The researchers chose a phenomenological hermeneutic approach, a qualitative tradition that seeks to understand not just what people do but how they interpret and make meaning of their lived experiences. Rather than measuring outcomes with surveys or statistics, the method asks participants to describe their encounters in depth and then probes those descriptions for the underlying structures of meaning. This is well suited to a question like the one Çınar and Erbay posed: what is it like, day after day, to provide pharmaceutical services to Syrian refugees navigating an unfamiliar health system?

Data collection rested on semi-structured, in-depth interviews conducted with eight pharmacy professionals. Some interviews took place face to face, others by telephone, and all were digitally recorded, transcribed, and then reviewed thoroughly by the researchers before analysis. Semi-structured interviewing is a deliberate choice in this kind of research: it provides a common framework of questions while leaving room for participants to raise themes the researchers had not anticipated. The small sample size is typical of phenomenological studies, where the goal is depth of insight into a shared experience rather than statistical generalization across a population.

From the transcripts, the researchers extracted three overarching themes: perceptions and attitudes toward Syrians, adaptations in the working environment, and coping with difficulties. The first theme captures how pharmacy professionals view the refugee population they serve, a dimension that shapes every subsequent interaction. Attitudes in healthcare settings are not static; they are formed and reformed through repeated encounters, and the study treats them as an integral part of the service experience rather than a background variable.

The second theme, adaptations in the working environment, describes the practical changes pharmacists made to keep serving patients effectively. Language barriers emerged as the central challenge. When a patient cannot describe symptoms in Turkish and the pharmacist cannot read a prescription written in Arabic, the risk of misunderstanding is immediate and consequential. In the absence of formal interpreter services, professionals improvised, relying on gestures, drawings, translation applications, bilingual family members, and whatever fragments of shared vocabulary they could assemble. Each workaround carries its own risks, since a family member translating medical information may filter, soften, or distort it, and machine translation remains unreliable for nuanced health communication.

Cultural differences compounded the linguistic ones. Expectations about medication, adherence, and the role of the pharmacist vary across health cultures, and misunderstandings about how and why medicines should be taken can undermine treatment. The study highlights that these were not abstract cultural notes but daily operational realities, surfacing in consultations, in questions about dosing, and in the emotional texture of encounters between people who have fled war and the professionals who serve them.

The third theme, coping with difficulties, brings the emotional dimension of the work into focus. Çınar and Erbay emphasize that their findings illuminate not only practical adaptations but also the emotional burdens pharmacy professionals faced. Serving a traumatized population within a strained system exacts a psychological toll, and the study argues that this burden has been largely invisible in discussions of refugee healthcare, which tend to center on physicians, nurses, and hospitals. Pharmacists, by contrast, work in dispersed community settings where they absorb the pressures of the front line with less institutional support.

Systemic limitations ran through all three themes. The authors point to the need for interpreter services as a concrete, actionable gap: a professional interpreter in the pharmacy would reduce the risk of medication errors, relieve pharmacists of an improvised translation role they were never trained for, and improve the dignity and accuracy of consultations. The finding aligns with a broader international literature the authors cite, including studies of pharmacists serving Syrian refugees in Germany, Jordan, and Lebanon, and qualitative work on refugee healthcare barriers in Australia, Malaysia, and across sixteen European countries. Across these settings, language access recurs as the single most consequential modifiable barrier.

The study also situates itself within the scale of the displacement crisis. Türkiye’s refugee population grew rapidly after 2011, and the United Nations Refugee Agency’s global trends reports document the magnitude of forced displacement worldwide. Previous Turkish studies have documented difficulties refugees face in primary care and in hospital settings, including communication problems and unmet expectations, and a World Bank background paper on the Syrian case in Türkiye has weighed both the successes and the challenges of the response. What the new study adds is the pharmacy counter perspective, a vantage point close to where patients actually obtain medicines.

Methodologically, the authors ground their work in established qualitative traditions, drawing on Colaizzi’s phenomenological analysis procedure and on methodological references from Creswell, Lincoln and Guba, and van Manen, among others. The study received ethical approval from the Ankara University Ethics Committee, and informed consent was obtained from all participants, with procedures conducted in accordance with the Helsinki Declaration. The authors report no competing interests and no external funding. The paper carries a poignant dedication to the memory of Saad Ismail, a Syrian student of the authors who lost his life in the earthquakes that struck Türkiye on February 6, 2023, a reminder that the populations and the people who study them are bound together in the same fragile circumstances.

