Journal articles on the topic 'Refugees – Medical care – Canada'
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Duke, Pauline S., Fern Brunger, and Elizabeth Ohle. "Morning in refugee health: an introduction for medical students." International Journal of Migration, Health and Social Care 11, no. 2 (June 15, 2015): 86–94. http://dx.doi.org/10.1108/ijmhsc-05-2014-0020.
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Purpose – Migration is increasing worldwide. health care practitioners must provide care to migrants in a culturally competent manner that is sensitive to cultural, political and economic contexts shaping health and illness. Many studies have provided strong evidence that health providers benefit from training in cross-cultural care. Cultural competence education of medical students during their early learning can begin to address attitudes and responsiveness toward refugees. At Memorial University in Canada, the authors designed “Morning in Refugee Health”, an innovative program in cultural competency training for first year medical students in the Clinical Skills and Ethics course. The purpose of this paper is to discuss these issues. Design/methodology/approach – Here the authors introduce the curriculum and provide the rationale for the specific pedagogical techniques employed, emphasizing the consideration of culture in its relation to political and economic contexts. The authors describe the innovation of training standardized patients (SPs) who are themselves immigrants or refugees. The authors explain how and why the collaboration of community agencies and medical school administration is key to the successful implementation of such a curriculum. Findings – Medical students benefit from early pre-clinical education in refugee health. Specific attention to community context, SP training, small group format, linkages between clinical skills and medical ethics, medical school administrative and community agency support are essential to development and delivery of this curriculum. As a result of the Morning in Refugee Health, students initiated a community medical outreach project for newly arriving refugees. Originality/value – The approach is unique in three ways: integration of training in clinical skills and ethics; training of SPs who are themselves immigrants or refugees; and reflection on the political, economic and cultural contexts shaping health and health care.
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Roy, Meagan A. "The War on Language: Providing Culturally Appropriate Care to Syrian Refugees." University of Ottawa Journal of Medicine 6, no. 2 (November 30, 2016): 21–25. http://dx.doi.org/10.18192/uojm.v6i2.1544.
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ABSTRACTOntario’s Ministry of Health and Long-Term Care released a document in January 2016 regarding medical care of Syrian refugees as an effort to support primary care providers in the care and early assessment of their new patients [1]. The fourteen-page document provides an overview of the transition to Ontario medical care, from the Immigration Medical Examination prior to the refugee’s entry into Canada, to health insurance coverage resources and information [1]. Health care providers may welcome this plethora of information, but the presence of a language barrier may prove to be the most considerable issue. RÉSUMÉEn janvier 2016, le ministère de la Santé et des Soins de longue durée de l’Ontario a publié un document au sujet des soins médicaux pour les réfugiés syriens, pour appuyer les fournisseurs de soins primaires lorsqu’ils soignent et effectuent l’évaluation initiale de leurs nouveaux patients [1]. Le document de quatorze pages fournit un survol de la transition vers les soins de santé ontariens, allant de l’examen médical aux fins d’immigration précédant l’entrée du réfugié au Canada, à de l’information sur les régimes d’assurance-maladie [1]. Les professionnels de la santé recevront sans doute favorablement cette abondance d’information, mais la présence d’une barrière linguistique pourrait se révéler comme étant le problème le plus substantiel.
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Sidhu, Aven, Rohan Kakkar, and Osamah Alenezi. "The Management of Newly Diagnosed HIV in a Sudanese Refugee in Canada: Commentary and Review of Literature." Reviews on Recent Clinical Trials 14, no. 1 (January 30, 2019): 61–65. http://dx.doi.org/10.2174/1574887113666180903145323.
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Background: Human Immunodeficiency Virus (HIV) prevalence rates in refugee camps are inconclusive in current literature, with some studies highlighting the increased risk of transmission due to poor living conditions and lower levels of education. With the increasing number of refugees from HIV endemic countries, it is important to assess the programs established to support patients upon arrival. Refugees have been reported to have a lower health literacy and face disease-related stigmatization, which must be overcome for the lifelong treatment of HIV. </P><P> Case Presentation: 31-year-old female arrived in Canada as a refugee from Sudan with her 5 children in July of 2017. She was diagnosed with HIV and severe dental carries during her initial medical evaluation and referred to our centre. A lack of social support has resulted in severe psychological stress. The first being stigmatization which has led to her not disclosing the diagnosis to anyone outside her medical care team. Her level of knowledge about HIV is consistent with literature reporting that despite HIV prevention programs in refugee camps, compliance with risk reduction behaviors, especially in females, is low. Lastly, her major concern relates to the cost of living and supporting her children. Conclusion: Assessment of current HIV programs is necessary to recognize and resolve gaps in the system. Focusing on programs which increase both risk reduction behaviors in refugee camps and integration of refugees in a new healthcare system can facilitate an easier transition for patients and aid in the quest for global 90-90-90 targets for HIV.
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Lane, Ginny, Marwa Farag, Judy White, Christine Nisbet, and Hassan Vatanparast. "Chronic health disparities among refugee and immigrant children in Canada." Applied Physiology, Nutrition, and Metabolism 43, no. 10 (October 2018): 1043–58. http://dx.doi.org/10.1139/apnm-2017-0407.
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There are knowledge gaps in our understanding of the development of chronic disease risks in children, especially with regard to the risk differentials experienced by immigrants and refugees. The Healthy Immigrant Children study employed a mixed-methods cross-sectional study design to characterize the health and nutritional status of 300 immigrant and refugee children aged 3–13 years who had been in Canada for less than 5 years. Quantitative data regarding socioeconomic status, food security, physical activity, diet, and bone and body composition and anthropometric measurements were collected. Qualitative data regarding their experiences with accessing health care and their family lifestyle habits were gathered through in-depth interviews with the parents of newcomer children. Many newcomers spoke about their struggles to attain their desired standard of living. Regarding health outcomes, significantly more refugees (23%) had stunted growth when compared with immigrants (5%). Older children, those with better-educated parents, and those who consumed a poorer-quality diet were at a higher risk of being overweight or obese. Sixty percent of refugees and 42% of immigrants had high blood cholesterol. Significant health concerns for refugee children include stunting and high blood cholesterol levels, and emerging trends indicate that older immigrant children from privileged backgrounds in low-income countries may be more at risk of overweight and obesity. A variety of pathways related to their families’ conceptualization of life in Canada and the social structures that limit progress to meeting their goals likely influence the development of health inequity among refugee and immigrant children. Public health initiatives should address these health inequities among newcomer families.
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Robert, Emilie, and Pierre-Marie David. "“Healthcare as a refuge”: building a culture of care in Montreal for refugees and asylum-seekers living with HIV." International Journal of Human Rights in Healthcare 12, no. 1 (March 11, 2019): 16–27. http://dx.doi.org/10.1108/ijhrh-01-2018-0003.
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Purpose Between 2012 and 2016, the Government of Canada modified health insurance for refugees and asylum seekers. In Quebec, this resulted in refusals of care and uncertainties about publicly reimbursed services, despite guaranteed coverage for people with this status under the provincial plan. The Chronic Viral Illness Service (CVIS) at the McGill University Health Centre in Montreal continued to provide care to refugees and asylum seekers living with HIV. The purpose of this paper is to explain how and why challenges brought by this policy change could be overcome. Design/methodology/approach A qualitative case study was conducted using interviews with patients and staff members, observation sessions and a review of media, documents and articles. A discussion group validated the interpretation of preliminary results. Findings The CVIS provides patient-centered care through a multidisciplinary team. It collectively responds to medical, social and legal issues specific to refugees. Its organizational culture and expertise explain the sustained provision of care. The team’s empathetic view of patients, anchored in the service’s history, care for men who have sex with men and commitment to human rights, is key. A culture of care developed over time thanks to the commitment of exemplary figures. Because they countered the team’s values, changes in refugee healthcare coverage strengthened the service’s culture of care. However, the healthcare system reform launched in 2014 in Quebec is perceived as jeopardizing the culture of care, as it makes, refugee and asylum-seeker patients a non-lucrative venture for providers. Originality/value This research analyzes the origin of sustained provision of care to refugees and asylum seekers living with HIV through the lens of culture of care. It considers the historical and political contexts in which this culture developed.
