Healthcare needs and health service utilization by Syrian refugee women in Toronto

Abstract

ObjectiveAccess to healthcare is an important part of the (re)settlement process for Syrian refugees in Canada. There is growing concern about the healthcare needs of the 54,560 Syrian refugees who were admitted to Canada by May 2018, 80% of whom are women and children. We explored the healthcare needs of newcomer Syrian women, their experiences in accessing and using health services, and the factors and conditions that shape whether and how they access and utilize health services in the Greater Toronto Area (GTA).MethodThis community-based qualitative descriptive interpretive study was informed by Yang & Hwang (2016) health service utilization framework. Focus group discussions were held with 58 Syrian newcomer women in the GTA. These discussions were conducted in Arabic, audio-recorded with participants’ consent, translated into English and transcribed, and analyzed using thematic analysis.ResultsParticipants’ health concerns included chronic, long-term conditions as well as new and emerging issues. Initial health insurance and coverage were enabling factors to access to services, while language and social disconnection were barriers. Other factors, such as beliefs about naturopathic medicine, settlement in suburban areas with limited public transportation, and lack of linguistically, culturally, and gender-appropriate services negatively affected access to and use of healthcare services.ConclusionResponding to the healthcare needs of Syrian newcomer women in a timely and comprehensive manner requires coordinated, multi-sector initiatives that can address the financial, social, and structural barriers to their access and use of services.

Exploring the State of Gender-Centered Health Research in the Context of Refugee Resettlement in Canada: A Scoping Review

“…The centrality of gender in determining health-seeking behavior was reflected in the way women often de-prioritized their own health, leisure and self-care, and healthcare-seeking in favor of their partners’ and children’s [ 3 , 32 , 35 ]. Another common experience during resettlement was the inability to care for one’s own health and wellbeing due to childcare roles and responsibilities [ 32 , 36 , 37 ].…”

“…In general, women struggled to engage in social or leisure activities during resettlement for a number of reasons. Female refugee participants often contended with reduced familial and social support in Canada compared to their countries of origin, where they depended on extended family to assist with attending appointments and provide childcare as well as advice and comfort [ 3 , 44 ]. Women also experienced increased difficulty in accessing health information during resettlement, as social networks were often a primary vehicle for health promotion information in their home countries [ 3 , 44 ].…”

“…Female refugee participants often contended with reduced familial and social support in Canada compared to their countries of origin, where they depended on extended family to assist with attending appointments and provide childcare as well as advice and comfort [ 3 , 44 ]. Women also experienced increased difficulty in accessing health information during resettlement, as social networks were often a primary vehicle for health promotion information in their home countries [ 3 , 44 ]. In qualitative interviews, participants commonly noted having to adapt to the different social norms in Canada, where it is less common to drop by unannounced for a visit with friends and neighbors [ 36 , 38 ].…”

“…These include pre- and post-arrival healthcare and orientation services, access to loans to cover the costs of travel to Canada, and financial and social support during the first twelve months of resettlement [ 2 ]. Often referred to as convention refugees, these individuals or families arrive with pre-determined refugee status and are considered permanent residents upon arrival [ 2 , 3 ]. Incoming refugees often face social and economic barriers and have increased risk of poor physical and mental health outcomes compared to other immigrant classes in Canada [ 3 , 4 , 5 ].…”

“…Often referred to as convention refugees, these individuals or families arrive with pre-determined refugee status and are considered permanent residents upon arrival [ 2 , 3 ]. Incoming refugees often face social and economic barriers and have increased risk of poor physical and mental health outcomes compared to other immigrant classes in Canada [ 3 , 4 , 5 ]. Refugees often face difficulties finding employment due to relatively lower levels of education, insufficient English language and literacy, limited access to social support services, transportation barriers, unrecognized credentials, and health challenges [ 6 , 7 , 8 ].…”