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Key Barriers to Health Care Access among Sub-Saharan African Migrants: A Documentary Review


By Laston Gonah and Marc Van der Putten


Background:
 The phenomenon of barriers to health care services among sub-Saharan African migrants is a global health problem of increasing concern as illustrated by various arguments (WHO, 2013; Boateng, 2012; Napier, 2014). Of particular concern is the finding that these diverse populations often migrate without paying a fair consideration to, or preparing for, the potential challenges they are most likely to face upon arrival in host countries (WHO, 2010). As noted by the Global Consultation on Migrants Health (2010), there is a possibility that migrants may travel with diseases and/or may acquire diseases or conditions while travelling or while staying in the host country that present a need for regular use of health care services. Migrant health profiles, values and beliefs may differ from those of the host population and could potentially render them more vulnerable to poor health while they simultaneously face potential barriers in accessing health services (WHO, 2010). Access to health care services among migrants thus becomes a major issue of concern especially in such a globalized world. Exploring barriers to health care access among sub-Saharan African migrants facilitates identification of potential knowledge gaps that may exist. 

Objectives: To explore key barriers to health care access and ways of coping with these among Sub-Saharan African (SSA) migrants living outside the African continent. Identify knowledge gaps on barriers to health care access and coping mechanisms among Sub - Saharan African migrants living outside the African continent. 

Methods: A narrative review design was applied to qualitative documentary research using a variety of search engines employing a Boolean search strategy to retrieve research publications, “grey literature, and expert working group reports serving as content analysis.

Findings: The review study established that research on barriers to access to health care for sub - Saharan migrants is limited to Australia, Europe and the USA, while little is known about the situation in Asia. Commonly reported hindrances to health care access among SSA migrants can be categorized into four categories: economic, geographical, socio - cultural and functional barriers. Financial and health system - related barriers are reported most frequently and strategies in coping with hindrances to health care access included reliance on social networks and internet - based information sources.

Conclusion: In conclusion, despite indications of a national trend toward increasing numbers of SSA migrants in Thailand, and the importance of understanding culturally diverse influences contributing to inadequate access and utilization of health services, no studies were identified exploring barriers to access and strategies in coping with these barriers among SSA in Bangkok, Thailand. Therefore, the purpose of a planned case study is to compare the findings of the present study from the literature with on - site findings on barriers to access and the common coping strategies employed in dealing with these barriers among SSA migrants in Thailand.