Identifying challenges and enabling factors in utilizing health care services by undocumented immigrant women: a scoping review of qualitative research.

Abstract

Background: Undocumented immigrant women often face significant barriers in accessing healthcare services, which can adversely affect their health outcomes. This scoping review aims to identify the main challenges and enabling factors to undocumented immigrant women's health service utilization and evaluate the methodological quality of existing qualitative studies on this topic.

Methods: PubMed, Scopus, Web of Science, Embase, and ProQuest were searched until the end of April 2024. The methodological quality of included studies was assessed using the Critical Appraisal Skills Programme (CASP) Qualitative Checklist. The eligible studies must explore perspectives of undocumented immigrant women themselves, healthcare providers or both, as long as findings relate to women's access challenges and enabling factors. Thematic analysis was employed to synthesize the collected data.

Results: In total, 3,339 records retrieved, 1,537 screened, and 35 studies included. Common barriers identified include fear of deportation, language barriers, economic constraints, and discriminatory practices by healthcare providers. Facilitators include strong social networks, community support, free or low-cost clinics, outreach programs, and policies ensuring confidentiality and non-discrimination. Most of the included studies achieving high scores (8-10) based on the CASP checklist.

Conclusion: Undocumented immigrant women face considerable challenges in accessing healthcare services due to personal and institutional barriers. However, accessible community services and inclusive healthcare policies can significantly enhance their access to healthcare. These findings highlight an urgent need for policy reform and the effective implementation of culturally sensitive healthcare services to address these barriers.