Salman Amirah Adnan, Whyle Eleanor, de Oliveira Livia Costa, Olivier Jill
University of Cape Town, Cape Town, South Africa.
Premier Institute, São Paulo, SP, Brazil.
J Immigr Minor Health. 2025 May 2. doi: 10.1007/s10903-025-01693-y.
This review aimed to examine the barriers to accessing health systems among undocumented migrants in low- and middle-income countries (LMICs). This qualitative review study was conducted to answer the question: 'What are the tangible and intangible barriers undocumented migrants face in accessing health systems in LMICs?'. Thirty-one studies published in English, Portuguese or Spanish between 2013 and 2023 were included. As a growing body of evidence demonstrates, undocumented migrants are among the most vulnerable populations with access to healthcare services impacted by high costs, legal barriers, document requirements and unclear policy messages. This review found that these barriers are interrelated and complicated by individual and institutional discrimination, xenophobia, and perceptions that undocumented migrants are less deserving and compete for local resources. Delayed care and limited primary healthcare access with critical health consequences were described in all such cases. The review suggests that barriers to healthcare access result from the intersection of outdated legislation, economic factors, weak health systems and service provision, bureaucratic inefficiencies and cultural norms and values. As such, improving access to care for undocumented migrants require intersectoral action and policy change that needs to be guided by context-sensitive research.
本综述旨在探讨低收入和中等收入国家（LMICs）中无证移民在获取卫生系统服务方面所面临的障碍。开展这项定性综述研究是为了回答以下问题：“无证移民在低收入和中等收入国家获取卫生系统服务时面临哪些有形和无形的障碍？”。纳入了2013年至2023年间以英文、葡萄牙文或西班牙文发表的31项研究。越来越多的证据表明，无证移民是最脆弱的人群之一，他们获得医疗服务受到高成本、法律障碍、文件要求以及不明确的政策信息的影响。本综述发现，这些障碍相互关联，并且因个人和机构的歧视、仇外心理以及认为无证移民不值得获得服务并与当地资源竞争的观念而变得更加复杂。在所有这些案例中都描述了延迟就医以及获得初级卫生保健的机会有限并产生严重健康后果的情况。该综述表明，获取医疗服务的障碍源于过时的立法、经济因素、薄弱的卫生系统和服务提供、官僚效率低下以及文化规范和价值观的相互交织。因此，改善无证移民获得医疗服务的机会需要跨部门行动和政策变革，而这需要以因地制宜的研究为指导。