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McKnight, Anthony, Simone N. Vigod, Cindy-Lee Dennis, Susitha Wanigaratne, and Hilary K. Brown. "Association Between Chronic Medical Conditions and Acute Perinatal Psychiatric Health-Care Encounters Among Migrants: A Population-Based Cohort Study." Canadian Journal of Psychiatry 65, no. 12 (November 9, 2020): 854–64. http://dx.doi.org/10.1177/0706743720931231.
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Objectives: To examine the relationship between prepregnancy chronic medical conditions (CMCs) and the risk of acute perinatal psychiatric health-care encounters (i.e., psychiatric emergency department visits, hospitalizations) among refugees, nonrefugee immigrants, and long-term residents in Ontario. Methods: We conducted a population-based study of 15- to 49-year-old refugees ( N = 29,189), nonrefugee immigrants ( N = 187,430), and long-term residents ( N = 641,385) with and without CMC in Ontario, Canada, with a singleton live birth in 2005 to 2015 and no treatment for mental illness in the 2 years before pregnancy. Modified Poisson regression was used to estimate the relative risk of a psychiatric emergency department visit or hospitalization from conception until 1 year postpartum among women with versus without CMC, stratified by migrant status. An unstratified model with an interaction term between CMC and migrant status was used to test for multiplicativity of effects. Results: The association between CMC and risk of a psychiatric emergency department visit or hospitalization was stronger among refugees (adjusted relative risk [aRR] = 1.87; 95% confidence interval [CI], 1.36 to 2.58) compared to long-term residents (aRR = 1.39; 95% CI, 1.30 to 1.48; interaction P = 0.047). The strength of the association was no different in nonrefugee immigrants (aRR = 1.26; 95% CI, 1.05 to 1.51) compared to long-term residents (interaction P = 0.45). Conclusion: Our study identifies refugee women with CMC as a high-risk group for acute psychiatric health care in the perinatal period. Preventive psychosocial interventions may be warranted to enhance supportive resources for all women with CMC and, in particular refugee women, to reduce the risk of acute psychiatric health care in the perinatal period.
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Pépin, Jacques, France Desjardins, Alex Carignan, Michel Lambert, Isabelle Vaillancourt, Christiane Labrie, Dominique Mercier, Rachel Bourque, and Louiselle LeBlanc. "Impact and benefit-cost ratio of a program for the management of latent tuberculosis infection among refugees in a region of Canada." PLOS ONE 17, no. 5 (May 19, 2022): e0267781. http://dx.doi.org/10.1371/journal.pone.0267781.
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Introduction The identification and treatment of latent tuberculosis infection (LTBI) among immigrants from high-incidence regions who move to low-incidence countries is generally considered an ineffective strategy because only ≈14% of them comply with the multiple steps of the ‘cascade of care’ and complete treatment. In the Estrie region of Canada, a refugee clinic was opened in 2009. One of its goals is LTBI management. Methods Key components of this intervention included: close collaboration with community organizations, integration within a comprehensive package of medical care for the whole family, timely delivery following arrival, shorter treatment through preferential use of rifampin, and risk-based selection of patients to be treated. Between 2009–2020, 5131 refugees were evaluated. To determine the efficacy and benefit-cost ratio of this intervention, records of refugees seen in 2010–14 (n = 1906) and 2018–19 (n = 1638) were reviewed. Cases of tuberculosis (TB) among our foreign-born population occurring before (1997–2008) and after (2009–2020) setting up the clinic were identified. All costs associated with TB or LTBI were measured. Results Out of 441 patients offered LTBI treatment, 374 (85%) were compliant. Adding other losses, overall compliance was 69%. To prevent one case of TB, 95.1 individuals had to be screened and 11.9 treated, at a cost of $16,056. After discounting, each case of TB averted represented $32,631, for a benefit-cost ratio of 2.03. Among nationals of the 20 countries where refugees came from, incidence of TB decreased from 68.2 (1997–2008) to 26.3 per 100,000 person-years (2009–2020). Incidence among foreign-born persons from all other countries not targeted by the intervention did not change. Conclusions Among refugees settling in our region, 69% completed the LTBI cascade of care, leading to a 61% reduction in TB incidence. This intervention was cost-beneficial. Current defeatism towards LTBI management among immigrants and refugees is misguided. Compliance can be enhanced through simple measures.
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Zhang, E., F. Razik, and S. Ratnapalan. "MP05: Injuries in refugee children presenting to a paediatric emergency department." CJEM 20, S1 (May 2018): S41—S42. http://dx.doi.org/10.1017/cem.2018.159.
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Introduction: The number of refugees accepted to Canada grew from 24,600 in 2014 to 46,700 in 2016. Many of these refugees have young families and the number of child refugees has increased accordingly. Although child refugee health care has been in the forefront of media and medical attention recently, there is limited data on injury patterns in this population. Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) collects data on injuries in children presenting to the emergency department (ED). Our objective is to examine the clinical presentations and outcomes of refugee children with injuries presenting to a tertiary care paediatric ED. Methods: Our paediatric hospital has approximately 70,000 ED visits per year of which 13,000 are due to injuries and/or poisonings. The CHIRPP database was accessed to identify children with injuries presenting to our ED from April 2014 to March 2017 with Interim Federal Health Program (IFHP) registration status. All patient charts were reviewed to extract demographic and clinical care information. Results: There were 74 children with 81 ED visits during the study period of whom 19% were transferred from other facilities. Most of them (72%) were males with a mean age of 8.7 years (standard deviation 4.29). There were significant medical histories in 32% of children. The presentation to our ED (greater than 24 hours post-injury) was seen in 25% of visits. Twenty five percent of injured children were seen in our ED. The distribution of Canadian Triage Acuity Score (CTAS) scores 1, 2, 3, 4, and 5 were 0%, 16%, 37%, 46% and 1% respectively. However, subspecialty consultations were required in 69%, 60% and 27% of CTAS 2, 3 and 4 children respectively. Overall, 46% of all patients required subspecialty consults. The top three categories of injuries include fractures (23%), soft tissue injuries (20%) and lacerations (17%). More than half (56%) required diagnostic imaging. Most (89%) were treated in ED and discharged (average length-of-stay 3 hours 55 minutes) and 11% required admissions. 47% of children lacked primary care physicians. Conclusion: Almost half of refugee children with IFHP status require DI testing, sub-specialty consultations and primary care referrals when presenting to our ED with injuries. Follow up arrangements are needed as many do not have access to primary care providers. This demonstrates a need for securing primary care providers early for this vulnerable population.
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Maritim, Charity, Leigh McClarty, Stella Leung, Sharon Bruce, Gayle Restall, Paula Migliardi, and Marissa Becker. "HIV treatment outcomes among newcomers living with HIV in Manitoba, Canada." Official Journal of the Association of Medical Microbiology and Infectious Disease Canada 6, no. 2 (July 2021): 119–28. http://dx.doi.org/10.3138/jammi-2020-0042.
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Background: Despite the overrepresentation of immigrants and refugees (newcomers) in the HIV epidemic in Canada, research on their HIV treatment outcomes is limited. This study addressed this knowledge gap by describing treatment outcomes of newcomers in comparison with Canadian-born persons living with HIV in Manitoba. Methods: Clinical data from 1986 to 2017 were obtained from a cohort of people living with HIV and receiving care from the Manitoba HIV Program. Retrospective cohort analysis of secondary data was completed using univariate and multivariate statistics to compare differences in socio-demographic and clinical characteristics and treatment outcomes among newcomers, Canadian-born Indigenous persons, and Canadian-born non-Indigenous persons on entry into HIV care. Results: By end of 2017, 86 newcomers, 259 Canadian-born Indigenous persons, and 356 Canadian-born non-Indigenous persons were enrolled in the cohort. Newcomers were more likely than Canadian-born Indigenous and non- Indigenous cohort participants to be younger and female and have self-reported HIV risk exposure as heterosexual contact. Average CD4 counts at entry into care did not differ significantly between groups. A higher proportion of newcomers was also diagnosed with tuberculosis within 6 months of entry into care (21%), compared with 6% and 0.6% of Canadian-born Indigenous non-Indigenous persons, respectively. Newcomers and Canadian-born non-Indigenous persons had achieved viral load suppression (< 200 copies/mL) at a similar proportion (93%), compared with 82% of Canadian-born Indigenous participants ( p < 0.05). Conclusions: The distinct demographic and clinical characteristics of newcomers living with HIV requires a focused approach to facilitate earlier diagnosis, engagement, and support in care.
