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Kanengoni-Nyatara B, Watson K, Galindo C, Charania NA, Mpofu C, Holroyd E. Barriers to and Recommendations for Equitable Access to Healthcare for Migrants and Refugees in Aotearoa, New Zealand: An Integrative Review. J Immigr Minor Health 2024; 26:164-180. [PMID: 37665540 PMCID: PMC10771599 DOI: 10.1007/s10903-023-01528-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/05/2023]
Abstract
The health system in Aotearoa New Zealand is predicated on equity in access to health services as a fundamental objective yet barriers to equitable access for migrant and refugees continue to exist. There is a paucity of studies that synthesise the experiences and realities of migrants, refugees and healthcare providers that hinder access to healthcare and provide recommendations to improve services. This review synthesised these barriers and recommendations, with an aim to improve equitable access to healthcare to migrants and refugees. An integrative review of 13 peer-reviewed research studies from EBSCOhost research databases published between January 2016 and September 2022. Studies included: (i) related to Aotearoa; (ii) had a focus on equitable delivery of healthcare to migrants and refugees; and (iii) had a full English text available. The PRISMA framework guided the reporting of the review. The findings were thematically analysed and presented using a narrative empirical synthesis. The findings were organised into three broad themes: attitudinal barriers, structural barriers, and recommendations. Attitudinal barriers included the lack of culturally competent healthcare providers, discrimination by healthcare providers, and personal, social, and cultural attributes. Structural barriers referred to policies and frameworks that regulated the accessibility of health services such as the cost of healthcare, accessibility and acceptability of interpreter services, length of allocated appointments and long waiting times for an appointment, difficulties navigating the health system, and logistical barriers. Recommendations focused on promoting a sense of belonging, enabling a whole-of-society approach that brings together all sectors involved in providing health care for collective impact, and advocating for government policies to create a system that addresses the core health service access needs. This review provides rich context-specific findings on the barriers to equitable access to healthcare and proposed interventions to enhance equitable health outcomes for migrants and refugees in Aotearoa. The review contributes to relevant policy decisions and has practical implications to build responsive health systems which are inclusive, equitable and best address the health needs of populations from diverse cultural backgrounds.
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Affiliation(s)
- Blessing Kanengoni-Nyatara
- AUT Migrant and Refugee Health Research Centre, Faculty of Health and Environmental Sciences, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand
| | - Katie Watson
- Hato Hone St John, 600 Great South Road, Ellerslie, Auckland, 1051, New Zealand
| | - Carolina Galindo
- Hato Hone St John, 600 Great South Road, Ellerslie, Auckland, 1051, New Zealand
| | - Nadia A Charania
- AUT Migrant and Refugee Health Research Centre, Faculty of Health and Environmental Sciences, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand
| | - Charles Mpofu
- AUT Migrant and Refugee Health Research Centre, Faculty of Health and Environmental Sciences, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand
| | - Eleanor Holroyd
- AUT Migrant and Refugee Health Research Centre, Faculty of Health and Environmental Sciences, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand.
- AUT Migrant and Refugee Health Research Centre, School of Public Health and Interdisciplinary Studies, Auckland University of Technology, 90 Akoranga Drive, Northcote, Auckland, 0627, New Zealand.
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