Abstract
Objective: This review will critically compare how national health coverage and access policies shape refugee women’s maternal outcomes across pregnancy, birth, and the first year postpartum in four selected countries (Canada, Germany, Australia, and the United States), and identify policies that negatively impact maternal outcomes of refugee women.
Introduction: Refugee and other migrant women frequently encounter host-country coverage and access rules that constrain antenatal, intrapartum, and postnatal care, and are associated with poorer maternal and perinatal outcomes (Aldridge et al., 2018; Fair et al., 2020; Heslehurst et al., 2018; ; Lebano et al., 2020; Mantini et al., 2017). Because these policies vary widely across global health systems, a cross-country analysis is needed to isolate policy effects, establish comparable indicators, and generate transferable recommendations to improve maternal access and outcomes.
Inclusion Criteria: This review will include all literature from Canada, Germany, Australia, or the United States on pregnant or ≤12-month postpartum refugee women that evaluate a health coverage/access policy. It will exclude studies lacking this population.
Methods: The JBI methodology for systematic reviews of mixed evidence will be followed, with reporting in line with PRISMA 2020. Searches will be conducted on many databases from 2013 onward, published in English. A JBI-adapted extraction template will be used, and findings will be presented as cross-country comparative tables and effect-direction plots with concise narrative syntheses to address the review questions. To check for existing reviews/protocols, MEDLINE, CINAHL and ProQuest were searched and none matched our focus.
Implications for Nursing: Findings will equip nurses with policy-linked indicators and practical recommendations to improve maternal access and continuity for refugee women and to support evidence-based advocacy and participation in policy making.
Notes
References:
Aldridge, R. W., Nellums, L. B., Bartlett, S., Barr, A. L., Patel, P., Burns, R., Hargreaves, S., Miranda, J. J., Tollman, S., Friedland, J. S., & Abubakar, I. (2018). Global patterns of mortality in international migrants: a systematic review and meta-analysis. The Lancet (British Edition), 392(10164), 2553–2566. https://doi.org/10.1016/S0140-6736(18)32781-8
Fair, F., Raben, L., Watson, H., Vivilaki, V., van den Muijsenbergh, M., & Soltani, H. (2020). Migrant women’s experiences of pregnancy, childbirth and maternity care in European countries: A systematic review. PloS One, 15(2), e0228378. https://doi.org/10.1371/journal.pone.0228378
Heslehurst, N., Brown, H., Pemu, A., Coleman, H., & Rankin, J. (2018). Perinatal health outcomes and care among asylum seekers and refugees: a systematic review of systematic reviews. BMC Medicine, 16(1), Article 89. https://doi.org/10.1186/s12916-018-1064-0
Lebano, A., Hamed, S., Bradby, H., Gil-Salmerón, A., Durá-Ferrandis, E., Garcés-Ferrer, J., Azzedine, F., Riza, E., Karnaki, P., Zota, D., & Linos, A. (2020). Migrants’ and refugees’ health status and healthcare in Europe: a scoping literature review. BMC Public Health, 20(1), Article 1039. https://doi.org/10.1186/s12889-020-08749-8
Mantini, A., Skinner, A., Haque, N., Khanlou, N., & Kurtz Landy, C. (2017). Scoping Review on Maternal Health among Immigrant and Refugee Women in Canada: Prenatal, Intrapartum, and Postnatal Care. Journal of Pregnancy, 2017(2017), 1–14. https://doi.org/10.1155/2017/8783294
Sigma Membership
Lambda Pi at-Large
Type
Poster
Format Type
Text-based Document
Study Design/Type
Systematic Review
Research Approach
Mixed/Multi Method Research
Keywords:
Policy and Advocacy, Health Equity or Social Determinants of Health, Sustainable Development Goals, Maternal Health Services, Refugees, Health Status Disparities, Maternal-Child Health
Recommended Citation
Ebadi, Sana Sahar; Amiri, Burhan; and Haghiri-Vijeh, Roya, "Coverage and Access Policies and Maternal Outcomes for Refugee Women: A Cross-Country Analysis" (2026). International Nursing Research Congress (INRC). 27.
https://www.sigmarepository.org/inrc/2026/posters_2026/27
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-25
Funder
Sigma Foundation for Nursing
Coverage and Access Policies and Maternal Outcomes for Refugee Women: A Cross-Country Analysis
Toronto, Ontario, Canada
Objective: This review will critically compare how national health coverage and access policies shape refugee women’s maternal outcomes across pregnancy, birth, and the first year postpartum in four selected countries (Canada, Germany, Australia, and the United States), and identify policies that negatively impact maternal outcomes of refugee women.
Introduction: Refugee and other migrant women frequently encounter host-country coverage and access rules that constrain antenatal, intrapartum, and postnatal care, and are associated with poorer maternal and perinatal outcomes (Aldridge et al., 2018; Fair et al., 2020; Heslehurst et al., 2018; ; Lebano et al., 2020; Mantini et al., 2017). Because these policies vary widely across global health systems, a cross-country analysis is needed to isolate policy effects, establish comparable indicators, and generate transferable recommendations to improve maternal access and outcomes.
Inclusion Criteria: This review will include all literature from Canada, Germany, Australia, or the United States on pregnant or ≤12-month postpartum refugee women that evaluate a health coverage/access policy. It will exclude studies lacking this population.
Methods: The JBI methodology for systematic reviews of mixed evidence will be followed, with reporting in line with PRISMA 2020. Searches will be conducted on many databases from 2013 onward, published in English. A JBI-adapted extraction template will be used, and findings will be presented as cross-country comparative tables and effect-direction plots with concise narrative syntheses to address the review questions. To check for existing reviews/protocols, MEDLINE, CINAHL and ProQuest were searched and none matched our focus.
Implications for Nursing: Findings will equip nurses with policy-linked indicators and practical recommendations to improve maternal access and continuity for refugee women and to support evidence-based advocacy and participation in policy making.
Description
This review will examine how coverage and access policies shape refugee women’s maternal care across Canada, Germany, Australia, and the United States. We link policy features to access and outcomes from pregnancy to 12 months postpartum, providing concise indicators and evidence to guide nursing practice and policy change.