International Journal of Community Based Nursing & Midwifery

International Journal of Community Based Nursing & Midwifery

Structural Social Determinants of Health Affecting Afghan Migrant Women’s Access to Reproductive Health Services: A Scoping Review

Document Type : Review article

Authors
zahra Bayat Jozani 1
Zohreh Mahmoodi 2
Amirhossain Takian 3, 4, 5
zeinab Talebi Tamajani 6
Seyedeh Tahereh Mirmolaei 1
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
Emigrants and immigrants
Health equity
Reproductive health services
Afghanistan
Social Determinants of health

Zahra Bayat Jozani (Google Scholar) (PubMed)

Seyedeh Tahereh Mirmolaei (PubMed)

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