The practical implications are clear. If community pharmacists are de facto primary care providers for refugee populations, then health policy should equip them accordingly: funded interpreter access, cultural competence training, and clearer referral pathways to physicians and social services. For the global health community, the study is a reminder that healthcare systems are only as accessible as their most local interfaces, and that in Türkiye those interfaces are often staffed by pharmacists improvising across a language divide. Understanding their experience, the authors argue, is a necessary step toward building services that work for everyone who walks through the door.

Subject of Research: Pharmacy professionals' lived experiences providing healthcare services to Syrian refugees in Türkiye

Article Title: The voice of pharmacy professionals: experiences in providing services to Syrian refugees in Türkiye

Article References: Çınar, C., & Erbay, E. (2026). The voice of pharmacy professionals: experiences in providing services to Syrian refugees in Türkiye. SN Social Sciences, 6(9), Article 427. https://doi.org/10.1007/s43545-026-01728-7

Image Credits: AI Generated

DOI: 10.1007/s43545-026-01728-7

Keywords: Syrian refugees, pharmacy professionals, refugee healthcare, Türkiye, qualitative research, phenomenology, language barriers, interpreter services, community pharmacists, health communication, cultural differences, healthcare access

The scale of the evidence base lends the findings considerable weight. The research team, led by Trishika Wickramarathne, searched five major databases—PubMed, MEDLINE, CINAHL, Scopus and Web of Science—for studies published over a decade, and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, the international standard for ensuring such reviews are conducted and reported transparently. The review was prospectively registered with PROSPERO, the international prospective register of systematic reviews, under registration number CRD420251218875, a step designed to guard against selective reporting. By combining a quantitative meta-analysis with a structured qualitative synthesis in what the authors describe as a convergent segregated design, the study captures both the magnitude of the problem and the lived experiences behind the statistics.

Maternal health literacy, the central concept of the review, is more than the ability to read a pamphlet. Researchers define it as the cognitive and social skills that determine a woman’s motivation and ability to gain access to, understand and use information in ways that promote and maintain the health of herself and her child during pregnancy and early parenthood. It shapes whether a woman books timely antenatal appointments, recognises warning signs of complications, follows medical advice, and feels confident asking questions of clinicians. When health literacy falters, the consequences cascade: missed appointments, delayed presentation of complications, poorer birth outcomes and deepening distrust of health services. For migrant mothers, who often arrive with interrupted healthcare histories, unfamiliarity with local systems and varying proficiency in the host country’s language, the stakes are especially high.

The quantitative pooling relied on random-effects meta-analysis, a statistical technique that accounts for the fact that individual studies differ in their populations, settings and measurement tools. Rather than assuming a single true effect size, random-effects models estimate a distribution of effects and produce wider, more honest confidence intervals. Even so, the intervals in this review tell a consistent story. The pooled estimate for difficulty understanding health information, at 22.9 percent, carries a 95 percent confidence interval of 14.7 to 33.9 percent; language barriers cluster at 29.8 percent with an interval of 19.6 to 42.6 percent; and navigation difficulties reach 31.2 percent with an interval of 19.5 to 45.9 percent. The breadth of these intervals reflects genuine heterogeneity across countries and cohorts, yet every lower bound remains clinically meaningful, indicating that even under the most conservative reading, a substantial minority of migrant mothers faces each of these barriers.

The qualitative strand of the review dug into why these barriers persist. Using deductive framework analysis and hybrid content analysis, the researchers identified six key determinants of maternal health literacy among migrant women: language proficiency, access to interpreters, educational attainment, cultural beliefs, socioeconomic constraints and pre-migration experiences. Each factor interacts with the others in ways that can compound disadvantage. A mother with limited formal education who is also learning a new language faces a double burden when a clinician explains a gestational diabetes screening protocol in rapid, jargon-laden speech. Pre-migration experiences, including trauma or healthcare systems in countries of origin that function very differently, can shape expectations and trust in ways that mainstream services rarely anticipate.

Barriers to actually accessing care clustered into four recurring themes: discrimination by healthcare providers, difficulties navigating complex systems, social isolation, and unmet need for professional interpreters. The interpreter finding is particularly striking because it represents a failure of infrastructure rather than of individual knowledge. Many high-income countries have policies mandating interpreter access, yet the review suggests that in practice, women frequently attend appointments without qualified interpretation, relying instead on family members, bilingual staff pulled from other duties, or nothing at all. Ad hoc interpretation by relatives raises its own concerns, from inaccurate translation of clinical information to the suppression of sensitive disclosures, particularly around mental health or domestic circumstances, when a husband or in-law is acting as the intermediary.

