Publication: Challenges in the provision of healthcare services for migrants: a systematic review through providers’ lens
Issued Date
2015
Resource Type
Language
eng
Rights
Mahidol University
Rights Holder(s)
BioMed Central
Bibliographic Citation
BMC Health Services Research. Vol.15, (2015), 390
Suggested Citation
Rapeepong Suphanchaimat, Kanang Kantamaturapoj, Weerasak Putthasri, Phusit Prakongsai Challenges in the provision of healthcare services for migrants: a systematic review through providers’ lens. BMC Health Services Research. Vol.15, (2015), 390. doi:10.1186/s12913-015-1065-z Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/3132
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Thesis
Title
Challenges in the provision of healthcare services for migrants: a systematic review through providers’ lens
Abstract
Background: In recent years, cross-border migration has gained significant attention in high-level policy dialogues
in numerous countries. While there exists some literature describing the health status of migrants, and exploring
migrants’ perceptions of service utilisation in receiving countries, there is still little evidence that examines the issue
of health services for migrants through the lens of providers. This study therefore aims to systematically review the
latest literature, which investigated perceptions and attitudes of healthcare providers in managing care for migrants,
as well as examining the challenges and barriers faced in their practices.
Methods: A systematic review was performed by gathering evidence from three main online databases: Medline,
Embase and Scopus, plus a purposive search from the World Health Organization’s website and grey literature
sources. The articles, published in English since 2000, were reviewed according to the following topics: (1) how
healthcare providers interacted with individual migrant patients, (2) how workplace factors shaped services for
migrants, and (3) how the external environment, specifically laws and professional norms influenced their practices. Key
message of the articles were analysed by thematic analysis.
Results: Thirty seven articles were recruited for the final review. Key findings of the selected articles were synthesised
and presented in the data extraction form. Quality of retrieved articles varied substantially. Almost all the selected
articles had congruent findings regarding language andcultural challenges, and a lack of knowledge of a host country's
health system amongst migrant patients. Most respondents expressed concerns over in-house constraints resulting
from heavy workloads and the inadequacy of human resources. Professional norms strongly influenced the behaviours
and attitudes of healthcare providers despite conflicting with laws that limited right to health services access for illegal
migrants.
Discussion: The perceptions, attitudes and practices of practitioners in the provision of healthcare services for
migrants were mainly influenced by: (1) diverse cultural beliefs and language differences, (2) limited
institutional capacity, in terms of time and/or resource constraints, (3) the contradiction between professional
ethics and laws that limited migrants’ right to health care. Nevertheless, healthcare providers addressedsuch
problems by partially ignoring the immigrants’precarious legal status, and using numerous tactics, including
seeking help from civil society groups, to support their clinical practice. Conclusion: It was evident that healthcare providers faced several challenges in managing care for migrants,
which included not only language and cultural barriers, but also resource constraints within their workplaces,
and disharmony between the law and their professional norms. Further studies, which explore health care
management for migrants in countries with different health insurance models, are recommended.