Health Equity Research and Development Unit, a unit of Clinical Services Integration and Population Health, Sydney Local Health District and a research hub of the Centre for Primary Health Care and Equity, University of New South Wales, Kensington, Australia.
Centre for Primary Health Care and Equity, University of New South Wales, Kensington, Australia.
BMC Health Serv Res. 2020 Apr 15;20(1):309. doi: 10.1186/s12913-020-05157-x.
Recently arrived culturally and linguistically diverse migrant mothers in Western Industrialised Nations are less likely to access health care and are more likely to report negative healthcare experiences than more established migrant or non-migrant populations. This is particularly an issue in Australia where nearly half of all Australians were born overseas or have at least one parent born overseas.
A systematic scoping review was conducted to identify a) the main enablers and barriers to accessing appropriate health care for migrant families with a new baby/young child who speak a language other than English, and b) the effectiveness of interventions that have been tested to improve access to appropriate health care for this group. Three academic databases (CINAHL, Medline and ProQuest) were searched, with additional publications identified through expert knowledge and networks. Data was extracted and analysed according to the Access framework, which conceptualises access to health care as being generated by the interaction of dimensions of accessibility of services (supply side) and abilities of potential users (demand side).
A total of 1964 records were screened for eligibility, with nine of these included in the review. Seven studies only described barriers and enablers to health care access, one study reported on an evaluation of an intervention and one study described the barriers and enablers and the evaluation of an intervention. This review identified that the most significant barriers occurred on the supply side, within the 'appropriateness' domain. Overall, the most frequently cited barrier was a lack of cultural sensitivity/understanding of different cultural practices (five studies). The most significant enablers also occurred on the supply side, but within the 'acceptability' domain. The most frequently cited enabler was cultural sensitivity and understanding.
There is a dearth of evaluated interventions in the peer reviewed literature to improve appropriate access to postnatal care for migrant families who speak a language other than English. The literature focuses on identifying barriers and enablers to access to healthcare for this population group. Interventions which aim to address barriers within the 'appropriateness' dimension may have the greatest impact on access.
在西方工业化国家，新移民的文化和语言背景多样化，他们获得医疗保健的机会较少，报告负面医疗体验的可能性高于更成熟的移民或非移民群体。在澳大利亚，这种情况尤其严重，近一半的澳大利亚人在海外出生，或者至少有一位父母在海外出生。
进行了系统的范围审查，以确定 a）讲英语以外语言的新移民家庭获得适当医疗保健的主要促进因素和障碍，以及 b）已测试的改善该群体获得适当医疗保健的干预措施的有效性。检索了三个学术数据库（CINAHL、Medline 和 ProQuest），并通过专家知识和网络确定了其他出版物。根据 Access 框架提取和分析数据，该框架将医疗保健的可及性概念化为服务供应方（供给侧）的可及性维度和潜在用户（需求侧）的能力的相互作用的结果。
共筛选了 1964 条记录以确定其是否符合资格，其中有 9 项纳入了审查。有七项研究仅描述了医疗保健获取的障碍和促进因素，一项研究报告了干预措施的评估，一项研究描述了障碍和促进因素以及干预措施的评估。本综述发现，最主要的障碍发生在供给侧，在“适宜性”领域。总体而言，最常被引用的障碍是缺乏文化敏感性/对不同文化习俗的理解（五项研究）。最主要的促进因素也发生在供给侧，但在“可接受性”领域。最常被引用的促进因素是文化敏感性和理解。
在同行评议文献中，几乎没有评估干预措施来改善讲英语以外语言的移民家庭获得产后护理的适当机会。文献重点在于确定该人群群体获得医疗保健的障碍和促进因素。旨在解决“适宜性”维度障碍的干预措施可能对获取途径产生最大影响。
