Research Library

Female refugees can be a vulnerable population, often having suffered through traumatic events that pose risks to their health, especially during pregnancy. Pregnancy can be an entry point into the health care system, providing health care professionals the opportunity to gain women’s trust, connect refugees with resources, and optimize the health of mother and child. Policies surrounding the provision and funding of health care services to refugees can impact access to and quality of care. The aim of our study was to understand the experiences of health care professionals caring for pregnant refugee women in Calgary, AB. Health care providers described several barriers when caring for pregnant refugees, including language barriers, difficulty navigating the health care system, and cultural barriers such as managing traditional gender dynamics, only wanting a female provider and differences in medical practices. Providers managed these barriers through using a team-based approach to care, coordinating the patient’s care with other services, and addressing both the medical and social needs of the patient. The federal funding cuts added additional challenges, as many refugees were left without adequate health coverage and the system was complicated to understand. Health care providers developed creative strategies to maximize coverage for their patients including paying out of pocket or relying on donations to care for uninsured refugees. Finally, the recent Syrian refugee influx has increased the demand on service providers and further strained already limited resources. Female refugees can be a vulnerable population, often having suffered through traumatic events that pose risks to their health, especially during pregnancy. Pregnancy can be an entry point into the health care system, providing health care professionals the opportunity to gain women’s trust, connect refugees with resources, and optimize the health of mother and child. Policies surrounding the provision and funding of health care services to refugees can impact access to and quality of care. The aim of our study was to understand the experiences of health care professionals caring for pregnant refugee women in Calgary, AB. Health care providers described several barriers when caring for pregnant refugees, including language barriers, difficulty navigating the health care system, and cultural barriers such as managing traditional gender dynamics, only wanting a female provider and differences in medical practices. Providers managed these barriers through using a team-based approach to care, coordinating the patient’s care with other services, and addressing both the medical and social needs of the patient. The federal funding cuts added additional challenges, as many refugees were left without adequate health coverage and the system was complicated to understand. Health care providers developed creative strategies to maximize coverage for their patients including paying out of pocket or relying on donations to care for uninsured refugees. Finally, the recent Syrian refugee influx has increased the demand on service providers and further strained already limited resources.
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Syrian refugees resettling in Alberta face complex integration challenges. Social connections are a key foundation to successful integration. The goal of this study was to better understand the nature of social networks, social support and social capital among Syrian refugees arriving in Alberta in 2015 and in 2016. The study also focused on comparing the resettlement experience of refugees from larger centers and small centers in Alberta, differentiating the experience of government assisted refugees (GARs), privately sponsored refugees (PSRs) and blended visa office referred (BVOR) refugees. The study found that social relationships are crucial to settlement and integration. The importance of ethno-cultural communities, sponsors and community organizations in settlement and integration is discussed. Overall, the study found that while newcomers were making friends and building ties, these were still nebulous and largely focused on settlement needs or linking to socio-cultural community. GARs had stronger links to settlement agencies as compared to PSRs who were more closely linked to community networks. Refugees in smaller centers reported a higher level of belonging and reported more engagement with settlement or community organizations, but had lower rates of participation in recreation or religious activities. While most participants experienced a certain sense of belonging to Canada, they simultaneously felt challenged while managing settlement concerns and combatting racism and social exclusion. Syrian refugees resettling in Alberta face complex integration challenges. Social connections are a key foundation to successful integration. The goal of this study was to better understand the nature of social networks, social support and social capital among Syrian refugees arriving in Alberta in 2015 and in 2016. The study also focused on comparing the resettlement experience of refugees from larger centers and small centers in Alberta, differentiating the experience of government assisted refugees (GARs), privately sponsored refugees (PSRs) and blended visa office referred (BVOR) refugees. The study found that social relationships are crucial to settlement and integration. The importance of ethno-cultural communities, sponsors and community organizations in settlement and integration is discussed. Overall, the study found that while newcomers were making friends and building ties, these were still nebulous and largely focused on settlement needs or linking to socio-cultural community. GARs had stronger links to settlement agencies as compared to PSRs who were more closely linked to community networks. Refugees in smaller centers reported a higher level of belonging and reported more engagement with settlement or community organizations, but had lower rates of participation in recreation or religious activities. While most participants experienced a certain sense of belonging to Canada, they simultaneously felt challenged while managing settlement concerns and combatting racism and social exclusion.
