Access to Prenatal Care for Pregnant Refugee Women in Toronto, Ontario, Canada: An Audit Study
Bibliographic record
Abstract
We assessed whether eligible refugee claimants faced barriers to accessing prenatal care in the context of changes to Canadian health care policy that generated multiple categories of refugee health care eligibility. METHODS: Prenatal care providers in Toronto were contacted twice using standardized scripts to book appointments for a pregnant non-refugee and refugee claimant, both eligible for prenatal care. PRIMARY OUTCOME: unequivocal offer of appointment. Secondary outcome: reasons for refusal of prenatal care. RESULTS: There was a statistically significantly lower rate of offering prenatal care (34%) to refugee claimants compared with non-refugees (95%) (p < .001). Lack of knowledge, confusion about policies, time-consuming administrative requirements, and slow reimbursement processes were cited as reasons for refusal of care. CONCLUSIONS: Our results highlighted barriers to accessing prenatal care for refugee women. There are important future policy implications when considering the numerous changes to refugee health care policy in the last five years.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.003 |
| Science and technology studies | 0.003 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".