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Bakewell, F., S. Addleman, and V. Thiruganasambandamoorthy. "P010: Use of the emergency department by refugees under the Interim Federal Health Program." CJEM 18, S1 (May 2016): S81—S82. http://dx.doi.org/10.1017/cem.2016.187.
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Introduction: In June 2012, the federal government made cuts to the Interim Federal Health (IFH) Program that reduced or eliminated health insurance for refugee claimants in Canada. The purpose of this study was to examine the effect of the cuts on emergency department (ED) use among patients claiming IFH benefits. Methods: We conducted a health records review at two tertiary care EDs in Ottawa. We reviewed all ED visits wherein an IFH claim was made at triage, for 18 months before and 18 months after the changes to the program on June 30, 2012 (2011-2013). Claims made before and after the cuts were compared in terms of basic demographics, chief presenting complaints, acuity, diagnosis, presence of primary care, and financial status of the claim. Results: There were a total of 612 IFH claims made in the ED from 2011-2013. The demographic characteristics, acuity of presentation and discharge diagnosis were similar during both the before and after periods. Overall, 28.6% fewer claims were made under the IFH program after the cuts. Of the claims made, significantly more were rejected after the cuts than before (13.7% after vs. 3.9% before, p<0.05). The majority (75.0%) of rejected claims have not been paid by patients. Fewer patients after the cuts indicated that they had a family physician (20.4% after vs. 30% before, p<0.05) yet a higher proportion of these patients were still advised to follow up with their family doctor during the after period (67.2% after vs. 41.8% before, p<0.05). Conclusion: A higher proportion of both rejected and subsequently unpaid claims after the IFH cuts in June 2012 represents a potential barrier to emergency medical care, as well as a new financial burden to be shouldered by patients and hospitals. A reduction in IFH claims in the ED and a reduction in the number of patients with access to a family physician also suggests inadequate care for this population. Yet, the lack of primary care was not reflected in the follow-up advice offered by ED physicians to patients.
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Ratnayake, Ayesha, Shahab Sayfi, Luisa Veronis, Sara Torres, Sihyun Baek, and Kevin Pottie. "How Are Non-Medical Settlement Service Organizations Supporting Access to Healthcare and Mental Health Services for Immigrants: A Scoping Review." International Journal of Environmental Research and Public Health 19, no. 6 (March 18, 2022): 3616. http://dx.doi.org/10.3390/ijerph19063616.
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Following resettlement in high-income countries, many immigrants and refugees experience barriers to accessing primary healthcare. Local non-medical settlement organizations, such as the Local Immigration Partnerships in Canada, that support immigrant integration, may also support access to mental health and healthcare services for immigrant populations. This scoping review aims to identify and map the types and characteristics of approaches and interventions that immigrant settlement organizations undertake to support access to primary healthcare for clients. We systematically searched MEDLINE, Social Services Abstracts, CINAHL, and PsycInfo databases from 1 May 2013 to 31 May 2021 and mapped research findings using the Social-Ecological Model. The search identified 3299 citations; 10 studies met all inclusion criteria. Results suggest these organizations support access to primary healthcare services, often at the individual, relationship and community level, by collaborating with health sector partners in the community, connecting clients to health services and service providers, advocating for immigrant health, providing educational programming, and initiating community development/mobilization and advocacy activities. Further research is needed to better understand the impact of local non-medical immigrant settlement organizations involved in health care planning and service delivery on reducing barriers to access in order for primary care services to reach marginalized, high-need immigrant populations.
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Rizwan, Ayesha, and Shazeen Suleman. "115 An Evidence-Based Model of Care for Newcomer Children with Special Health Care Needs." Paediatrics & Child Health 25, Supplement_2 (August 2020): e47-e48. http://dx.doi.org/10.1093/pch/pxaa068.114.
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Abstract Background In 2018, Canada resettled the most refugees in the world, in response to the greatest migration crisis in global history. The refugee and resettlement experience at critical stages of children’s development places children at risk for a number of chronic illnesses. Newcomer children with chronic illnesses or special health care needs (NCSHCN) require services and care providers across many systems, but face greater barriers to healthcare access and are at an increased risk of unmet needs, yet no research has been done to identify best practices for this vulnerable population. Objectives To develop an evidence-based model for high-quality, patient-centered care for NCSHCN and identify areas of need in a large Canadian city with a high density of newcomers. Design/Methods Using formative research design, a literature review and thematic analysis was performed to develop a conceptual model of care for NCSHCN. Next, a local environmental scan was conducted to identify and evaluate current clinics serving newcomers in a large urban Canadian city. Variables collected included the constructs identified in the conceptual model, and information about population served, providers and services offered including access to paediatrics. Results 326 studies were identified, of which 43 studies underwent full-text review and 21 were included in the final synthesis. Six key components were identified to best support NCSHCN: access to interpreters and appropriately translated resources; delivery of culturally competent care; access to care coordination and system navigation; longer appointment times; family-centered care through medical homes and home-based services; and an enhanced knowledge and understanding of health insurance processes. The environmental scan identified 50 clinics and programs serving newcomers, with 88% providing referrals to paediatric services but only 12% with a paediatrician on-site. Eighty-eight percent offered some form of interpreter services and while 71% offered patient navigation/care coordination services, only one program was specific to navigating child health services and programs. Conclusion We propose a data-driven model of care for NCSHCN that can reduce the intersecting disparities these families face by promoting equitable access to health and community services, thereby improving child outcomes and quality of life. While many programs for newcomers exist, access to paediatric services remains elusive and training in cultural competency and insurance processes is variable. More programs that integrate paediatric services into the community to make quality care more accessible and family-centered are required.
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Cooke, Regina, Sally Murray, Jonathan Carapetis, James Rice, Nigisti Mulholland, and Susan Skull. "Demographics and utilisation of health services by paediatric refugees from East Africa: implications for service planning and provision." Australian Health Review 27, no. 2 (2004): 40. http://dx.doi.org/10.1071/ah042720040.
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Regina Cooke is a Clinical Fellow at the Royal Children's Hospital, Melbourne. Sally Murray is an Honorary Fellow of the University of Melbourne and former Program Coordinator of the Victorian Immigrant Health Program, Department of Paediatrics, University of Melbourne. Jonathan Carapetis is an Infectious Diseases Physician, Royal Children's Hospital, Senior Lecturer, Department of Paediatrics,University of Melbourne and Research Fellow, Murdoch Children's Research Institute. James Rice is a Clinical Fellow at University of British Columbia, Canada and formerly of Royal Children's Hospital, Melbourne. Nigisti Mulholland is a Social Scientist, formerly of Royal Children's Hospital, Melbourne.Susan Skull is Deputy Director of the Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, and Senior Lecturer, Department of Paediatrics, University of Melbourne.Little is known of difficulties in accessing health care for recently arrived paediatric refugees in Australia. We reviewedroutinely collected data for all 199 East African children attending a hospital Immigrant Health Clinic for the first time over a 16 month period. Although 63% of parents reported medical consultations since arrival, 77% of this group reported outstanding, unaddressed health problems. Availability of interpreters and information on health services were the main factors hindering access to care. These data have informed future service planning at the Clinic.Ongoing data collection is key to maintaining a responsive, targeted service for a continually changing population.
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DCruz, Jennifer T. "A Cry for Help: Suicide Attempts by an Iraqi Refugee and the Role of Community Service Learning." University of Ottawa Journal of Medicine 8, no. 1 (May 7, 2018): 72–74. http://dx.doi.org/10.18192/uojm.v8i1.2346.
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Community Service Learning (CSL) is a method of teaching where students learn through active participation in thoughtfully organized community service. CSL has emerged as a promising training method to address the changing needs of medical students and to improve their social accountability (1,2). Medical schools are beginning to incorporate community service learning into their curriculums as a way to introduce students to the complicated world of delivering care to vulnerable populations.
Mr. A, a refugee from Iraq, immigrated to Canada in June 2015 with his family. Five months later, during a CSL medical intake interview with two medical students and an Arabic interpreter, he revealed to have ongoing suicidal ideation and multiple suicide attempts. Due to significant cultural taboos and stigma around mental illness, Mr. A was initially very hesitant to seek medical help. However, with the help of the CSL program he was able to get much needed medical care.
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Tran, Don Quang, Andrew G. Ryder, and G. Eric Jarvis. "Reported immigration and medical coercion among immigrants referred to a cultural consultation service." Transcultural Psychiatry 56, no. 5 (June 6, 2019): 807–26. http://dx.doi.org/10.1177/1363461519847811.
