Published in PLOS One on 2026-06-10, this study is presented as an attributed evidence briefing. The excerpts below are the original researchers’ words, reproduced under their Creative Commons Attribution licence. Health Signal has selected the abstract and, where needed, opening background paragraphs; the complete methods, results, limitations and references remain in the linked paper.
Original authors: Adanze Nge Cynthia, Jude Tsafack Zefack, Faustus Ajamah, Selouis Fuanyi Nkengfua, Emmanuel Mouladje Tchuela, Esua Alphonsius. F
Source: PLOS One • DOI 10.1371/journal.pone.0351011
Read the complete primary study ↗ · Creative Commons Attribution licence
From the researchers
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.
Introduction
Europe hosts approximately 36% of the global migrant population, yet less than half of the member states in the World Health Organization (WHO) European Region systematically report health data for migrants, revealing a systemic failure to prioritize their wellbeing [1]. Sub-Saharan African (SSA) migrants represent a significant and growing proportion of Europe's diverse migrant population, concentrated primarily in the United Kingdom, France, Italy, Spain, and Portugal [2,3]. Despite increasing migration flows from SSA countries driven by conflict, socioeconomic instability, and climate challenges, there remains a critical paucity of research examining how these populations navigate healthcare access in European contexts [4,5]. The 2024 Lancet Series on Migration and Health Inequity in Europe emphasizes that migrants face legal, structural, linguistic, and cultural barriers that systematically exclude many from national healthcare systems, with widespread biases and inadequate cultural competency among healthcare providers’ further worsening disparities in access to preventive and clinical care [1,6]. SSA migrants encounter unique challenges shaped by recent migration patterns, distinct settlement experiences, and cultural frameworks that often conflict with European healthcare delivery models [7,8]. According to available data, SSA communities in Europe face significant obstacles to accessing healthcare, such as a lack of health insurance, language barriers, discrimination in medical settings, legal precarity, and cultural misunderstandings between patients and doctors [9–11]. A recent qualitative study in the United Kingdom (UK) found that SSA migrants experienced challenges navigating healthcare systems, fragile patient-doctor relationships, and reliance on self-medication practices when accessing healthcare [12]. Similarly, research across multiple European countries demonstrates that undocumented migrants face significant barriers including fear of deportation, financial constraints, and restricted entitlements that lead to delayed care-seeking and reliance on alternative health strategies [13,14].
Reading this evidence
Use the full paper to check the study design, participant selection, comparator and outcome definitions before drawing a practical conclusion. An association does not by itself show cause and effect. A reported performance measure needs its denominator and uncertainty. A finding from a particular facility, sample or time period should retain that scope when it is discussed elsewhere.
This briefing makes the source accessible within the wider financing & policy desk. It does not assess an individual patient or certify a product. When considering relevance to another health system, examine the original authors’ account of context and limitations, then seek local implementation evidence. The related reporting below provides other studies to read alongside this one; it is a topic connection, rather than a claim that their results are directly comparable.
© 2026 Adanze Nge Cynthia, Jude Tsafack Zefack, Faustus Ajamah, Selouis Fuanyi Nkengfua, Emmanuel Mouladje Tchuela, Esua Alphonsius. F. Excerpts reproduced under CC BY. Selection, formatting and contextual notes by Health Signal. The researchers are the authors of the source study, not members of Health Signal’s staff.
Explore connected evidence
- Evidence brief: Barriers to healthcare access among women in sub-Saharan Africa: A pooled analysis of multi-country DHS data (2019–2023)
- Evidence brief: Integrating smoking cessation into HIV care settings: A systematic review and meta-analysis of effectiveness and the evidence gap in cost-effectiveness
- Evidence brief: Strategies to improve outcomes of obstetric emergencies in sub-Saharan Africa: A scoping review
