Maternal outcomes and access to maternal healthcare services among migrant, refugees and forced displaced women in the Middle East and North Africa: A systematic scoping review

Background: Over the past decade, migration, particularly forced displacement has increased, impacting the Middle East and North Africa region. Some migrant women encounter significant healthcare access barriers, particularly with regard to maternal health. This review summarises the available evidence on maternal outcomes, as well as access to healthcare for migrant women in the region. Methods: We searched six electronic databases and grey literature for primary research from 2000-2026 with no language restrictions We used the Joanna Briggs Institute critical appraisal tools for study design to evaluate the quality of the studies. The data were synthesised narratively. The protocol was registered on PROSPERO (CRD42023412011). Results: In total, we identified 11,869 papers, we included 43 peer-reviewed articles and added one grey literature paper. Miscarriage, hypertension/eclampsia, and anemia were common complications, with refugees showing higher rates of anaemia and hypertension than the host populations. Infectious diseases were also prevalent, particularly hepatitis B among Syrian refugees. Preterm birth and caesarean section rates were higher, with Palestinian refugees in Lebanon having the highest caesareans prevalence. Maternal mortality remains high, with some studies indicating a substantial number of deaths among women are caused by pregnancy-related complications. Access to antenatal care varied, and interventions improved attendance in some settings. However, barriers such as cost, cultural attitudes, and transport hindered access. Conclusion: This review highlights the significant challenges that refugee and displaced women face when trying to accessing maternal healthcare. It's important to highlight the need for targeted interventions by developing solutions to improve maternal healthcare access and outcomes in migrant communities.