Gypsy, Roma and Traveller access to and engagement with health services: a systematic review

TY - JOUR

T1 - Gypsy, Roma and Traveller access to and engagement with health services

T2 - a systematic review

AU - McFadden, Alison

AU - Siebelt, Lindsay

AU - Gavine, Anna

AU - Atkin, Karl

AU - Bell, Kerry

AU - Innes, Nicola

AU - Jones, Helen

AU - Jackson, Cath

AU - Haggi, Haggi Michael

AU - MacGillivray, Stephen

N1 - This report is independent research commissioned and funded by the Department of Health Policy Research Programme (Enhancing Gypsy/Travellers’ trust: using maternity and early years’ health services and dental health services as exemplars of mainstream service provision, PR-R8-0314-24002). The views expressed in this publication are those of the authors and not necessarily those of the Department of Health.

PY - 2018/2/1

Y1 - 2018/2/1

N2 - Background: Gypsy, Roma and Traveller people represent the most disadvantaged minority groups in Europe, having the poorest health outcomes. This systematic review addressed the question of how Gypsy, Roma and Traveller people access healthcare and what are the best ways to enhance their engagement with health services. Methods: Searches were conducted in 21 electronic databases complemented by a focussed Google search. Studies were included if they had sufficient focus on Gypsy, Roma or Traveller populations; reported data pertinent to healthcare service use or engagement; and were published in English from 2000 to 2015. Study findings were analysed thematically and a narrative synthesis reported. Results: Ninety-nine studies from 32 countries were included, covering a range of health services. Nearly half of the presented findings related to primary healthcare services. Reported barriers to health service usage related to organisation of health systems, discrimination, culture and language, health literacy, service-user attributes, and economic barriers. Promising engagement strategies included specialist roles, outreach services, dedicated services, raising health awareness, handheld records, training for staff, and collaborative working. Conclusion: This review provides evidence that Gypsy, Roma and Traveller populations across Europe struggle to exercise their right to healthcare on account of multiple barriers; and related to other determinants of disadvantage such as low literacy levels and experiences of discrimination. Some promising strategies to overcome barriers were reported but the evidence is weak, therefore rigorous evaluations of interventions to improve access to and engagement with health services for Gypsy, Roma and Traveller people are needed.

AB - Background: Gypsy, Roma and Traveller people represent the most disadvantaged minority groups in Europe, having the poorest health outcomes. This systematic review addressed the question of how Gypsy, Roma and Traveller people access healthcare and what are the best ways to enhance their engagement with health services. Methods: Searches were conducted in 21 electronic databases complemented by a focussed Google search. Studies were included if they had sufficient focus on Gypsy, Roma or Traveller populations; reported data pertinent to healthcare service use or engagement; and were published in English from 2000 to 2015. Study findings were analysed thematically and a narrative synthesis reported. Results: Ninety-nine studies from 32 countries were included, covering a range of health services. Nearly half of the presented findings related to primary healthcare services. Reported barriers to health service usage related to organisation of health systems, discrimination, culture and language, health literacy, service-user attributes, and economic barriers. Promising engagement strategies included specialist roles, outreach services, dedicated services, raising health awareness, handheld records, training for staff, and collaborative working. Conclusion: This review provides evidence that Gypsy, Roma and Traveller populations across Europe struggle to exercise their right to healthcare on account of multiple barriers; and related to other determinants of disadvantage such as low literacy levels and experiences of discrimination. Some promising strategies to overcome barriers were reported but the evidence is weak, therefore rigorous evaluations of interventions to improve access to and engagement with health services for Gypsy, Roma and Traveller people are needed.

KW - Gypsy

KW - Roma

KW - Travellers

KW - access to healthcare

KW - healthcare utilisation

KW - Systematic review

U2 - 10.1093/eurpub/ckx226

DO - 10.1093/eurpub/ckx226

M3 - Review article

C2 - 29346666

SN - 1101-1262

VL - 28

SP - 74

EP - 81

JO - European Journal of Public Health

JF - European Journal of Public Health

IS - 1

ER -