Exploring Health Service Underutilization: A Process Evaluation of the Newcomer Women's Health Clinic

Health-wellness resources on Canadian immigrant service provider organizations’ websites: A content, navigability, usability, and credibility analysis towards service & asset mapping

Background

Immigrant service provider organizations (SPOs) are often immigrants’ first point of contact to Canadian systems, such as job, education, health and social care, and housing. Prior research emphasizes the health literacy potential of websites as information infrastructures that can reduce information poverty and improve health outcomes. Yet, whether health-wellness resources are present on immigrant SPOs’ websites in a user-friendly manner remains unexplored.

Methods

We identified the presence of health-wellness resources on SPOs’ websites and analyzed those contents to understand their typology. We also ascertained the navigability, usability, and credibility of those websites regarding the health-wellness resources.

Results

Among the 1453 SPO websites identified, only 289 (35.9%) had health-wellness information in their web-contents. Of the websites with health-wellness contents, “lifestyle and wellness resources” were present on 86.5% and “healthcare system resources” were present on 80.6% of the websites. Regarding “navigability”, zero to two mouse clicks were required to access health-wellness resources on 94.8% of the websites; however, more than one language option was very limited, available on less than a quarter of websites.

Conclusions

As immigrants continue to seek information online, immigrant SPOs’ websites hold value in increasing the health literacy and health-wellness of immigrants. This research assessed the current state of immigrant SPOs’ websites as information infrastructures and reveals areas for improvement. We recommend SPOs add resources for obtaining healthcare card, accessing primary care, sexual and reproductive, parenting, senior's health, mental wellbeing, and women's health information to their websites. We also recommend websites accommodate ethnic language option to improve navigability for immigrants.

The postnatal experiences of resettled Syrian refugee women: Access to healthcare and social support in Nova Scotia, Canada

AIM

The purpose of this qualitative study was to understand Syrian refugee women's perceptions and experiences of access to formal health services and informal supports during the postpartum period in Nova Scotia, Canada and to identify valued and missing services and supports in the community.

BACKGROUND

The postnatal period is a critical time when mothers may need access to health services (e.g., family physicians, psychologists) and informal supports (e.g., friends, family) to support their positive mental and physical health after birth. Resettled refugee women commonly encounter barriers when accessing care during the postnatal period and often have limited social supports.

METHODS

Semi-structured, telephone or virtual interviews were conducted with 11 resettled Syrian refugee women who gave birth in Nova Scotia, Canada within the past five years. Data were collected in the summer of 2020. This study was conducted using elements of constructivist grounded theory.

FINDINGS

Four key themes were identified from women's experiences: (i) postpartum social support was critical, but often lacking, (ii) structural barriers (e.g., irregular interpreter services, limited childcare options) impeded women's access to healthcare, (iii) paternalistic healthcare providers limited women's decision-making autonomy, and (iv) the value and need for culturally competent, integrated care (e.g., newcomer specific healthcare centres), in-home services, and family support.

CONCLUSION

Resettled Syrian refugee women in Nova Scotia, Canada experience a range of barriers that limits their access to postnatal healthcare. Policy change, program development, and/or interventions are needed to improve access to postnatal services and supports for resettled Syrian women in Canada.

Access and use of sexual and reproductive health services among resettled refugee and refugee-claimant women in high-income countries: a scoping review protocol

OBJECTIVE

The purpose of this review is to understand access to and use of sexual and reproductive health services among resettled refugees and refugee-claimant women in high-income countries.

INTRODUCTION

Sexual and reproductive health is a critical component of women's well-being and quality of life. Refugee and refugee-claimant women have demonstrated a lower level of sexual health knowledge and reduced usage of sexual and reproductive health services after resettling in high-income countries. This has led to negative outcomes among resettled refugee populations, including unwanted pregnancies and abortion, lower than recommended rates of cervical cancer screening, high rates of sexually transmitted infections, and non-consensual sex. Despite these negative outcomes, no review has been conducted to understand access to and use of sexual and reproductive health services among resettled refugee women in high-income countries.

INCLUSION CRITERIA

This scoping review will seek to identify studies that describe access to and use of sexual and reproductive health services among refugee and refugee-claimant women who have resettled in a high-income country. Evidence from qualitative, quantitative, mixed method studies, and gray literature will be included.

METHODS

This review will be conducted in accordance with JBI methodology for scoping reviews. A comprehensive search strategy, developed with a librarian scientist, will be used to identify relevant sources. Titles, abstracts, and full texts will be evaluated against inclusion criteria. Information will be extracted by two independent reviewers using a screening tool. Data will be synthesized and presented narratively, with tables and figures where appropriate.

Patient-Reported Experiences in Accessing Primary Healthcare among Immigrant Population in Canada: A Rapid Literature Review

(1) Background: Immigrants represent around 21.9% of the total population in Canada and encounter multifaceted obstacles in accessing and receiving primary healthcare. This literature review explores patient experiences in primary care from the perspective of immigrants and identifies areas for further research and improvement. (2) Methods: A comprehensive search was performed on PubMed, MEDLINE, Embase, SCOPUS, and Google scholar to identify studies published from 2010 to July 2020. Relevant articles were peer-reviewed, in English language, and reported patient experiences in primary healthcare in Canada. (3) Results: Of the 1566 searched articles, 19 articles were included in this review. Overall, the finding from articles were summarized into four major themes: cultural and linguistic differences; socioeconomic challenges; health system factors; patient–provider relationship. (4) Conclusion: Understanding the gaps to accessing and receiving appropriate healthcare is important to shape policies, enhance the quality of services, and deliver more equitable healthcare services. It is therefore pertinent that primary healthcare providers play an active role in bridging these gaps with strong support from policymakers. Understanding and respecting diversity in culture, language, experiences, and systems is crucial in reducing health inequalities and improving access to quality care in a respectful and responsive manner.