Pushing for Equity, Pulling at Heartstrings: Perinatal Care Access for Uninsured Migrants
Bibliographic record
Abstract
Despite widely accepted clinical care guidelines, uninsured pregnant migrants in Canada face health inequalities and there are ethical implications of denying them publicly-funded care. Uninsured migrants face multiple barriers (financial, systemic, and cultural) to their perinatal care access, which can negatively impact their health and psychosocial outcomes, as well as those of their families. Drawing on interviews with 10 uninsured migrant women in Montreal, Canada, we explore the factors that enabled their access to perinatal care. Our findings underline the importance of health professionals' ability to exercise discretion to volunteer their time, reduce their fees, or "go the extra mile" to ensure care. On the part of the pregnant migrants themselves, individual factors such as resourcefulness, patient proficiency, and social location may enable their care access. This individualization of the access to care is both ethically and politically problematic, and we discuss the role of social workers in addressing the needs of this population.
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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 | 0.003 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.013 | 0.008 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.001 | 0.007 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 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".