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Members of visible minorities are commonly targets of social coercion related to immigration and medical measures. Social coercion is associated with poor mental health outcomes and mistrust of medical services. This study will determine if Afro-Canadian immigrants referred to a Cultural Consultation Service (CCS) in Montreal report more or less medical and immigration coercion compared with other ethnic minorities. We reviewed the charts of 729 referrals to the CCS and gathered data on the 401 patients included in the study. Chi-square statistics examined the relation between minority group and self-reported coercion. Binary logistic regression models controlled for standard sociodemographic variables in addition to ethnicity, language barrier, length of stay in Canada since immigration, refugee claimant status, referral source, presence of psychosis in the main diagnosis, and presence of legal history. Patients were diverse and included 105 Afro-Canadians, 40 Latin Americans, 73 Arab and West Asians, 149 South Asians, and 34 East and Southeast Asians. Being Afro-Canadian was significantly and positively associated with medical coercion (p = .02, 95% CI = 1.15-4.57), while being South Asian was negatively and significantly associated with immigration coercion (p = .03, 95% CI = .29–.93). Members of visible minority communities are not equal in their reported experience of social coercion after arriving to Canada. Future research clarifying pathways to mental health care for immigrants and the experience of new Canadians in immigration and health care settings would give needed context to the findings of this study.
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Vandenberg, Helen. "“A Powerful Protector of the Japanese People”: The History of the Japanese Hospital in Steveston, British Columbia, Canada, 1896–1942." Nursing History Review 25, no. 1 (2017): 54–81. http://dx.doi.org/10.1891/1062-8061.25.1.54.
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AbstractFrom 1896 to 1942, a Japanese hospital operated in the village of Steveston, British Columbia, Canada. For the first 4 years, Japanese Methodist missionaries utilized a small mission building as a makeshift hospital, until a larger institution was constructed by the local Japanese Fishermen’s Association in 1900. The hospital operated until the Japanese internment, after the attack on Pearl Harbor during World War II. This study offers important commentary about the relationships between health, hospitals, and race in British Columbia during a period of increased immigration and economic upheaval. From the unique perspective of Japanese leaders, this study provides new insight about how Japanese populations negotiated hospital care, despite a context of severe racial discrimination. Japanese populations utilized Christianization, fishing expertise, and hospital work to garner more equitable access to opportunities and resources. This study demonstrates that in addition to providing medical treatment, training grounds for health-care workers, and safe refuge for the sick, hospitals played a significant role in confronting broader racialized inequities in Canada’s past.
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Kholina, Ksenia, Shawn H. E. Harmon, and Janice E. Graham. "An equitable vaccine delivery system: Lessons from the COVID-19 vaccine rollout in Canada." PLOS ONE 17, no. 12 (December 30, 2022): e0279929. http://dx.doi.org/10.1371/journal.pone.0279929.
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Background The COVID-19 pandemic exacerbated existing health disparities and disproportionately affected vulnerable individuals and communities (e.g., low-income, precariously housed or in institutional settings, racialized, migrant, refugee, 2SLBGTQ+). Despite their higher risk of infection and sub-optimal access to healthcare, Canada’s COVID-19 vaccination strategy focused primarily on age, as well as medical and occupational risk factors. Methods We conducted a mixed-methods constant comparative qualitative analysis of epidemiological data from a national database of COVID-19 cases and vaccine coverage in four Canadian jurisdictions. Jurisdictional policies, policy updates, and associated press releases were collected from government websites, and qualitative data were collected through 34 semi-structured interviews of key informants from nine Canadian jurisdictions. Interviews were coded and analyzed for themes and patterns. Results COVID-19 vaccines were rolled out in Canada in three phases, each accompanied by specific challenges. Vaccine delivery systems typically featured large-venue mass immunization sites that presented a variety of barriers for those from vulnerable communities. The engagement and targeted outreach that featured in the later phases were driven predominantly by the efforts of community organizations and primary care providers, with limited support from provincial governments. Conclusions While COVID-19 vaccine rollout in Canada is largely considered a success, such an interpretation is shaped by the metrics chosen. Vaccine delivery systems across Canada need substantial improvements to ensure optimal uptake and equitable access for all. Our findings suggest a more equitable model for vaccine delivery featuring early establishment of local barrier-free clinics, culturally safe and representative environment, as well as multi-lingual assistance, among other vulnerability-sensitive elements.
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Alexander, C. "Health care and refugees in Canada." Canadian Medical Association Journal 186, no. 8 (May 12, 2014): 614–15. http://dx.doi.org/10.1503/cmaj.114-0031.
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Legters, Llewellyn J. "Medical Care of Refugees." American Journal of Tropical Medicine and Hygiene 39, no. 2 (August 1, 1988): 223–24. http://dx.doi.org/10.4269/ajtmh.1988.39.223.
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Bazaid, K. "Syrian Refugees in Canada: Clinical Experience in Mental Health Care." European Psychiatry 41, S1 (April 2017): S620. http://dx.doi.org/10.1016/j.eurpsy.2017.01.996.
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War is the most serious of all threats to health (World Health Organization, 1982) and can have severe and lasting impacts on mental health. Forced displacement and migration generate risks to mental well-being, which can result in psychiatric illness. Yet, the majority of refugees do not develop psychopathology. Rather, they demonstrate resilience in the face of tremendous adversity. The influx of Syrian refugees to Canada poses challenges to the health care system. We will present our experience to date in the Ottawa region, including a multisector collaborative effort to provide settlement and health services to newly arriving refugees from the Middle East and elsewhere. The workshop will be brought to life by engaging with clinical cases and public health scenarios that present real world clinical challenges to the provision of mental health care for refugees.Objectives(1) Understand the predicament of refugees including risks to mental health, coping strategies and mental health consequences, (2) know the evidence for the emergence of mental illness in refugees and the effectiveness of multi-level interventions, (3) become familiar with published guidelines and gain a working knowledge of assessment and management of psychiatric conditions in refugee populations and cultural idioms of distress.How will the participants receive feedback about their learning? Participants will have direct feedback through answers to questions. The authors welcome subsequent communication by email. Presenters can give attendants handouts on pertinent and concise information linked to the workshop.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Epstein, Iris, Lorivie Balaquiao, Kai Ya Chang, and Jade Nguyen. "Refugee smartphone access to health care in Canada: Concept analysis." Journal of Nursing Education and Practice 9, no. 1 (September 17, 2018): 78. http://dx.doi.org/10.5430/jnep.v9n1p78.
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Objective: With the ever-changing smartphone healthcare technology also comes nurses’ responsibilities to recognize its ethical implications particularly among vulnerable population. The aim of this paper is to explore what we know about the use of smartphone to access health care among refugees and new immigrants.Methods: We were guided by Walker and Avant (2011) concept analysis methodology. Concept analysis is a rigorous method to better understand ethical implications, meaning, attributes, antecedents and consequences of smartphone access to health care. Diverse databases were included such as CINAHL, Journals@Ovid, ProQuest Nursing & Allied Health Source, ProQuest Psychology Journals, PsychINFO, ERIC, and Education Full Text.Results: The concept analysis retrieved 23 studies. Overarching themes included the physical (e.g. income, geographical location) and social (generation; access to regular internet; digital literacy; relationship with practitioners) that were attributed to refugee and new immigrant access to health care.Conclusions: Some of the ethical implication when using smartphone to access health care technology with refugees and new immigrants are discussed and the skills needed for nursing practice are identified and recommendations for nurse education and research are made.
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Tanya, Stuti M., Bonnie He, and Christine Aubrey-Bassler. "Eye-care utilization among a Canadian diabetic refugee population: retrospective cohort study of an interdisciplinary care model." International Journal of Care Coordination 24, no. 3-4 (September 2021): 120–24. http://dx.doi.org/10.1177/20534345211061032.
