The social and structural determinants of sexual and reproductive health and rights in migrants and refugees: a systematic review of reviews

Dianne Egli-Gany, Wafa Aftab, Sarah Hawkes, Laith Abu-Raddad, Kent Buse, Fauziah Rabbani, Nicola Low, Kristine Onarheim

Research output: Contribution to journalReview articlepeer-review

14 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1203-1213
Number of pages11
JournalEastern Mediterranean Health Journal
Volume27
Issue number12
DOIs
Publication statusPublished - 1 Dec 2021

Keywords

  • Migrants
  • Refugees
  • Sexual and reproductive health
  • Social and structural determinants of health

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