Barriers and facilitators to dental care access among asylum seekers and refugees in highly developed countries: a syste
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RESEARCH ARTICLE
Open Access
Barriers and facilitators to dental care access among asylum seekers and refugees in highly developed countries: a systematic review Martha Paisi1,2* , Rebecca Baines3 , Lorna Burns4 , Anastasios Plessas4 , Philip Radford5 , Jill Shawe2 and Robert Witton1,4
Abstract Background: Dental diseases are prevalent among asylum seekers and refugees (ASRs). Despite significant treatment needs, access to dental care in host countries is often limited. The aim of this systematic review was to identify the barriers and enablers to dental care access for ASRs in host countries of very high development. Methods: Five health and social care databases and eight grey literature sources of information were searched. The Critical Appraisal Skills Programme tool was used to critically appraise included studies. Thematic analysis was undertaken to identify common themes. These were then deductively organised according to Penchansky and Thomas’s modified access model. All review stages were conducted by two independent reviewers. Results: Nine papers were included in the review. ASRs encounter significant challenges to accessing dental care in their host countries. These include affordability, communication difficulties, insufficient interpretation, limited knowledge of the healthcare systems and healthcare rights, and negative encounters with healthcare teams. The views and experiences of dental care teams providing care to ASRs were explored in only one study. Conclusions: Both population and healthcare characteristics influence access to dental care for ASRs. Affordability, awareness and accommodation are most frequently described as barriers to dental access for this population. The diverse needs of this population need to be recognised by policy makers, commissioners and practitioners alike. Cultural competence needs to be incorporated into dental services and any interventions to improve access to dental care for this population. Registration PROSPERO- International prospective register of systematic reviews (CRD42019145570). Keywords: Asylum seeker, Refugee, Displaced persons, Access, Dental care Background The United Nations Refugee Agency (UNHCR) is witnessing the highest level of forced displacement on record, with 70.8 million people displaced worldwide due *Correspondence: [email protected] 1 Peninsula Dental Social Enterprise (Derriford Dental Education Facility), University of Plymouth, 20 Research Way, Plymouth PL6 8BT, UK Full list of author information is available at the end of the article
to war, persecution, violence, and violations of human rights [1]. Among the people of concern for UNHCR, are asylum seekers and refugees (ASRs). As per the UNHCR’s 1951 Geneva Convention, a refugee is defined as a person who ‘owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group, or political opinion, is outside the country of his nationality, and is unable to or, owing to such fear, is unwilling to av
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