Barriers and facilitators to healthcare access among Sub-Saharan African migrants in Europe: A scoping review.

Abstract

Sub-Saharan African (SSA) migrants represent a significant and growing proportion of Europe's diverse migrant population; yet face substantial barriers in accessing healthcare services. Understanding these barriers is essential for developing equitable healthcare policies and anticipating long-term care needs as these populations age. This scoping review systematically mapped and synthesised existing evidence on healthcare access, utilization, barriers, and facilitators among SSA migrants across European settings. The primary review question was: What are the barriers and facilitators to healthcare access and utilization among Sub-Saharan African migrants in Europe? Following Arksey and O'Malley framework and PRISMA-ScR guidelines, we systematically searched Europe PMC, Scopus, Web of Science, PubMed, and Google Scholar. Fourteen studies met inclusion criteria. Data were synthesised using thematic analysis to identify descriptive and analytical themes. Three overarching analytical themes emerged: (1) structural determinants as persistent barriers to care, including health insurance gaps, legal precarity, and administrative complexity; (2) intersectional vulnerabilities shaping healthcare experiences, particularly among undocumented migrants, women, and those living with HIV; and (3) cultural mediation and system misalignment, characterized by language barriers and inadequate cultural competency. Only one study specifically examined ageing and chronic care decision-making. Studies predominantly employed qualitative designs (n = 7) and cross-sectional surveys (n = 4). SSA migrants encounter multi-layered barriers that compound over time, with critical implications for health trajectories as populations age. Findings underscore the urgent need for migrant-sensitive healthcare approaches that address structural inequities, enhance cultural competency, and integrate long-term care planning. Future research should prioritize longitudinal studies examining healthcare needs across the life course and policy evaluations of migrant-inclusive interventions.