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Introduction Vision health is an important and underutilized health service among newly arrived refugees in Canada, yet the body of literature on eye-care delivery in this population is limited. The study objective was to identify patterns of eye-care utilization among refugee patients with type 2 diabetes mellitus (T2DM) in Newfoundland and Labrador (NL) under an interdisciplinary clinic model comprised of family physicians, eye-care providers, and settlement services. Methods This was a retrospective cohort study at the Memorial University Family Medicine clinic. All patients with a new T2DM diagnosis between 2015–2020 were included. Data were described using basic statistics and unpaired t-tests. This study received full ethics approval. Results Seventy-three (18 refugee, 55 non-refugee) patients were included. Refugees had a higher rate of referral to an eye-care provider ( p = 0.0475) and were more likely to attend their eye-care provider appointment than non-refugees ( p = 0.016). The time from diagnosis to referral was longer for refugees than non-refugees ( p = 0.0498). A trend towards longer time from referral to appointment attendance for refugees than non-refugees was noted ( p = 0.9069). Discussion Refugee patients had higher rates of referral to eye-care providers and utilization of eye-care services. However, refugees also experienced a longer time to access vision screening services suggesting possible gaps in accessible care delivery. This suggests that the interdisciplinary model of care may be effective in referring refugee patients for vision screening and there may be a role for increased collaboration across family physicians, eye-care providers, and settlement services to improve accessibility of vision screening services.
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Magee, Laura A., Anne-Marie Cote, Geena Joseph, Tabassum Firoz, and Winnie Sia. "Obstetric medical care in Canada." Obstetric Medicine 9, no. 3 (June 21, 2016): 117–19. http://dx.doi.org/10.1177/1753495x16645730.
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Obstetric medicine is a growing area of interest within internal medicine in Canada. Canadians continue to travel broadly to obtain relevant training, particularly in the United Kingdom. However, there is now a sufficient body of expertise in Canada that a cadre of ‘home-grown’ obstetric internists is emerging and staying within Canada to improve maternity care. As this critical mass of practitioners grows, it is apparent that models of obstetric medicine delivery have developed according to local needs and patterns of practice. This article aims to describe the state of obstetric medicine in Canada, including general internal medicine services as the rock on which Canadian obstetric medicine has been built, the Canadian training curriculum and opportunities, organisation of obstetric medicine service delivery and the future.
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Aronson, Louise. "Health Care for Cambodian Refugees." Practicing Anthropology 9, no. 4 (September 1, 1987): 10–12. http://dx.doi.org/10.17730/praa.9.4.51p323mt13751031.
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One of the major challenges to the American health care system posed by the hundreds of thousands of Southeast Asian refugees who have come to the United States since 1975 initially appeared to be the containment and treatment of infectious diseases carried by many. However, this challenge was rapidly overshadowed by another more fundamental one: the cultural differences between American care-givers and their refugee patients. Since culture controls perceptions of health, illness, and disease causation and classification, culturally regulated beliefs and practices are key determinants of patient behavior and clinical care. Hospitals and clinics with significant Southeast Asian clientele have attempted to minimize cultural misunderstanding between staff and refugee patients by adding refugees to treatment teams. These refugees act as intermediaries between medical staff and members of their own ethnic communities.
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Duclos, Diane, Fouad Mohamed Fouad, and Karl Blanchet. "When Refugees Care for Refugees in Lebanon: Providing Contextually Appropriate Care from the Ground Up." Medicine Anthropology Theory 8, no. 3 (September 28, 2021): 1–22. http://dx.doi.org/10.17157/mat.8.3.5159.
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Despite a surge in initiatives to integrate foreign-trained physicians into local health systems and a drive to learn from localised humanitarian initiatives under the COVID-19 pandemic, we still know little about the on-the-ground strategies developed by refugee doctors to meet the needs of refugee patients. In Lebanon, displaced Syrian health professionals have mounted informal, local responses to care for displaced Syrian patients. Drawing on ethnographic work shadowing these healthcare providers across their medical and non-medical activities, we explore how clinical encounters characterised by shared histories of displacement can inform humanitarian medicine. Our findings shed light on the creation of breathing spaces in crises. In particular, our study reveals how displaced healthcare workers cope with uncertainty, documents how displaced healthcare workers expand the category of ‘appropriate care’ to take into account the economic and safety challenges faced by patients, and locates the category of ‘informality’ within a complex landscape of myriad actors in Lebanon. This research article shows that refugee-to-refugee healthcare is not restricted to improvised clinical encounters between ‘frontliners’ and ‘victims of war’. Rather, it is proactively enacted from the ground up to foster appropriate care relationships in the midst of violent, repeated, and protracted disruptions to systems of care.
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Kondro, Wayne. "Canada to define essential medical care." Lancet 346, no. 8970 (July 1995): 300. http://dx.doi.org/10.1016/s0140-6736(95)92178-8.
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Barer, Morris L. "Controlling Medical Care Costs in Canada." JAMA 265, no. 18 (May 8, 1991): 2393. http://dx.doi.org/10.1001/jama.1991.03460180099042.
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Barer, M. L. "Controlling medical care costs in Canada." JAMA: The Journal of the American Medical Association 265, no. 18 (May 8, 1991): 2393–94. http://dx.doi.org/10.1001/jama.265.18.2393.
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McMurray, Josephine, Katherine Breward, Michael Breward, Rob Alder, and Neil Arya. "Integrated Primary Care Improves Access to Healthcare for Newly Arrived Refugees in Canada." Journal of Immigrant and Minority Health 16, no. 4 (November 30, 2013): 576–85. http://dx.doi.org/10.1007/s10903-013-9954-x.
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Tuck, Andrew, Anna Oda, Michaela Hynie, Caroline Bennett-AbuAyyash, Brenda Roche, Branka Agic, and Kwame McKenzie. "Unmet Health Care Needs for Syrian Refugees in Canada: A Follow-up Study." Journal of Immigrant and Minority Health 21, no. 6 (January 8, 2019): 1306–12. http://dx.doi.org/10.1007/s10903-019-00856-y.
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Zanchetta, Margareth Santos, Abinet Gebremariam, David Aftab Ansari, Elizabeth Huang, Stéphanie Larchanché, Clément Picot-Ngo, Marguerite Cognet, and Shone John. "Immigration, settlement process and mental health challenges of immigrants/ refugees: Alternative care thinking." Aporia 13, no. 2 (August 23, 2021): 5–20. http://dx.doi.org/10.18192/aporia.v13i2.6016.
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This paper discusses progressive thinking and clinical views on improving mental health practice for immigrants and refugees. It addresses policy, care delivery, professionals’ attitudes, and immigrants’ access to mental health care — all factors especially pertinent for practice in major immigration hubs. The data was gathered from invited presentations and discussions among participants at an international multidisciplinary symposium, including health and social scientists from Toronto (Canada) and Paris (France), major urban centres attracting large numbers of immigrant and refugees who constantly encounter challenges for their successful settlement. The focus is on alternative care thinking and innovative approaches for better care and understanding of these populations’ health behavior. Recommendations on how to advance knowledge relevant for these two urban hubs of immigration were documented, underpinned by the consensus that economic disparities, societal and political forces, as well as cultural and linguistic factors, influence immigrants’ and refugees’ vulnerability regarding mental health stability.
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Evans, Andrea, and Savithiri Ratnapalan. "EMERGENCY DEPARTMENT VISITS BY CHILD REFUGEE CLAIMANTS AT A PEDIATRIC TERTIARY CARE CENTER." Paediatrics & Child Health 23, suppl_1 (May 18, 2018): e7-e7. http://dx.doi.org/10.1093/pch/pxy054.018.
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Abstract BACKGROUND The Canadian government has announced the resettlement of 50 000 refugees from the Middle East by 2018. The proportion of refugees that are below 18 years of age have increased from 20% to almost 40% from 2005 to 2014 and is expected to increase further with new refugee influxes. Barriers to timely health care can worsen clinical presentations and outcomes, especially in vulnerable children such as refugees. This study aims to provide an overview of the epidemiology, clinical presentations, hospital stay metrics, and non-clinical support needs for child refugee claimants presenting to the emergency department at a large tertiary care hospital in Canada. OBJECTIVES To describe the emergency department visits by refugee claimants with IFH, including demographics, primary care access, immunization status, acuity of presentation, repeat visits, and admission rates. DESIGN/METHODS A retrospective chart review of all refugee children presenting to the emergency department at this tertiary care hospital from April 1 2014 to March 31st 2017. A case was defined as a child who presented to the hospital with Interim Federal Health (IFH) which is the federal health insurance program covers newly arrived refugee claimants in Canada. Descriptive statistics and chi square test for categorical data was used. Data was analyzed using SPSS v21 IBM 2012. Ethics was approved by the Ethics Review Board of the hospital. RESULTS In total, there were 646 visits to the emergency department by 388 patients with IFH. The average age was 6.4 years (IQR 2.9–9.3), of which 58% were females. Travel history was documented in 65% of cases. The majority of patients arrived from Southeast Asia and the Middle East. The average time spent in Canada was 217 days (IQR 78–205). Sixty percent of patients did not have an identified primary care provider. Those with an identified primary care provider had more non-acute (CTAS 4–5) visits than those without an identified primary care provider (p<0.05). Immunizations were not up-to-date per Canadian standard in 25% of those who had an immunization history documented. Translation services was used in 11% of visits. Admission rate was 12%, with average length of stay 3.4 days (std 4). Top three reasons for admission were febrile neutropenia, respiratory distress, and blood per rectum. One fifth (20%) of admissions occurred on the same day as the arrival of the patient to Canada. CONCLUSION A significant number of refugee children are needing emergency care and admission to hospital on the day they arrive to Canada. Most child refugees presenting to the emergency department did not have an identified primary care provider, and a quarter did not have up-to-date immunizations. Association with primary care provider suggests that linkage to primary care in this population should be a priority.
