Introduction: Most nurses and midwives do not feel adequately prepared to respond to the complex trauma and social and cultural needs of female clients who have experienced trafficking. There are data to support a lack of knowledge among health care providers about the types of human trafficking as well as poor structural supports within health care systems. The purpose of this review was to gain a more comprehensive understanding of the global health care experiences of females who have experienced trafficking.
Methods: Noblit and Hare's 7-step meta-ethnographic approach was used. We analyzed constructs, concepts, themes, and metaphors using reciprocal translations. The guidelines for preferred reporting the synthesis of qualitative research were adhered to enhancing transparency (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).
Results: The collaborative search process in the PsycINFO, CINAHL, and Scopus databases resulted in 7 high-quality research studies published between January 2016 and January 2021. Most studies explored individuals' experiences of trafficking and views of health care services, challenges, and service use barriers. A total of 228 female survivors who experienced trafficking participated. They primarily experienced trafficking within different parts of North America, Eastern Europe, Africa, and South and Southeast Asia. Three main themes emerged: privacy, confidentiality, and identity problems; powerlessness; and clinician recognition and responsiveness.
Discussion: All participants reported being exposed to extremely high levels of physical and mental abuse before, during, and after exiting trafficking. Therefore, clinicians will require ongoing training and clearer guidance from clinical leadership to adequately care for the varying health needs of women and girls who have experienced trafficking or are currently in a trafficking situation. Adoption of a culturally sensitive, patient-centered, and trauma-informed approach is needed, as clients' reasons for staying in a trafficking situation vary. Relationships of trust should be formed in which rapport is cocreated and in which members of the health care team and client work hand in hand together to envision, identify, and pursue future-oriented and strength-based goals toward healing.
Keywords: domestic servitude; female survivors; forced labor; human trafficking; immigrant; international migrant; modern slavery; sexual exploitation; systematic review; women and girls.
© 2023 by the American College of Nurse-Midwives.