Document Type : Review article
Authors
1
Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran;
2
Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran;
3
Department of Global Health & Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;
4
Department of Health Management, Policy and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;
5
Health Equity Research Center (HERC), Tehran University of Medical Sciences, Tehran, Iran;
6
Student Research Committee, Alborz University of Medical Sciences, Karaj, Iran
10.30476/ijcbnm.2026.107378.2828
Abstract
Background: Health is vital for migrants and host countries, supporting human rights and sustainable
development. With rising migration of Afghan women, tackling barriers to reproductive health
services is critical. This scoping review synthesizes evidence on structural social determinants of
health (SSDH) that affect Afghan migrant women’s access to reproductive health services.
Methods: Using PRISMA guidelines and Arksey and O’Malley’s framework with the PCC model
(Population: Afghan migrant women of reproductive age; Concept: structural social determinants of
health-influenced reproductive health access; Context: host countries), we searched Web of Science,
Scopus, PubMed, and Google Scholar for studies from January 2000 to March 2025. Reference lists
were screened. Eligible studies were empirical, quantitative, or mixed-methods, in English only.
Results: From 1,170 records, 18 studies were included. SSDH which influences access fell into
six domains: Macroeconomic Policies, Social Policy, Social Class, Public Policy, Governance, and
Culture & Social Norms. Key barriers included economic hardship, lack of insurance, undocumented
status, low health literacy, and cultural-linguistic challenges, limiting service access. The identified
sexual and reproductive health outcomes were identified in various domains, including maternal and
perinatal outcomes, reproductive health service utilization, and other reproductive health outcomes,
including mental health and awareness.
Conclusion: This review demonstrates that Afghan migrant women’s reproductive health access is
shaped by intersecting structural determinants that collectively generate compounded health inequities.
Improving this requires upstream structural reforms encompassing legal protection, health system
integration, and cultural sensitivity, rather than service-oriented approaches alone. Policies that ignore
these SSDH will remain ineffective.
Keywords
)