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Sandre, Anthony Robert, and K. Bruce Newbold. "Telemedicine: Bridging the Gap between Refugee Health and Health Services Accessibility in Hamilton, Ontario." Refuge: Canada's Journal on Refugees 32, no. 3 (November 23, 2016): 108–18. http://dx.doi.org/10.25071/1920-7336.40396.
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Refugees face considerable challenges upon seeking asylum in Canada, and accessing health care services remains a prominent issue. Recurrent themes in the literature outlining barriers to health-services accessibility include geographic, economic, and cultural barriers. Drawing on the experiences of service providers in Hamilton, Ontario, we explored the efficacy of telemedicine services in bridging the gap between refugee health and health services accessibility. Research methodology included structured interviews with clinicians who provide health-care services to refugees, complemented by a scoping literature review. The results of this exploratory study demonstrate the efficacy of telemedicine in encouraging dialogue and policy change in the greater health-care setting, and its potential to increase access to specialist health-care services.
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Redwood-Campbell, Lynda, Harpreet Thind, Michelle Howard, Jennifer Koteles, Nancy Fowler, and Janusz Kaczorowski. "Understanding the Health of Refugee Women in Host Countries: Lessons from the Kosovar Re-Settlement in Canada." Prehospital and Disaster Medicine 23, no. 4 (August 2008): 322–27. http://dx.doi.org/10.1017/s1049023x00005951.
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AbstractIntroduction:Refugees from Kosovo arrived in several Canadian cities after humanitarian evacuations in 1999. Approximately 500 arrived in Hamilton, Canada. Volunteer sponsors from community organizations assisted the families with settlement, which included providing them access to healthcare services.Hypothesis/Problem: It was anticipated that women, in particular, would have unmet health needs relating to trauma and a lack of healthcare access after experiencing forced migration.Methods:This study describes the results of a self-administered survey regarding women's health issues and experiences with health services after the arrival of refugees. It also describes the sponsor group's experience related to women's health care. The survey was administered to a random sample of 85 women refugees, and focus groups with 14 sponsors.Women self-completed questionnaires about their health, which included the Harvard Trauma Questionnaire for post-traumatic stress disorder (PTSD) and use of preventive health services. Sponsor groups participated in a focus group discussing healthcare needs and experiences of their assigned refugee families. Themes pertaining to women's issues were identified from the focus groups.Results:Preventive screening rates were low, only 1/19 (5.3%) women ≥50- years-old had ever received a mammogram; 34.1% (28/82) had ever received a Pap test); and PTSD was prevalent (25.9%, 22/85). Sponsor groups identified challenges relating to prenatal care needs, finding family physicians, language barriers to health care services, cultural influences of women's healthcare decision-making, mental health concerns, and difficulties accessing dental care, eye care, and prescriptions.Conclusions:Many women refugees from Kosovo had unmet health needs. Culturally appropriate population level screening campaigns and integration of language and interpretation services into the healthcare sector on a permanent basis are important policy actions to be adequately prepared for newcomers and women in displaced situations. These needs should be anticipated during the evacuation period by host countries to aid in planning the provision of health resources more efficiently for refugees and displaced people going to host countries.
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Zihindula, Ganzamungu, Anna Meyer-Weitz, and Olagoke Akintola. "Lived Experiences of Democratic Republic of Congo Refugees facing Medical Xenophobia in Durban, South Africa." Journal of Asian and African Studies 52, no. 4 (August 11, 2015): 458–70. http://dx.doi.org/10.1177/0021909615595990.
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This research was undertaken to explore experiences of xenophobia by refugees from the Democratic Republic of Congo (DRC) with the health care system in Durban, South Africa. The study adopted a qualitative methodology consisting of 31 in-depth interviews with refugees from the DRC. Framework analysis was conducted. The findings revealed that refugees face medical xenophobia during their encounter with health care workers with language barriers and documentation as the first stumbling block in efforts to seek health care services. The pervasiveness of xenophobia is also experienced in prejudice evident in ethnic slurs, unwelcome and insensitive comments and discriminatory practices, including denial of treatment, contributing to inequality in health care delivery.
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Davidson, Marta B., Garielle Brown, Lesley Street, Kerry McBrien, Eric Norrie, Andrea Hull, Rachel Talavlikar, Linda Holdbrook, and Gabriel E. Fabreau. "Iron deficiency, anemia and association with refugee camp exposure among recently resettled refugees: A Canadian retrospective cohort study." PLOS ONE 17, no. 12 (December 15, 2022): e0278838. http://dx.doi.org/10.1371/journal.pone.0278838.
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Malnutrition and poor health are common among recently resettled refugees and may be differentially associated with pre-migration exposure to refugee camp versus non-camp dwelling. We aimed to investigate the associations of iron deficiency (ID), anemia, and ID anemia (IDA) with pre-migration refugee camp exposure among recently arrived refugees to Canada. To this end, we conducted a retrospective cohort study of 1032 adult refugees who received care between January 1, 2011, and December 31, 2015, within a specialized refugee health clinic in Calgary, Canada. We evaluated the prevalence, severity, and predictors of ID, anemia, and IDA, stratified by sex. Using multivariable logistic regression, we estimated the association of refugee camp exposure with these outcomes, adjusting for age, months in Canada prior to investigations, global region of origin, and parity. Among female refugees, the prevalence of ID, anemia, and IDA was 25% (134/534), 21% (110/534), and 14% (76/534), respectively; among males, 0.8% (4/494), 1.8% (9/494), and 0% (0/494), respectively. Anemia was mild, moderate, and severe in 55% (60/110), 44% (48/110) and 1.8% (2/110) of anemic females. Refugee camp exposure was not associated with ID, anemia, or IDA while age by year (ID OR = 0.96, 95% CI 0.93–0.98; anemia OR = 0.98, 95% CI 0.96–1.00; IDA OR = 0.96, 95% CI 0.94–0.99) and months in Canada prior to investigations (ID OR = 0.85, 95% CI 0.72–1.01; anemia OR = 0.81, 95% CI 0.67–0.97; IDA OR = 0.80, 95% CI 0.64–1.00) were inversely correlated with these outcomes. ID, anemia, and IDA are common among recently arrived refugee women irrespective of refugee camp exposure. Our findings suggest these outcomes likely improve after resettlement; however, given proportionally few refugees are resettled globally, likely millions of refugee women and girls are affected.
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Saunders, Natasha Ruth, Alison Macpherson, Jun Guan, and Astrid Guttmann. "Unintentional injuries among refugee and immigrant children and youth in Ontario, Canada: a population-based cross-sectional study." Injury Prevention 24, no. 5 (September 25, 2017): 337–43. http://dx.doi.org/10.1136/injuryprev-2016-042276.
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BackgroundUnintentional injuries are a leading reason for seeking emergency care. Refugees face vulnerabilities that may contribute to injury risk. We aimed to compare the rates of unintentional injuries in immigrant children and youth by visa class and region of origin.MethodsPopulation-based, cross-sectional study of children and youth (0–24 years) from immigrant families residing in Ontario, Canada, from 2011 to 2012. Multiple linked health and administrative databases were used to describe unintentional injuries by immigration visa class and region of origin. Poisson regression models estimated rate ratios for injuries.ResultsThere were 6596.0 and 8122.3 emergency department visits per 100 000 non-refugee and refugee immigrants, respectively. Hospitalisation rates were 144.9 and 185.2 per 100 000 in each of these groups. The unintentional injury rate among refugees was 20% higher than among non-refugees (adjusted rate ratio (ARR) 1.20, 95% CI 1.16, 1.24). In both groups, rates were lowest among East and South Asians. Young age, male sex, and high income were associated with injury risk. Compared with non-refugees, refugees had higher rates of injury across most causes, including for motor vehicle injuries (ARR 1.51, 95% CI 1.40, 1.62), poisoning (ARR 1.40, 95% CI 1.26, 1.56) and suffocation (ARR 1.39, 95% CI 1.04, 1.84).InterpretationThe observed 20% higher rate of unintentional injuries among refugees compared with non-refugees highlights an important opportunity for targeting population-based public health and safety interventions. Engaging refugee families shortly after arrival in active efforts for injury prevention may reduce social vulnerabilities and cultural risk factors for injury in this population.
