Maternal health literacy and access to maternal healthcare among migrant mothers in high-income countries: a systematic review and meta-analysis

Maternal health literacy (MHL) is an increasingly recognized concept that shapes maternal health behaviours, access to healthcare and pregnancy outcomes, particularly among migrant mothers who often experience inequities in maternal health outcomes. This systematic review and meta-analysis aimed to synthesize evidence on MHL and barriers to maternal healthcare access among migrant mothers in high-income countries (HICs). A comprehensive search of PubMed, MEDLINE, CINAHL, Scopus, and Web of Science was conducted to identify studies published between January 2015 and December 2025. This systematic review and meta-analysis were conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A convergent segregated design was employed, whereby qualitative findings were synthesised using deductive framework analysis and hybrid content analysis, while quantitative findings were pooled using random-effects meta-analysis. A total of 81 studies were included in this review. Meta-analysis of proportions showed that 22.9% (95% CI: 14.7–33.9) of migrant women reported difficulty understanding health information provided by healthcare professionals, while 29.8% (95% CI: 19.6–42.6) experienced language barriers and 31.2% (95% CI: 19.5–45.9) reported difficulties navigating healthcare systems. Pooled estimates indicated that migrant women had higher odds of suboptimal antenatal care utilisation (aOR: 2.66, 95% CI: 2.38–2.98) and lower satisfaction with maternity care (aOR: 1.77, 95% CI: 1.33–2.35) compared with non-migrant women. Qualitative synthesis identified language proficiency, interpreter access, educational attainment, cultural beliefs, socioeconomic constraints, and pre-migration experiences as key determinants of MHL. Provider discrimination, navigation difficulties, social isolation, and unmet interpreter need were the major barriers to care access, while culturally responsive providers, community support networks, and family support were the most frequently reported facilitators. This review highlights persistent challenges in maternal health literacy and access to maternity care among migrant women in HICs. The findings underscore the need for culturally and linguistically responsive maternity services, strengthened communication strategies, and policies addressing structural inequities. Improving maternal health literacy among migrant populations is essential to advancing equitable maternity care and achieving Sustainable Development Goals 3 and 10. PROSPERO registration number—CRD420251218875. Date of registration – 13th January 2026.