Healthcare Access for Older Indigenous Women in Latin America: A Scoping Review of Barriers, Facilitators, and Knowledge Gaps
TL;DR
This scoping review aimed to map and synthesize the available evidence on healthcare access for older Indigenous women in the region, identifying relevant dimensions, barriers, facilitators, and existing knowledge gaps, indicating that structural and cultural barriers continue to persist.
Abstract
Background: Over recent decades, Latin America has undergone significant population aging, accompanied by persistent inequalities that adversely affect healthcare access, particularly among Indigenous populations. This scoping review aimed to map and synthesize the available evidence on healthcare access for older Indigenous women in the region, identifying relevant dimensions, barriers, facilitators, and existing knowledge gaps. Methods: A systematic search was performed in scientific databases and gray literature up to 19 June 2026, including studies published between 2020 and 2026 in Spanish, English, or Portuguese. The PCC framework (Population, Concept, Context) was applied. Following a multi-reviewer selection process involving seven reviewers and data extraction using a standardized matrix, the findings were narratively synthesized in accordance with the PRISMA-ScR guidelines. Results: Eleven sources of evidence were included, representing six Latin American countries and including one regional review; qualitative approaches were the most common among the primary studies. Eight dimensions of accessibility were identified: geographic, economic, cultural, organizational, linguistic, functional, administrative, and social. Principal barriers included geographic isolation, poverty, a lack of cultural and linguistic relevance, bureaucratic hurdles, structural racism, and a scarcity of disaggregated data. Facilitators encompassed family and community networks, traditional medicine, local leadership, social programs, and technological/intercultural adaptations such as telemedicine. Compared with the Levesque framework, approachability, appropriateness, and formal system-navigation mechanisms were not clearly represented in the Latin American evidence, while engagement was insufficiently characterized. Conclusions: The findings indicate that structural and cultural barriers continue to persist.