Barriers to effective right of access to health: a systematic review with metanalysis

Abstract

Objective: Evaluating evidence involving the assurance of health rights for refugee population throughout the world by systematic revision with metanalysis. Data Source: the following database was used: MEDLINE, accessed via Virtual Health Library (BVS), and SCOPUS. In order to make more assured and straightforward research, the authors chose to unify all the descriptors (MeSH) using the operator AND on the following form: (Refugees AND Right to health AND Human Rights). Study Selection: The primary selection occur through triage of titles and abstracts followed by eligibility criteria based on full reading of the articles selected under previously stablished inclusion criteria. Data Extraction: Some of the information were extracted from studies enclosing author, year, type of participants and its respective numbers, type of intervention, number of sessions or time of follow-up, and outcomes. Results: The research strategies resulted in 201 articles. Considering inclusion and exclusion criteria, 10 studies were included in the sample (N). The metanalysis make possible to assess the failure of the effective policy towards the refugee population´s welfare, thus there is an effective close proximity with the absence line, I^2 (variation in ES attributable to heterogeneity) = 98.32%; Estimate of between-study variance Tau^2 = 0.04; Test of ES=0: z = 1.08 p = 0.00. Conclusion: The lack of access to information, the language and cultural issues, and the oddness/estrangement over the hosting country are major factors contributing for the refugee´s health precariousness in making it difficult in its access. The report “Global Trends” of the United Nations High Commissioner for Refugees (UNHCR) indicate that such difficulties in the health access may be related to the level of social-economic development of the hosting countries. There are plenty of difficulties on the accessing health services, among then the lack of official documentation and information. Objective: Evaluating evidence involving the assurance of health rights for refugee population throughout the world by systematic revision with metanalysis. Data Source: the following database was used: MEDLINE, accessed via Virtual Health Library (BVS), and SCOPUS. In order to make more assured and straightforward research, the authors chose to unify all the descriptors (MeSH) using the operator AND on the following form: (Refugees AND Right to health AND Human Rights). Study Selection: The primary selection occur through triage of titles and abstracts followed by eligibility criteria based on full reading of the articles selected under previously stablished inclusion criteria. Data Extraction: Some of the information were extracted from studies enclosing author, year, type of participants and its respective numbers, type of intervention, number of sessions or time of follow-up, and outcomes. Results: The research strategies resulted in 201 articles. Considering inclusion and exclusion criteria, 10 studies were included in the sample (N). The metanalysis make possible to assess the failure of the effective policy towards the refugee population´s welfare, thus there is an effective close proximity with the absence line, I^2 (variation in ES attributable to heterogeneity) = 98.32%; Estimate of between-study variance Tau^2 = 0.04; Test of ES=0: z = 1.08 p = 0.00. Conclusion: The lack of access to information, the language and cultural issues, and the oddness/estrangement over the hosting country are major factors contributing for the refugee´s health precariousness in making it difficult in its access. The report “Global Trends” of the United Nations High Commissioner for Refugees (UNHCR) indicate that such difficulties in the health access may be related to the level of social-economic development of the hosting countries. There are plenty of difficulties on the accessing health services, among then the lack of official documentation and information.