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We studied how the gender of a medical provider affects the experience of immigrant women with obstetrical care. We interviewed 38 immigrant women from one hospital in Edmonton, Alberta. These women came from varied educational and ethnic backgrounds (predominately North/East African, Middle Eastern, and South Asian), but most were Muslim and married. Their average age was 27 years old. All of the women stated that they preferred a female provider. They explained their preference because they placed a high value on modesty, often as part of the Muslim faith. At the same time, the women deemed provider competency and having safe childbirth more important. Many said that they would accept care from a male provider if necessary. A small minority of the women reported experiencing psychological stress as a consequence of having received care from a male provider. Overall, women who participated in our study stated that they accepted care from male providers. But for some of them this compromise came at a price, and a small minority of women perceived it as hurtful. With this in mind, we see a need to identify those women for whom gender of provider is important. It will help with providing them with optimal care. We studied how the gender of a medical provider affects the experience of immigrant women with obstetrical care. We interviewed 38 immigrant women from one hospital in Edmonton, Alberta. These women came from varied educational and ethnic backgrounds (predominately North/East African, Middle Eastern, and South Asian), but most were Muslim and married. Their average age was 27 years old. All of the women stated that they preferred a female provider. They explained their preference because they placed a high value on modesty, often as part of the Muslim faith. At the same time, the women deemed provider competency and having safe childbirth more important. Many said that they would accept care from a male provider if necessary. A small minority of the women reported experiencing psychological stress as a consequence of having received care from a male provider. Overall, women who participated in our study stated that they accepted care from male providers. But for some of them this compromise came at a price, and a small minority of women perceived it as hurtful. With this in mind, we see a need to identify those women for whom gender of provider is important. It will help with providing them with optimal care.
This publication has no Abstract to dispaly

Many African immigrants moving to Canada tend to experience deterioration of health with time in their host country due to the influence of multiple factors on their health care decisions. The purpose of this study was to understand the problems and decision dynamics relevant to Ghanaian adult immigrants’ health care choices with the first five to ten years of arrival in Calgary, Alberta. Thematic analysis revealed that participants’ healthcare choices were influenced by their pre-and post-migration experiences, which informed their pathways to care. Participants provided insights about tensions among themselves and with health providers in making healthcare choices as they settled in a new environment. Further, there is a need to provide health education programs and a strong support system to facilitate better health choices and encourage health care service use among recent newcomers. Many African immigrants moving to Canada tend to experience deterioration of health with time in their host country due to the influence of multiple factors on their health care decisions. The purpose of this study was to understand the problems and decision dynamics relevant to Ghanaian adult immigrants’ health care choices with the first five to ten years of arrival in Calgary, Alberta. Thematic analysis revealed that participants’ healthcare choices were influenced by their pre-and post-migration experiences, which informed their pathways to care. Participants provided insights about tensions among themselves and with health providers in making healthcare choices as they settled in a new environment. Further, there is a need to provide health education programs and a strong support system to facilitate better health choices and encourage health care service use among recent newcomers.
This publication has no Abstract to dispaly

Over the past decade, scholars have begun to explore neglected aspects of immigrant family life such as gender relations, domestic violence, parenting, and relationships with service providers. Many of these studies, however, are based on women’s experiences. As an equally crucial starting point in building sustainable and resilient immigrant communities, our study focuses on the experiences of African immigrant men in a Canadian context. It reveals African immigrant men’s frustration with their search for a better life. Our thematic analysis of participants’ responses identified three main stressors among this group: challenges with economic integration, changing ideals about masculinities and gender relations across transnational spaces, and tensions in the parent-child relationship. These findings suggest that despite the vulnerabilities they face in Canada, African men could play a strategic role as critical agents of change in families’ transitions and integration. Overall, our study calls for the active engagement of both African immigrant men and women in developing policies and practices that impact their everyday lives. Over the past decade, scholars have begun to explore neglected aspects of immigrant family life such as gender relations, domestic violence, parenting, and relationships with service providers. Many of these studies, however, are based on women’s experiences. As an equally crucial starting point in building sustainable and resilient immigrant communities, our study focuses on the experiences of African immigrant men in a Canadian context. It reveals African immigrant men’s frustration with their search for a better life. Our thematic analysis of participants’ responses identified three main stressors among this group: challenges with economic integration, changing ideals about masculinities and gender relations across transnational spaces, and tensions in the parent-child relationship. These findings suggest that despite the vulnerabilities they face in Canada, African men could play a strategic role as critical agents of change in families’ transitions and integration. Overall, our study calls for the active engagement of both African immigrant men and women in developing policies and practices that impact their everyday lives.
