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Access to healthcare services for migrant and left-behind children: A scoping review
Jane Spiteri1, Anne Carolina Ramos2, Catarina Pinheiro Mota3,4,5,6
1Department of Early Childhood & Primary Education, Faculty of Education, University of Malta, Msida, Malta.
Insights
Migrant and left-behind children face significant healthcare access barriers. Improving child health requires inclusive, continuous, and culturally responsive healthcare systems adapting to their unique needs.
Area of Science:
- Public Health
- Health Services Research
- Child Health
Background:
- Migrant and left-behind children face unique health vulnerabilities influenced by climate change, displacement, and healthcare system organization.
- Existing healthcare systems often fail to adequately address the complex needs of these children, leading to health inequities.
Purpose of the Study:
- To map the evidence on healthcare services for migrant and left-behind children.
- To identify health needs, service provision, access barriers, facilitators, and care gaps for this population.
Main Methods:
- A scoping review following PRISMA-ScR guidelines.
- Searches conducted in Web of Science/MEDLINE and Scopus for English-language publications up to May 2026.
- Inclusion of 35 publications after screening and duplicate removal.
Main Results:
- These children require comprehensive care, including preventive, primary, specialist, and mental health services.
- Access is hindered by legal exclusion, cost, language barriers, discrimination, and fragmented care.
- Left-behind children are under-represented, with limited evidence on their preventive and chronic care access.
Conclusions:
- Healthcare inequity stems from systems not adapting to children's legal, linguistic, and transnational realities.
- Rights-based child health policy must shift towards universal entitlements, continuous care, and integrated, culturally responsive support.
Abstract:
Migrant and left-behind children experience health vulnerability that are shaped by climate change, including by climate change, including illness, displacement, and family separation, but also by the organisation of healthcare systems. This scoping review maps the evidence on healthcare services for migrant and left-behind children, with attention to health needs, service provision, barriers and facilitators to access, and gaps in care. Following PRISMA-ScR reporting guidance, searches were conducted in Web of Science/MEDLINE and Scopus for peer-reviewed English-language publications from the database inception to May 2026. After duplicate removal and two-stage screening, 35 publications were included. The evidence shows that migrant and left-behind children require a continuum of preventive, primary, specialist, developmental, nutritional, dental, mental health, and emergency care. However, access is frequently constrained by legal exclusion, documentation requirements, cost, language barriers, limited health system navigation, discrimination, mobility, disrupted continuity of care, and under-resourced services. Left-behind children remain especially under-represented, with limited evidence on preventive, mental health, and chronic care access. Facilitators include inclusive entitlements, community outreach, school provision, interpreters, bilingual professionals, culturally responsive care, health literacy support, and cross-sector coordination. The review argues that healthcare inequity for children affected by migration is produced not only by service absence, but by systems that fail to adapt to children's legal, linguistic, relational, and transnational realities. Rights-based child health policy should therefore move from episodic and discretionary provision towards universal entitlements, continuous care pathways, and integrated support that is culturally responsive, developmentally appropriate, and accountable to the lived experiences of migrant and left-behind children.
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