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Salam, Zoha, Amy Gajaria, Olive Wahoush, and Elysee Nouvet. "Coping with Stressors by Drawing on Social Supports: The Experiences of Adolescent Syrian Refugees in Canada." Refuge: Canada's Journal on Refugees 38, no. 2 (December 31, 2022): 1–17. http://dx.doi.org/10.25071/1920-7336.40887.
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This study explores how teenage Syrian refugees use their social networks to cope with stressors. Through interviews with nine youth aged 16 to 18 living in Ontario, Canada, stressors related to pre- and post-migration emerged. Family, peers, school staff, and organizations were identified as social networks, each having unique reasons why they were selected. Coping was categorized as individualistic or collectivistic. Teenage Syrian refugees draw upon social resources to navigate situations they are faced with, and cultural values influence the stress and coping process. Findings have implications for mental health care providers and policy-makers focused on migrant resettlement.
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Azizi, Nemat, Bahram Delgoshaei, and Aidin Aryankhesal. "Lived Experience of Afghan Refugees in Iran Concerning Primary Health Care Delivery." Disaster Medicine and Public Health Preparedness 13, no. 5-6 (June 10, 2019): 868–73. http://dx.doi.org/10.1017/dmp.2018.169.
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ABSTRACTObjective:Access to primary health care (PHC) is very important for refugees. The aim of this study was to illuminate lived experience of Afghan refugees in Iran regarding PHC delivery.Methods:This qualitative study was conducted in 2016–2017 by using the content analysis technique. Data were collected through individual deep interviews with Afghan refugees who lived in Iran. The data were analyzed by using a method by Graneheim and Lundman.Results:Four main categories and 12 subcategories were emerged, including (1) challenges before PHC delivery: large number of children, high service cost, not having medical insurance, access to health centers, appointment to get services, simultaneity of breastfeeding, and pregnancy; (2) challenges during PHC delivery: understanding Iranian words, health care provider’s behavior, delay in getting service in PHC centers; (3) challenges after delivery PHC: referral patient, high costs of paraclinics; and (4) free and good services.Conclusion:Our results showed that Afghan refugees have several challenges in every stage of PHC delivery. Awareness of such problems can help medical personnel improve delivery of service to Afghan refugees, as well as using trained Afghani nurses to serve the refugees.
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Brunger, Fern, Pauline S. Duke, and Robyn Kenny. "Matching physicians to newly arrived refugees in a context of physician shortage: innovation through advocacy." International Journal of Migration, Health and Social Care 10, no. 1 (March 12, 2014): 36–51. http://dx.doi.org/10.1108/ijmhsc-05-2013-0004.
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Purpose – Access to a continuum of care from a family physician is an essential component of health and wellbeing. Refugees have particular barriers to accessing medical care. The MUN MED Gateway Project is a medical student initiative in partnership with a refugee settlement agency that provides access to and continuity of health care for new refugees, while offering medical students exposure to cross-cultural health care. This paper aims to report on the first six years of the project. Design/methodology/approach – Here the paper reports on: client patient uptake and demographics, health concerns identified through the project, and physician uptake and rates of patient-physician matches. Findings – Results demonstrate that the project integrates refugees into the health care system and facilitates access to medical care. Moreover, it provides learning opportunities for students to practice cross-cultural health care, with high engagement of medical students and high satisfaction by family physicians involved. Originality/value – Research has shown that student run medical clinics may provide less than optimum care to marginalized patients. Transient staff, lack of continuity of care, and limited budgets are some challenges. The MUN MED Gateway Project is markedly different. It connects patients with the mainstream medical system. In a context of family physician shortage, this student-run clinic project provides access to medical care for newly arrived refugees in a way that is effective, efficient, and sustainable.
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Basheti, IA, EA Qunaibi, and R. Malas. "Psychological Impact of Life as Refugees: A Pilot Study on a Syrian Camp in Jordan." Tropical Journal of Pharmaceutical Research 14, no. 9 (October 12, 2015): 1695–701. http://dx.doi.org/10.4314/tjpr.v14i9.22.
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Purpose: To investigate types and prevalence of psychological distresses endured by Syrian refugees at Alzatary Camp in Jordan.Methods: This observational study was conducted over a period of 2 months (November and December, 2012) at Alzatary Camp for Syrian refugees in Jordan. A validated questionnaire was filled by a field researcher to gather information on respondents’ living conditions, psychological distresses and perspectives of the medical care services provided.Results: The questionnaire was completed for 73 respondents with a mean age of 37.7 ± 11.2. A majority of refugees (63.3 %) lived in tents, and the rest in caravans. Some of the respondents (56 %) suffered from psychological distresses; 46 % believed that psychological therapy and support is needed, out of which 14.5 % reported receiving such therapy. Refugees staying in tents reported low satisfaction with the medical care services provided (54.2 % vs. 23.8 %) and great need for psychological support (66.7 % vs. 31.3 %) when compared to refugees staying in caravans.Conclusion: Syrian refugees at Alzatary Camp suffer from psychological distress that requires urgent attention. Current medical support is not sufficient, especially for refugees staying in tents.Keywords: Syrian refugees, Jordan camps, Alzatary Camp, Psychological disorders, Mental health
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Munyaneza, Yvonne, and Euphemia Mbali Mhlongo. "Medical Xenophobia: The Voices of Women Refugees in Durban, Kwazulu-Natal, South Africa." Global Journal of Health Science 11, no. 13 (November 3, 2019): 25. http://dx.doi.org/10.5539/gjhs.v11n13p25.
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BACKGROUND: Women refugees are mostly affected due to their specific needs for reproductive health services. In their attempt to utilize reproductive health care services, women refugees face medical xenophobia by the health care professionals. Upon their arrival in South Africa, refugee women do not undergo any screening, and this exposes them to health risks making them more prone to all different types of diseases, as many of them are survivors of rape and other acts of sexual violence.
OBJECTIVE: The aim of the study was to describe the voices of women refugees regarding reproductive health services in public health institutions in Durban KwaZulu-Natal
METHODS: A qualitative, descriptive design was used. Data was collected through face-to-face interviews with eight women refugees living in Durban, KwaZulu-Natal. Thematic content analysis guided the study.
RESULTS: Two main themes emerged from the data: negative experiences/challenges, and positive experiences. The negative experiences included medical xenophobia and discrimination, language barrier, unprofessionalism, failure to obtain consent and lack of confidentiality, ill-treatment, financial challenges, internalised fear, religious and cultural domination, the shortage of staff and overcrowding of public hospitals. The positive experiences included positive care and treatment.
CONCLUSION: The study concluded that discrimination and medical xenophobia remain a challenge for women refugees seeking reproductive health services in public health institutions in Durban, KwaZulu-Natal.
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Temu, Tecla Mtui, Lisa Ratanaprasatporn, Linda Ratanaprasatporn, Delma-Jean Watts, and Carol Lewis. "The Patient-Centered Medical Home for Refugee Children in Rhode Island." International Journal of Population Research 2012 (December 26, 2012): 1–6. http://dx.doi.org/10.1155/2012/394725.
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Purpose. To describe a “medical home” for pediatric refugees and its ability to provide culturally competent care, to partner with and train medical interpreters, and to improve health screening and follow-up adherence rates of pediatric refugees immigrating to Rhode Island. Methods. A retrospective chart review of refugees was performed. Background information, initial laboratory data, whether patients completed the recommended follow-ups scheduled at 1, 3, 6, and 12 months, and completion of tuberculosis treatment were recorded. Results. Since its initiation, 104 refugee children have attended the clinic ranging in age from 5 months to 18 years. Since the initiation of the medical home for refugee children in 2007, initial screening rates have gone up to 99-100% compared to a low of 41% in 2003–2006 prior to the establishment of the medical home. There was a 43% reduction in missed appointments in 15-month follow-up. Conclusion. The refugee “medical home” allows refugees to benefit from a comprehensive system for disease detection and ongoing primary health care.