Against these barriers, the review also catalogued what works. Culturally responsive providers emerged as the most frequently reported facilitator of care access, followed by community support networks and family support. Culturally responsive care is not a vague aspiration; in the literature it concretely means clinicians who take time to understand a patient’s health beliefs, who use professional interpreters consistently, who adapt communication to the patient’s literacy level, and who demonstrate respect for cultural practices around pregnancy and birth. Community networks, including migrant community organisations and peer support groups, appear to function as bridges that translate not just language but the unwritten rules of a foreign health system—when to call, where to go, what to expect at each stage of pregnancy.

The finding that migrant women face 2.66 times higher odds of suboptimal antenatal care utilisation matters because antenatal care is one of the most powerful preventive interventions in public health. Regular check-ups during pregnancy allow clinicians to detect hypertension, gestational diabetes, anaemia and fetal growth problems before they become emergencies. When a third of a population group struggles to navigate the system and nearly a third cannot fully understand the information they receive, the pipeline from risk to detection to treatment is compromised at every link. The elevated dissatisfaction odds, at 1.77, add a relational dimension: women who feel unheard or disrespected are less likely to return, creating a feedback loop in which poor experiences drive disengagement, which in turn worsens outcomes and reinforces stereotypes about non-compliance.

The authors frame their conclusions within the United Nations Sustainable Development Goals, specifically Goal 3 on health and well-being and Goal 10 on reduced inequalities, arguing that improving maternal health literacy among migrant populations is essential to advancing equitable maternity care. Their recommendations point toward culturally and linguistically responsive maternity services, strengthened communication strategies, and policies that address structural inequities rather than placing the burden of adaptation solely on migrant women themselves. In practical terms, that could mean routine professional interpreter provision funded as core infrastructure, health materials designed for low-literacy and multilingual audiences, navigation programs that pair migrant mothers with trained guides through the pregnancy pathway, and cultural competence embedded in clinician training rather than treated as an optional extra.

What makes this review resonate beyond academic circles is the universality of its underlying message: a health system is only as effective as its ability to communicate with the people it serves. High-income countries pride themselves on some of the safest maternity care in the world, yet this synthesis of 81 studies shows that safety is unevenly distributed along lines of language, culture and migration history. The statistics—nearly one in four unable to understand health information, nearly one in three blocked by language, one in three lost in the system—are not abstractions but the aggregated experiences of hundreds of thousands of women giving birth far from the contexts in which they grew up. As migration continues to shape the demographics of wealthy nations, the review suggests that the measure of a maternity service is not how well it performs for those who already know how to use it, but how well it reaches those who do not.

Subject of Research: Maternal health literacy and healthcare access among migrant mothers in high-income countries

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

Article References: Wickramarathne, T., Baten, A., Nedeljkovic, M., Apputhurai, P., & Bhowmik, J. (2026). Maternal health literacy and access to maternal healthcare among migrant mothers in high-income countries: a systematic review and meta-analysis. BMC Public Health. https://doi.org/10.1186/s12889-026-29851-3

Image Credits: AI Generated

DOI: 10.1186/s12889-026-29851-3

Keywords: maternal health literacy, migrant mothers, maternity care, antenatal care, health inequities, language barriers, systematic review, meta-analysis, high-income countries, culturally responsive care, interpreter services, public health

The research team, led by Eleanor Molloy of the University of Birmingham’s Department of Applied Health Sciences, conducted systematic searches across six electronic databases covering literature published between January 2013 and November 2025. The searches returned 2,652 results, which two reviewers independently screened at title, abstract and full-text stages, with disagreements resolved through discussion with the wider team. From this process, 84 studies encompassing 86 articles met the eligibility criteria, capturing the experiences of women who faced language barriers while navigating maternity services in countries including the United Kingdom and the United States.

Methodologically, the review is a qualitative evidence synthesis, a technique that goes beyond counting outcomes to extract meaning from lived experience. The team analysed the included studies using interpretive thematic synthesis, a method that allows researchers to develop new conceptual insights by systematically translating themes across individual studies. Crucially, the authors then interpreted their findings through the lens of the Socio-Ecological Model, a framework that situates individual experiences within nested layers of influence, from personal interactions up through organisational structures to broader policy environments. The review was prospectively registered on PROSPERO under registration number CRD42023416095, and reporting followed the ENTREQ standards for transparency in qualitative research synthesis.

