Maternal health and migration – a new HEN report outlines evidence for tackling inequalities

Women and girls are particularly susceptible to the health consequences of migration. Massive surges in migration in recent years in Europe have highlighted a need to develop and apply common indicators on migration and health to inform good policy decision-making across the WHO European Region, especially concerning this vulnerable group.

In response to this need, the Health Evidence Network (HEN) produced its 45th report, entitled “What is the evidence on the reduction of inequalities in accessibility and quality of maternal health care delivery for migrants? A review of the existing evidence in the WHO European Region”.

Conditions during migration can create and/or increase vulnerability to ill health. Success in accessing health and social services is variable, and language and cultural differences can form barriers. Low socioeconomic position and irregular status also increase the challenges faced by migrants.

The new HEN report shows that, across the board, migrating women face a higher incidence of induced abortions, caesarian births, instrumental deliveries and complications. Women in certain migrant groups also have low-birth-weight babies, suffer from pre-eclampsia and experience issues dating back to preconception more frequently. Some problems are related to uneven access to ante- and postnatal services.

Access to maternal health care may be restricted by migration status and affordability, as well as issues such as unfamiliarity of a health service, lack of understanding and lack of availability of care. Migrant women’s poorer maternal health is also often related to factors such as health-seeking behaviour, family planning and gender-based violence.

In addition, legal frameworks do not always protect migrant women and girls from sexual violence – they can even form barriers by failing to clarify status sufficiently for women to seek help and health care.

What do policy-makers need to consider?

The HEN report emphasizes that policy-makers need to consider the overall picture of women’s health. Policies that advocate sexual and reproductive health as a general feature leading to good maternal health reduce the risk factors associated with being a migrant woman.

Affordability is a significant barrier to health care access in many countries. Yet failure to access prenatal care often leads to more expensive emergency care and adverse pregnancy outcomes. Assuring universal access to maternal health care can be cost-effective for public health services. It can also clarify the provision of care, reducing the complications that arise when migrants’ legal entitlement to care is variable and both women and health professionals are left unsure of women’s current rights.

The report points out that language support, good educational aids and cultural sensitivity training can make accessing health care easier for migrant women, simultaneously breaking down barriers and increasing quality of care. Promoting and investing in family planning is also cost-effective and improves women’s health.