This publication has no Abstract to dispaly

Uninsured maternity patients comprise a small but complex group of patients and include marginalized Canadians, undocumented immigrants, visitors, and non-Canadians seeking health care and/ or citizenship for their newborn. This study found a trend of uninsured deliveries in Calgary that is accounted for by non-Canadian patients. Midwives and physicians agree on provision of emergency care but not preventive care. Across medical specialties, fewer caregivers felt obliged to care for non-Canadian patients seeking citizenship for their newborn. Among physicians, 61% were aware of the Canadian Medical Protective Association’s guidelines on liability coverage for non-Canadian patients, and only 28% consistently protected themselves legally. There is large variation regarding whether physicians bill for services when the patient is uninsured. In Calgary, the study observed an increase in numbers of uninsured maternity patients. Differing ethical perspectives on the care of these patients may lead to conflict within health care teams because of differences on ethical perspectives of care among team members. Health care providers require education to understand the implications and challenges of obstetrical care of non-Canadians. Uninsured maternity patients comprise a small but complex group of patients and include marginalized Canadians, undocumented immigrants, visitors, and non-Canadians seeking health care and/ or citizenship for their newborn. This study found a trend of uninsured deliveries in Calgary that is accounted for by non-Canadian patients. Midwives and physicians agree on provision of emergency care but not preventive care. Across medical specialties, fewer caregivers felt obliged to care for non-Canadian patients seeking citizenship for their newborn. Among physicians, 61% were aware of the Canadian Medical Protective Association’s guidelines on liability coverage for non-Canadian patients, and only 28% consistently protected themselves legally. There is large variation regarding whether physicians bill for services when the patient is uninsured. In Calgary, the study observed an increase in numbers of uninsured maternity patients. Differing ethical perspectives on the care of these patients may lead to conflict within health care teams because of differences on ethical perspectives of care among team members. Health care providers require education to understand the implications and challenges of obstetrical care of non-Canadians.
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In 2001, Rie Fujii, a 23-year-old Japanese national living without legal status in Calgary, Alberta, Canada left her two infant children alone in her apartment for 10 days while visiting her out-of-town boyfriend. The children, Domenic and Gemini, died of dehydration and starvation. Charged with two counts of second-degree homicide, Fujii plead guilty to manslaughter and received an 8-year sentence. Through an analysis of the publicly available judicial documents relating to the crimes of Rie Fujii, this paper explores how the law’s individualization and medicalization of crime and violence may obscure the multiple forms of everyday and structural violence that racialized women in white settler states such as Canada experience and may perpetrate. I argue that the law’s conceptualization of crime and violence conceals and thus advances the violence endemic to white settler colonialism. In 2001, Rie Fujii, a 23-year-old Japanese national living without legal status in Calgary, Alberta, Canada left her two infant children alone in her apartment for 10 days while visiting her out-of-town boyfriend. The children, Domenic and Gemini, died of dehydration and starvation. Charged with two counts of second-degree homicide, Fujii plead guilty to manslaughter and received an 8-year sentence. Through an analysis of the publicly available judicial documents relating to the crimes of Rie Fujii, this paper explores how the law’s individualization and medicalization of crime and violence may obscure the multiple forms of everyday and structural violence that racialized women in white settler states such as Canada experience and may perpetrate. I argue that the law’s conceptualization of crime and violence conceals and thus advances the violence endemic to white settler colonialism.
