Understanding the Experiences of Refugee Women in Accessing Maternal Health Services in Canada
Bibliographic record
Abstract
Introduction: In 2023, over 43.4 million refugees were forced to leave their countries due to worldwide conflicts, persecutions, human rights violations, and political unrest. Over 51,100 of these refugees were resettled in Canada. Women largely account for this population, with the majority in the childbearing age. Refugee women face a higher risk of adverse maternal health outcomes due to limited knowledge regarding reproductive health, language barriers, inadequate health insurance, as well as discrimination and racism. To address these barriers, metropolitan areas in Canada have established community health centres (CHCs) to support refugee women seeking maternal health services via centralized and culturally appropriate services. However, the role of CHCs in facilitating maternal health access for refugee women remains poorly understood. In Edmonton, the New Canadians Health Centre (NCHC) opened its doors in 2021 to support government-assisted refugees with their overall healthcare needs, and it provides context for this thesis research. Women comprise a significant portion of the NCHC’s patient population; however, the lived-experiences of refugee women patients in accessing maternal health services at the centre and the role of the NCHC in overcoming the barriers they face have not been fully explored. Methods: This community-engaged multi-study thesis aims to: (1) identify barriers and facilitators for refugee women accessing maternal health services through CHCs in Canada via a scoping review based on Joanna Briggs Institute methodology; and (2) explore the experiences of refugee women patients via a qualitative descriptive study, outlined as a study protocol. The scoping review included searches in peer-reviewed databases EMBASE, CINAHL, Medline, and Scopus, as well as the inclusion of grey literature. Additionally, the study protocol delineates a qualitative descriptive study which sets to explore the lived-experiences of 10 refugee women\npatients at the NCHC via semi-structured interviews. Thematic analysis will be used to understand patients’ perspectives. Results: Out of the 504 records that were identified, 47 sources of evidence were included (41 peer-reviewed and 6 grey literature) in the scoping review. Scoping review results highlight key barriers to accessing healthcare, including language, cultural differences, transportation challenges, racism and discrimination faced by refugee women in healthcare settings, gender roles, and low socioeconomic status. The facilitators identified were CHCs providing detailed information to refugee women, employing interpreter and translation services, adopting healthcare models surrounding culturally-safe care, and empathizing and advocating for refugee women patients. Conclusion: This community-engaged study utilizes diverse evidence to understand the complex issue surrounding refugee women's access to maternal health services. Scoping review outcomes outline current strategies and healthcare models that facilitate maternal health service access for refugee women in Canada; however, without further improvements and interventions, the barriers faced by refugee women will continue. Furthermore, the qualitative descriptive study will be essential in highlighting lived-experiences of refugee women patients at the NCHC. Its findings will not only help inform NCHC’s practices and programs to optimize access to maternal health services but will also contribute to the broader discourse on maternal health of refugee women and deepen our understanding of the role CHCs play in improving maternal health outcomes.
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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 | 0.007 | 0.017 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.008 |
| Science and technology studies | 0.014 | 0.006 |
| Scholarly communication | 0.008 | 0.003 |
| Open science | 0.002 | 0.006 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 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".