Facilitators and barriers of maternal and infant healthcare access for undocumented migrants in the first 1000 days of life: a systematic review of the literature.

Adequate access to maternal and infant healthcare in the first 1000 days of life is concurrent with lifelong well-being and should be guaranteed regardless of nationality, legal status, and social conditions. By exploring how migration status affects the social determinants of health, this review provides a nuanced understanding of the barriers and facilitators encountered accessing healthcare by undocumented women and their infants in the first 1000 days of life. Following the PRISMA guidelines and the registered protocol (CRD42022328220), a literature search was conducted in PubMed, Embase, CINAHL, PsycInfo, and Scopus. The search focused on manuscripts including undocumented migrants as study participants and reported direct or indirect data on the utilisation or outcomes of maternal and infant healthcare within the defined first 1000 days of life. Fifty-two studies met the inclusion criteria. A narrative synthesis was performed to summarise the information obtained from the data extraction process. Identified barriers include legal barriers (e.g. criminalisation of migrants or complexity of administrative procedures) and socio-cultural barriers (e.g. inadequate health literacy and financial challenges). Facilitators encompassed legal facilitators, like dedicated healthcare clinics, and socio-cultural facilitators, such as language support and healthier lifestyle habits. Ethical issues in connection to healthcare access of undocumented migrants in the first 1000 days were also mapped from the included papers. Considering the health consequences on future generations, the economic implications, and the vulnerability of migrant women, the findings offer positive examples that could be put into place to move towards universal health coverage through a holistic approach that shifts from exclusion and criminalisation to support and compassion.