Intermediary Determinants of Health and Access to  Reproductive Health Services among Afghan Migrant Women: A Scoping Review

Zahra Bayat  Jozani; Zohreh  Mahmoodi; Amirhossein  Takian; Seyedeh Tahereh  Mirmolaei

doi:10.18502/ijph.v54i9.19851

Zahra Bayat Jozani Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
Zohreh Mahmoodi Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
Amirhossein Takian Department of Global Health, Center of Excellence for Global Health (CEGH), School of Public Health, Tehran University of Med-ical Sciences, Tehran, Iran
Seyedeh Tahereh Mirmolaei Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran

DOI: https://doi.org/10.18502/ijph.v54i9.19851

Keywords: Social determinants; Health services; Afghan; Scoping review

Abstract

Background: This scoping review aimed to identify intermediary Social Determinants of Health (SDH) affecting access to reproductive health services among Afghan migrant women, emphasizing the challenges in achieving equitable health service access for this vulnerable population.

Methods: To ensure methodological rigor, the PRISMA checklist was followed. The inclusion criteria comprised quantitative studies addressing access to reproductive health services among Afghan migrants. Articles were retrieved from SCOPUS, Web of Science, and PubMed databases, as well as through manual reference checks, covering the period from Jan 2000 to Mar 2025. Data extraction was guided by the World Health Organization's SDH framework, with a specific focus on intermediary determinants such as healthcare quality, behavioral and psychosocial factors, and social networks.

Results: From an initial pool of 628 articles, 18 met the eligibility criteria. The most frequently reported intermediary SDH was the quality and condition of healthcare services. Other common factors included behavioral aspects, social capital and cohesion, and psychological well-being. These determinants were consistently linked to disparities in access to reproductive health services.

Conclusion: Effective access to reproductive health services among Afghan migrant women hinges on addressing both structural and intermediary SDH. The influence of these factors is context-specific, and tailored interventions are needed. Notably, the supportive role of non-governmental organizations and community-based social support systems should be prioritized to enhance reproductive health outcomes in migrant population.