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This report documents the settlement experiences of recently arrived Syrian refugees in Albertan cities. It then compares them across the three streams of sponsorship to better understand the perspectives of the refugees, the sponsors, and the social agencies that work with them. This report documents the settlement experiences of recently arrived Syrian refugees in Albertan cities. It then compares them across the three streams of sponsorship to better understand the perspectives of the refugees, the sponsors, and the social agencies that work with them.
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In Canada, tuberculosis disproportionately affects people who were born abroad. The national tuberculosis medical surveillance programme aims to prevent these cases. These people are referred (referrals) for further in-country surveillance after migration if they have a history of active tuberculosis or have features of old, healed tuberculosis on chest radiograph. Others who are not referred (non-referrals) do not undergo surveillance. In this study we looked at the risk of transmitting TB that comes from referrals and non-referrals. We also compared the transmission rates between the two groups. To make this comparison, we looked at information that Alberta Tuberculosis Registry had about foreign-born migrants (aged 15-64 years). We looked at information about people who came to Alberta between Jan 1, 2002, and Dec 31, 2013. We were interested in cases that had culture-positive pulmonary tuberculosis. We found that the incidence of culture-positive pulmonary disease was nine times higher in referrals than all non-referrals and five times higher in referrals than non-referrals from high-risk countries. Despite a much higher incidence of pulmonary tuberculosis in referrals than non-referrals, referrals were 80% less likely to transmit tuberculosis. But we suggest that instead of focusing only on referrals, Canada could consider screening and treatment of latent tuberculosis in all migrants from high-risk countries. In Canada, tuberculosis disproportionately affects people who were born abroad. The national tuberculosis medical surveillance programme aims to prevent these cases. These people are referred (referrals) for further in-country surveillance after migration if they have a history of active tuberculosis or have features of old, healed tuberculosis on chest radiograph. Others who are not referred (non-referrals) do not undergo surveillance. In this study we looked at the risk of transmitting TB that comes from referrals and non-referrals. We also compared the transmission rates between the two groups. To make this comparison, we looked at information that Alberta Tuberculosis Registry had about foreign-born migrants (aged 15-64 years). We looked at information about people who came to Alberta between Jan 1, 2002, and Dec 31, 2013. We were interested in cases that had culture-positive pulmonary tuberculosis. We found that the incidence of culture-positive pulmonary disease was nine times higher in referrals than all non-referrals and five times higher in referrals than non-referrals from high-risk countries. Despite a much higher incidence of pulmonary tuberculosis in referrals than non-referrals, referrals were 80% less likely to transmit tuberculosis. But we suggest that instead of focusing only on referrals, Canada could consider screening and treatment of latent tuberculosis in all migrants from high-risk countries.
This publication has no Abstract to dispaly

Children of newcomers to Canada are at a moderate to high risk for developing early childhood caries (ECC). The purpose of this study was to investigate the oral health of preschool children of refugee and immigrant families in Winnipeg. We recruited 211 children. Overall, 45.5% of the children had ECC and 31.8% had severe ECC (S-ECC). Infant dental enucleation was observed in 6 children. Things that we associate with severity of oral health conditions were increasing age, the presence of debris on teeth, parents believing their child has dental problems and the presence of enamel hypoplasia. Overall, ECC is prevalent in children of newcomer families in Manitoba. These data will inform advocacy efforts to improve access to dental care and tailor early childhood oral health promotion and ECC prevention activities for refugees and recent immigrants. Children of newcomers to Canada are at a moderate to high risk for developing early childhood caries (ECC). The purpose of this study was to investigate the oral health of preschool children of refugee and immigrant families in Winnipeg. We recruited 211 children. Overall, 45.5% of the children had ECC and 31.8% had severe ECC (S-ECC). Infant dental enucleation was observed in 6 children. Things that we associate with severity of oral health conditions were increasing age, the presence of debris on teeth, parents believing their child has dental problems and the presence of enamel hypoplasia. Overall, ECC is prevalent in children of newcomer families in Manitoba. These data will inform advocacy efforts to improve access to dental care and tailor early childhood oral health promotion and ECC prevention activities for refugees and recent immigrants.
This publication has no Abstract to dispaly