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The social and structural determinants of sexual and reproductive health and rights in migrants and refugees: a systematic review of reviews

Egli-Gany, Dianne; Aftab, Wafa; Hawkes, Sarah; Abu-Raddad, Laith; Buse, Kent; Rabbani, Fauziah; Low, Nicola; (2021) The social and structural determinants of sexual and reproductive health and rights in migrants and refugees: a systematic review of reviews. Eastern Mediterranean Health Journal , 27 (12) pp. 1203-1213. 10.26719/emhj.20.101. Green open access

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Abstract

Background: The sexual and reproductive health and rights (SRHR) of migrants and refugees present important public health challenges. Social and structural determinants affect both the general health and SRHR of migrants, but the drivers of SRHR among migrant and refugee populations remain understudied. Aims: To identify upstream social and structural determinants of SRHR health of migrants and refugees reported in systematic reviews. Methods: We conducted a systematic review of reviews. We studied 3 aspects of SRHR: sexually transmitted infections, sexual violence and unintended pregnancy in migrants and refugees. We used an inductive approach to synthesize emerging themes, summarized them in a narrative format and made an adapted version of Dahlgren and Whitehead’s social determinants of health (SDH) model. Results: We included 12 systematic reviews, of which 10 were related to sexually transmitted infections, 4 to sexual violence and 2 to unintended pregnancy. We identified 6 themes that operate at 4 different levels in an adapted version of the Dahlgren and Whitehead SDH model: economic crisis and hostile discourse on migration; limited legal entitlements,rights and administrative barriers; inadequate resources and financial constraints; poor living and working conditions; cultural and linguistic barriers; and stigma and discrimination based on migration status, gender, sex and ethnicity. Conclusion: This review provides evidence of how upstream social and structural determinants undermine the SRHR of refugees and migrants. Unless these are addressed in policy-making and planning, the health of migrants and refugees is at risk.

Type: Article
Title: The social and structural determinants of sexual and reproductive health and rights in migrants and refugees: a systematic review of reviews
Open access status: An open access version is available from UCL Discovery
DOI: 10.26719/emhj.20.101
Publisher version: https://doi.org/10.26719/ emhj.20.101
Language: English
Additional information: Copyright © World Health Organization (WHO) 2021. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
URI: https://discovery.ucl.ac.uk/id/eprint/10142690
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