcomes can be attributed to a variety of things, some groups of people experience persistent, avoidable and unjust health inequities that in part can be attributed to the access to and quality of care they receive (Braveman, 2014;Marmot, 2013). We will draw on two different marginalised communities to illustrate impacts of healthcare delivery on health for two groups who have ongoing inequities (McFadden et al, 2018;Ministry of Health, 2015): New Zealand M aori and Gypsy Roma Travellers with alternative worldviews of health and illness.…”

La migración sur/sur como un determinante social de impacto en las desigualdades e inequidades en salud bucal en Latinoamérica

“…Una búsqueda en PubMed (https://www.ncbi.nlm.nih.gov/ pubmed/), usando lenguaje libre mediante las palabras «immigrant OR migrant» AND «health», sin la aplicación de términos MeSH, da cuenta de 212 revisiones sistemáticas de diversos temas en salud en los últimos cinco años. De éstas, siete (3,3%) se ocupan de investigar temas relacionados con migración y salud bucal (10)(11)(12)(13)(14)(15)(16) . Esto da pie a la necesidad de analizar la situación de salud bucal desde un enfoque de los determinantes sociales que permita identificar las necesidades específicas en diferentes grupos sociales como la población migrante.…”

Experience of skin disease and relationships with healthcare providers: a qualitative study of Traveller women in Ireland

“…A myriad of social and economic factors create challenges in access to, and use of, health care in this minority group . Obstacles to engagement with health services include Travellers’ experience or perception of discrimination, and cultural and health literacy barriers …”