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Newbold, Bruce, and Marie McKeary. "Investigating the diversity of Canada’s refugee population and its health implications: does one size fit all?" International Journal of Migration, Health and Social Care 13, no. 2 (June 12, 2017): 145–56. http://dx.doi.org/10.1108/ijmhsc-02-2015-0007.
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Purpose Based on a case study in Hamilton, Ontario, Canada, the purpose of this paper is to explore the difficulties faced by local health care providers in the face of constantly evolving refugee policies, programs, and arrivals. In doing so, it illustrates the complications faced by service providers in providing care to refugee arrivals and how the diversity of arrivals challenges health care provision and ultimately the health and well-being of refugees. Design/methodology/approach A series of semi-structured, in-depth interviews with key service professionals in both the social service and health fields in Hamilton, Ontario, Canada, examined both health and health care issues. Findings Beyond challenges for service providers that have been previously flagged in the literature, including language barriers and the limited time that they have with their clients, analysis revealed that health care providers faced other challenges in providing care, with one challenge reflecting the difficulty of providing care and services to a diverse refugee population. A second challenge reflected the lack of knowledge associated with constantly evolving policies and programs. Both challenges potentially limit the abilities of care providers. Research limitations/implications On-going changes to refugee and health care policy, along with the diversity of refugee arrivals, will continue to challenge providers. The challenge, therefore, for health care providers and policy makers alike is how to ensure adequate service provision for new arrivals. Practical implications The Federal government should do a better job in disseminating the impact of policy changes and should streamline programs. This is particularly relevant given limited budgets and resources, tri-partite government funding, short time-frames to prepare for new arrivals, inadequate background information, barriers/challenges or inequitable criteria for access to health and social services, while addressing an increasingly diverse and complex population. Social implications The research reinforces the complexity of the needs and challenges faced by refugees when health is considered, and the difficulty in providing care to this group. Originality/value While there is a large refugee health literature, there is relatively little attention to the challenges and difficulties faced by service providers in addressing the health needs of the diverse refugee population, a topic that is particularly important given limited funding envelopes, shifting policies and programs, and a focus on clients (refugees). It is this latter piece – the challenges faced by providers in providing care to refugees – which this paper explores.
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Tulli, Mia, Bukola Salami, Lule Begashaw, Salima Meherali, Sophie Yohani, and Kathleen Hegadoren. "Immigrant Mothers’ Perspectives of Barriers and Facilitators in Accessing Mental Health Care for Their Children." Journal of Transcultural Nursing 31, no. 6 (February 4, 2020): 598–605. http://dx.doi.org/10.1177/1043659620902812.
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Introduction: Data on immigrant and refugees’ access to services in Canada typically focus on adult populations generally but not children specifically. To fill this gap, this study explored immigrant and refugee mothers’ perceptions of barriers and facilitators for mental health care for their children in Edmonton, Alberta, Canada. Method: In this qualitative descriptive study, researchers conducted 18 semistructured interviews with immigrant and refugee mothers who live in Edmonton, self-identify as women, and have children living in Canada. Results: Barriers included financial strain, lack of information, racism/discrimination, language barriers, stigma, feeling isolated, and feeling unheard by service providers. Facilitators included schools offering services, personal levels of higher education, and free services. Discussion: Nurses can improve access to mental health services by addressing issues related to racism within the health system, by creating awareness related to mental health, and by providing trained interpreters to help bridge barriers in communications.
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Gabriel, Patricia S., Cecily Morgan-Jonker, Charlene M. W. Phung, Rolando Barrios, and Janusz Kaczorowski. "Refugees and Health Care – The Need for Data: Understanding the Health of Government-assisted Refugees in Canada Through a Prospective Longitudinal Cohort." Canadian Journal of Public Health 102, no. 4 (July 2011): 269–72. http://dx.doi.org/10.1007/bf03404047.
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Polonsky, Michael Jay, Ahmed Shahriar Ferdous, Andre M. N. Renzaho, Neil Waters, and Zoe McQuilten. "Factors Leading to Health Care Exclusion Among African Refugees in Australia: The Case of Blood Donation." Journal of Public Policy & Marketing 37, no. 2 (November 2018): 306–26. http://dx.doi.org/10.1177/0743915618813115.
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Developed countries that accept refugees are obligated, under the UN Convention for Refugees, to integrate refugees into host communities, with inclusion in the health system being pivotal. Integration programs can be difficult though, because many refugees’ home countries have different health systems, lower health literacy, and different expectations of health services. Country health system differences require cultural adaptation of host country services when designing targeted, inclusive health care programs. Using a sample of 317 Australian-based African refugees, the authors examine how refugees’ acculturation, perceptions of discrimination, past behavior, objective knowledge, and medical mistrust affect their health inclusion, depending on their blood donation intentions. The results indicate that perceived discrimination and objective blood donation knowledge directly affect donation intentions. Perceived discrimination mediates the relationships between acculturation and intentions and between medical mistrust and donation intentions, and objective knowledge mediates the relationship between past behavior and donation intentions. The authors offer recommendations to policy makers designing social inclusion programs and health service providers designing and delivering targeted initiatives, to better facilitate refugee participation in host country health systems.
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Pérez-Molina, José Antonio, Miriam J. Álvarez-Martínez, and Israel Molina. "Medical care for refugees: A question of ethics and public health." Enfermedades Infecciosas y Microbiología Clínica 34, no. 2 (February 2016): 79–82. http://dx.doi.org/10.1016/j.eimc.2015.12.007.
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Hirani, Shela Akbar Ali, and Joan Wagner. "Impact of COVID-19 on Women Who Are Refugees and Mothering: A Critical Ethnographic Study." Global Qualitative Nursing Research 9 (January 2022): 233339362211213. http://dx.doi.org/10.1177/23333936221121335.
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Refugee women often experience trauma and social disconnection in a new country and are at risk of experiencing reduced physical, mental, and emotional well-being. Globally, COVID-19 has affected the health and well-being of the population at large. This critical ethnographic study aimed to explore the effects of COVID-19 on women who are refugees and mothering in Saskatchewan, Canada. In-depth interviews were undertaken with 27 women who are refugees and mothering young children aged 2 years and under. This study suggests that during COVID-19, refugee women are at high risk of experiencing add-on stressors due to isolation, difficulty in accessing health care, COVID-19-related restrictions in hospitals, limited follow-up care, limited social support, financial difficulties, and compromised nutrition. During COVID-19, collaborative efforts by nurses, other health-care professionals, and governmental and non-governmental organizations are essential to provide need-based mental health support, skills-building programs, nutritional counseling, and follow-up care to this vulnerable group.
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Nurelhuda, Nazik M., Mark T. Keboa, Herenia P. Lawrence, Belinda Nicolau, and Mary Ellen Macdonald. "Advancing Our Understanding of Dental Care Pathways of Refugees and Asylum Seekers in Canada: A Qualitative Study." International Journal of Environmental Research and Public Health 18, no. 16 (August 23, 2021): 8874. http://dx.doi.org/10.3390/ijerph18168874.
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The burden of oral diseases and need for dental care are high among refugees and asylum seekers (humanitarian migrants). Canada’s Interim Federal Health Program (IFHP) provides humanitarian migrants with limited dental services; however, this program has seen several fluctuations over the past decade. An earlier study on the experiences of humanitarian migrants in Quebec, Canada, developed the dental care pathways of humanitarian migrants model, which describes the care-seeking processes that humanitarian migrants follow; further, this study documented shortfalls in IFHP coverage. The current qualitative study tests the pathway model in another Canadian province. We purposefully recruited 27 humanitarian migrants from 13 countries in four global regions, between April and December 2019, in two Ontario cities (Toronto and Ottawa). Four focus group discussions were facilitated in English, Arabic, Spanish, and Dari. Analysis revealed barriers to care similar to the Quebec study: Waiting time, financial, and language barriers. Further, participants were unsatisfied with the IFHP’s benefits package. Our data produced two new pathways for the model: transnational dental care and self-medication. In conclusion, the dental care needs of humanitarian migrants are not currently being met in Canada, forcing participants to resort to alternative pathways outside the conventional dental care system.