Canada’s response to refugees at the primary health care level

Abstract

Responsive primary health care systems and services must be at once complex and nimble. Policy makers may wish to believe that existing health systems effectively care for all populations equally, including refugees. However, we know that refugees may require a health equity approach: an approach where all levels of government, all types of health practitioners, and even the public sector, participate to ensure access to effective primary health care.This article outlines some of Canada's healthcare responses for refugee populations. We provide field examples and guidelines that demonstrate responses, as well as ongoing inconsistencies and limitations. Refugeereceiving countries such as Australia, the US and Canada all have stories of success in resettlement and health systems. This article will focus on Canada. IntroductionThe global refugee crisis presents an opportunity for countries to come forward as leaders in resettlement of the more than 65 million refugees, asylum seekers and internally displaced persons worldwide. In 2016, Canada resettled 55 800 government-assisted and privately sponsored refugees, comprising 33 200 Syrian refugees and 22 600 refugees from other countries. The most common countries of origin for refugees being resettled in Canada include Syria, Iraq, Eritrea, Iran, Somalia, Afghanistan, Pakistan, China, Haiti and Colombia. In addition to government and privately sponsored refugees, Canada also accepted approximately 15 000 additional refugees from its population of asylum seekers. Government-sponsored resettlement programs in Canada aim to address many of the documented social determinants of health such as ensuring shelter and housing, employment, education, and training. Global health education in medical schools across Canada now includes refugee community service learning, with competency-based e-learning and interpreter, shelter and mental health initiatives.3 As these students become leaders and advocates, health settlement 4 has emerged to improve health

Best practices in refugee mental health

“…This advocacy group focused on repealing these cuts, and played a role in the reinstatement of coverage. 14 Some authors have highlighted gaps in medical education with regards to the care of patients from different cultures. 15 However, in recent years, medical schools have made efforts to teach their students cultural competency and social accountability.…”