Exploring health services accessibility by indigenous women in Asia and identifying actions to improve it: a scoping review

ABSTRACT

Objectives: The aim of this scoping review was to uncover and summarize what is known in the literature about the experiences of Indigenous women in Asia regarding access to health services.

Design: The study was informed by the scoping review methodology proposed by Arksey and O’Malley [2005. “Scoping Studies: Towards a Methodological Framework.” International Journal of Social Research Methodology 8 (1): 19–32. doi:10.1080/1364557032000119616]. A comprehensive search of the databases for peer-reviewed studies and grey literature was conducted between January 2000 and December 2016. The data of selected papers and abstracts were analysed by three independent researchers through a protocol of data charting, descriptive numerical summary, and thematic analysis.

Results: Sixteen articles and two abstracts met the inclusion criteria for this scoping review. These 18 peer-reviewed documents consisted of eight qualitative studies, seven quantitative studies, and three mixed-method studies, which included the peer-reviewed poster and oral presentation abstracts from international conferences. The findings were sorted and grouped under the following themes: health care access for Indigenous women in Asia, facilitators to accessing healthcare services, barriers to accessing healthcare services, and cultural contexts impacting health and access.

Conclusion: There is limited information about the experiences, facilitators, barriers, and cultural contexts faced by Indigenous women in Asia related to health services accessibility, and even less information related to improving health services accessibility and health outcomes. This scoping review in particular highlights the dearth of literature relating to Indigenous women's postpartum health and access to postnatal supports and services. Generally, it indicates that Indigenous women in Asia are more vulnerable to poor health in comparison to non-Indigenous women, and continue to face challenges and barriers in accessing quality and equitable health services. The barriers identified in this review are useful in explaining why inequities in health and access to health care for Indigenous women living in Asia continue to exist. Recommendations for future research directions are described.

KEYWORDS:

• Indigenous women in Asia
• ethnic minority
• health services accessibility
• equitable healthcare
• gender equality
• human rights

Acknowledgement

The authors acknowledge Ms. Linda Slater, Librarian at the Faculty of Nursing, University of Alberta, for her assistance in implementing search strategies.

Disclosure statement

No potential conflict of interest was reported by the authors.

Key messages

1. Indigenous women living in Asia continue to experience health service inaccessibility that result in health disparities.

2. This scoping review supports the need for future research that focuses specifically on issues related to health and access to healthcare services in this region and across the lifespan.

3. Consideration of health service access barriers and associated contextual influences can reveal culturally-specific strategies that will improve equitable access to, and the delivery of, culturally appropriate services of higher quality.

4. Efforts to ensure that health care providers are aware of cultural beliefs and practices, and are given relevant cultural skill training and education, will contribute to the development of best practices and policies that result in improved health service accessibility and health outcomes for Indigenous women in Asia.