Access to and engagement with health services among disadvantaged populations
Citation: McFadden A, Siebelt L, Gavine A, et al. Gypsy, Roma and Traveller access to and engagement with health services: a systematic review. European Journal of Public Health. 2018;28(1):74–81.
Language: Abstract and full text available in EN.
Free to view: Yes.
Funding sources: The Department of Health Policy Research Programme.
What is this? Access to quality healthcare is a fundamental human right, yet certain minority and disadvantaged groups continue to face barriers to care.
In this systematic review, the authors searched for articles that focused on Gypsy, Roma, and Traveller populations and their access to healthcare and looked for the interventions or strategies that facilitate their engagement with health services. They restricted their searches to articles published in English from 2000 to 2015. They included 121 articles that reported on 99 studies conducted in 32 countries.
What was found: Barriers to healthcare service usage were identified, including issues related to the health service, discrimination and negative attitudes from healthcare staff, cultural misunderstanding and language barriers, low health literacy levels, service-user attributes, and economic barriers. One common barrier was people being unable to register for healthcare services. Promising strategies included creating a specialist role to liaise between community members and healthcare providers, community outreach by healthcare professionals, providing targeted services, raising health awareness, handheld records, cultural awareness training for staff, and working collaboratively with community members.
Implications: The authors of the review stated that there is a need for targeted interventions to address these barriers and improve access to healthcare services, and rigorous evaluations to determine their efficacy. It is critical to ensure that engagement strategies do not discourage the use of mainstream services, leading to further marginalization and stigma. The findings highlight the ongoing challenge of cultural differences and health inequalities, and further research should consider the nuances within various cultures.
Other considerations: The authors of the review discussed their findings in the context of place of residence, race/ethnicity/culture/language, gender/sex, education, socioeconomic status, and personal characteristics associated with discrimination such as age and gender-related disparities.
This summary was prepared by Riwa Deghaim, checked by Grace Meng and finalized by Helen Worthington.