Sexual and Reproductive Health Rights and Service Use among Undocumented Migrants in the EU: A Systematic Literature Review

Author:

Mandroiu Alexandra12ORCID,Alsubahi Nizar13ORCID,Groot Wim14,Pavlova Milena1ORCID

Affiliation:

1. Department of Health Services Research, Care and Public Health Research Institute—CAPHRI, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands

2. Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), 1349-008 Lisbon, Portugal

3. Department of Health Service and Hospital Administration, Faculty of Economics and Administration, King Abdul Aziz University, Jeddah 21589, Saudi Arabia

4. Maastricht Economic and Social Research Institute on Innovation and Technology, United Nations University, 6211 LK Maastricht, The Netherlands

Abstract

Most EU member states fail to provide essential sexual and reproductive health services to undocumented migrants, a vulnerable population facing limited access, utilization, and worse health-related outcomes. This study systematically reviewed the literature on access to and use of these services, as well as related health, economic, and migratory outcomes for undocumented migrants in the EU-EFTA region. The systematic review is reported based on the PRISMA 2020 checklist and includes 37 studies published between 2017 and 2024. Included studies were based upon original quantitative, qualitative, or mixed-methods data; conducted in one or more European countries; and published in one or more of the following languages: English, Spanish, French, Portuguese, or Romanian. A quality assessment was conducted using the CASP checklist for qualitative studies and the NHLBI Study Quality Assessment Tools for quantitative studies. The findings revealed numerous access barriers, including refusal of care, lack of knowledge about national healthcare schemes, bureaucratic hurdles, and affordability issues. Even when care was available, stigma, fear of deportation, socio-economic precarity, and abuse further hindered utilization. These barriers contributed to generally worse reproductive health outcomes for undocumented migrants in Europe, though the findings may not generalize to all EU-EFTA countries.

Publisher

MDPI AG

Reference58 articles.

1. United Nations Population Fund [UNFPA] (2019). Sexual and Reproductive Health and Rights: An Essential Element of Universal Health Coverage. Background Document for the Nairobi Summit on ICPD25—Accelerating the Promise, UNFPA.

2. (2014). Programme of Action of the International Conference on Population Development, United Nations Population Fund [UNFPA]. [20th anniversary ed.].

3. (2019). State of World Population—Unfinished Business, United Nations Population Fund [UNFPA].

4. (2016). Plan for Sexual and Reproductive Health: Towards Achieving the 2030 Agenda for Sustainable Development in Europe—Leaving No One Behind, World Health Organization (WHO) Office for Europe Action.

5. Smith, A., and Levoy, M. (2022, March 05). Sexual and Reproductive Health Rights of Undocumented Migrants, European Union. Available online: https://picum.org/wp-content/uploads/2017/11/Sexual-and-Reproductive-Health-Rights_EN.pdf.

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