Immigrant women family caregivers in Canada: implications for policies and programmes in health and social sectors

Abstract

Migration has become a profound global phenomenon in this century. In Canada, uncoordinated policies, including those related to immigration, resettlement, employment, and government funding for health and social services, present barriers to immigrant women caregivers. The purpose of this paper is to share relevant insights from individual and group interviews with immigrant women family caregivers, service providers and policy influencers, and discuss these in relation to immigration, health and social policy, and programme trends in Canada. The present authors conducted individual interviews with immigrant women family caregivers (n = 29) in phase 1, followed by two group interviews with women family caregivers (n = 7), and two group interviews with service providers and policy-makers (n = 15) in phase 2. Using an inductive approach, the authors employed thematic content data analysis. Immigrant women experienced barriers to health and social services similar to Canadian-born family caregivers, particularly those who have low incomes, jobs with limited flexibility and heavy caregiving demands. These immigrant women family caregivers avoided certain formal services for a variety of reasons, including lack of cultural sensitivity. However, their challenges were compounded by language, immigration and separation from family in the home country. The identified barriers to support reinforce the importance of modifying and expanding policies and programmes affecting immigrant women's ability to care for family members with illnesses or disabilities within the context of Canadian society. Participants recommended changes to policies and programmes to deal with information, transportation, language, attitudinal and network barriers. The various barriers to services and programmes which were experienced by immigrant women caregivers underscore the importance of reviewing policies affecting immigration, caregiving, and access to health and social services. Intersectoral collaboration among agencies is essential to reduce the barriers identified in the present study, and to establish services which are linguistically and culturally appropriate.

A Scoping Review of Immigrant Experience of Health Care Access Barriers in Canada

“…Each category is regulated differently, and is therefore associated with different experiences. Though not specifically designed to explore the effects of immigration class on health care access, Donnelly et al [23], Sadavoy et al [29], and Stewart et al [32] each noted individual barriers to accessing health care that directly related to the immigration category of participants.…”

“…In the same study, immigrants who were interviewed cited family obligations related to financial concerns and time constraints as most important among barriers. Health care providers claimed that this resonates especially with immigrants who have arrived in Canada with family sponsorship, an arrangement in which they feel their presence is contingent on their usefulness [32].…”

“…Service providers also encountered social barriers resulting in a reluctance to share information when having a family member interpret [29,33,34]. However, interviews of immigrant women caregivers, service providers and policy makers in Stewart et al [32] advocated for including interpreter services where they did not exist.…”

“…Transportation, childcare, eldercare support, and general service orientation were seen as services that would enable immigrants and provide incentive to access health care services [32]. In Sadavoy et al's [29] study regarding mental health services for ethnic seniors, both immigrants and health care workers demonstrated limited knowledge of local formal health services.…”

“…Overall, there is a critical disconnect within the health care structure, which is identifiable by those working within it. Looking towards solutions, Stewart et al [32] recommends that culturally relevant, community support services should be implemented to combat the gaps that the system cannot fill, as suggested by both health care providers and immigrant participants.…”