What emerged from the synthesis was a model describing how outcomes for women depend on two pivotal factors: their interactions with professional interpreters, and the ‘workarounds’ they and their carers resort to when no professional interpreter is available. Women frequently reported that interpreter and translation services were inadequate, unavailable or entirely absent, and that communication with healthcare providers was inconsistent from one appointment to the next. At the system level, the review identified repeated failures to recognise and address linguistic needs, meaning that even when services existed on paper, they often failed to materialise at the bedside.

The consequences of these failures were not abstract. Women described becoming disengaged from their care, withdrawing from services, and experiencing profound isolation during one of the most medically consequential periods of their lives. Trust in maternity services eroded when women could not understand what was being said to them, what consent they were giving, or what risks they faced. The authors found that these experiences increased both perceived and actual risk for women and infants, a finding that carries particular weight given that language barriers are already associated with poorer birth outcomes and contribute to maternal morbidity and mortality in high-income countries.

The workarounds documented in the review deserve particular scrutiny because they reveal the improvisational reality of under-resourced care. In the absence of a professional interpreter, communication may fall to family members, including children, to bilingual but untrained staff, or to ad hoc solutions such as phone applications and gesture. Each of these substitutes carries distinct risks: family members may filter or soften clinical information, untrained staff may lack the vocabulary for informed consent discussions, and machine translation cannot capture clinical nuance or emotional context. The synthesis shows that these substitutions are not rare exceptions but recurring features of care when professional interpreting is not reliably available around the clock.

The Socio-Ecological framing allowed the researchers to show how these individual experiences are produced by structural and organisational constraints. Interpreter services in many high-income systems are commissioned inconsistently, funded through fragmented arrangements, and depend on local implementation decisions rather than guaranteed entitlements. The review concludes that institutional and individual-level understanding of language barriers may itself contribute to perpetuating lack of access to safe care, a striking suggestion that well-intentioned but superficial awareness can coexist with, and even mask, systemic failure. Guidelines from bodies such as the UK’s National Institute for Health and Care Excellence and audits from MBRRACE-UK have repeatedly flagged the dangers, yet provision remains patchy more than a decade into the period covered by the studies.

The implications for safety are stark. Maternity care depends on rapid, accurate, two-way communication: recognising when labour is not progressing, obtaining informed consent for interventions, explaining pain relief options, and conveying warning signs after discharge. When any of these channels break down, the clinical consequences can be severe. The authors argue that appropriate, effective, 24/7 interpreter services and enhanced cultural awareness among healthcare providers are essential, framing these not as optional enhancements but as core safety infrastructure. Failure to address language barriers, they warn, negatively impacts women’s maternity experiences, leading to disengagement and isolation that compound the risks to safety.

The scale of the evidence base lends the findings considerable authority. Eighty-four studies across 22 countries, spanning more than a decade of research and nearly two thousand women’s accounts, converged on remarkably consistent themes, suggesting that the problem is not confined to any single health system or migration pattern. As high-income countries experience increasingly diverse populations, the number of women requiring communication support in maternity care continues to rise, making the review’s timing significant. The work was funded by the National Institute for Health Research through the Applied Research Collaborative West Midlands maternity programme, with contributions from patient and public involvement members, and the authors declare no competing interests.

What distinguishes this synthesis is its insistence that the solution lies in system and personal change together. Individual clinicians cannot conjure interpreters that have not been commissioned, and commissioning bodies cannot anticipate needs that frontline staff fail to record or escalate. The model produced by the review illustrates how these layers interact to perpetuate inequality, and by the same logic, how they could interact to dismantle it: reliable round-the-clock interpreting, translated materials for all who need them, systematic identification of linguistic needs, and training that equips providers to work effectively with interpreters. The women whose voices populate this review did not describe a shortage of goodwill; they described a shortage of guaranteed, resourced, dependable communication. Closing that gap, the authors conclude, is a prerequisite for equity, understanding and safety in modern maternity care.

Subject of Research: Women's experiences of language barriers and interpreter provision in high-income maternity care settings

Article Title: Exploring women’s views and experiences of language barriers in high income maternity care settings: a qualitative systematic review and thematic synthesis

Article References: Exploring women’s views and experiences of language barriers in high income maternity care settings: a qualitative systematic review and thematic synthesis. (n.d.). https://doi.org/10.1186/s12939-026-03019-2

Image Credits: AI Generated

DOI: 10.1186/s12939-026-03019-2

Keywords: language barriers, maternity care, interpreter services, qualitative systematic review, thematic synthesis, health equity, high-income countries, maternal health, communication, translated resources, socio-ecological model, maternal safety