Open AccessThe social and structural determinants of sexual and reproductive health and rights in migrants and refugees: a systematic review of reviews
Author(s) -
Dianne Egli-Gany,
Wafa Aftab,
Sarah Hawkes,
Laith Abu Raddad,
Kent Buse,
Fauziah Rabbani,
Nicola Low,
Kristine Husøy Onarheim
Publication year - 2021
Publication title -
eastern mediterranean health journal/eastern mediterranean health journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.442
H-Index - 47
eISSN - 1687-1634
pISSN - 1020-3397
DOI - 10.26719/emhj.20.101
Subject(s) - refugee , sexual and reproductive health and rights , reproductive health , social determinants of health , public health , unintended consequences , unintended pregnancy , political science , gender studies , medicine , sociology , environmental health , reproductive rights , population , nursing , family planning , law , research methodology
Background: The sexual and reproductive health and rights (SRHR) of migrants and refugees present important public health challenges. Social and structural determinants affect both the general health and SRHR of migrants, but the drivers of SRHR among migrant and refugee populations remain understudied. Aims: To identify upstream social and structural determinants of SRHR health of migrants and refugees reported in systematic reviews. Methods: We conducted a systematic review of reviews. We studied 3 aspects of SRHR: sexually transmitted infections, sexual violence and unintended pregnancy in migrants and refugees. We used an inductive approach to synthesize emerging themes, summarized them in a narrative format and made an adapted version of Dahlgren and Whitehead’s social determinants of health (SDH) model. Results: We included 12 systematic reviews, of which 10 were related to sexually transmitted infections, 4 to sexual violence and 2 to unintended pregnancy. We identified 6 themes that operate at 4 different levels in an adapted version of the Dahlgren and Whitehead SDH model: economic crisis and hostile discourse on migration; limited legal entitlements,rights and administrative barriers; inadequate resources and financial constraints; poor living and working conditions; cultural and linguistic barriers; and stigma and discrimination based on migration status, gender, sex and ethnicity. Conclusion: This review provides evidence of how upstream social and structural determinants undermine the SRHR of refugees and migrants. Unless these are addressed in policy-making and planning, the health of migrants and refugees is at risk.