Please note, this is not an open access database or repository. We have focused on creating simple summaries of reports and articles that we have accessed through websites and academic journals, with a focus on key findings, so that even if a full report is not free to access you can reference it. When possible, we include a link to wherever the original document is hosted (which may or may not be open-access). If you come across a link that is no longer active, please let us know and we can update it. There are also some reports that will have been submitted directly to the project. In this case, these reports are uploaded directly with permission from the author or publisher. Any original documents found on this site are stored in Canada on our secure servers

Caring for pregnant refugee women in a turbulent policy landscape: perspectives of health care professionals in Calgary, Alberta

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.
This publication has no Abstract to dispaly

The Settlement Experiences of Syrian Newcomers in Alberta: Social Connections and Interactions

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.
This publication has no Abstract to dispaly

Perspectives of Immigrant Women on the Gender of Provider During Childbirth

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

Psychosocial Determinants of Adherence to Preventive Dental Attendance for Preschool Children Among Filipino Immigrants in Edmonton, Alberta

This study explores how immigrant parents in Alberta-Edmonton’s Filipino community adhere to preventive dental attendance (PDA) for their preschool children. We also look at the psychosocial factors influencing parental adherence. Results: Upon arriving in Canada, most Filipino parents thought that PDA was not a priority. After migration, however, they embraced new knowledge about the importance of PDA for their children. Discussion: Filipino parents were open to the Western model of preventive oral healthcare, with the duration of their time in Canada playing a key role in promoting regular dental visits for their children. This study explores how immigrant parents in Alberta-Edmonton’s Filipino community adhere to preventive dental attendance (PDA) for their preschool children. We also look at the psychosocial factors influencing parental adherence. Results: Upon arriving in Canada, most Filipino parents thought that PDA was not a priority. After migration, however, they embraced new knowledge about the importance of PDA for their children. Discussion: Filipino parents were open to the Western model of preventive oral healthcare, with the duration of their time in Canada playing a key role in promoting regular dental visits for their children.
This publication has no Abstract to dispaly

Health care choices of immigrants in Canada: a study among adult Ghanaian immigrants in Calgary, Alberta

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

Refugee pathways out of homelessness in urban Alberta, Canada: implications for social justice-oriented counselling

The study explores the challenges faced by refugees and how social justice-oriented counselling can help them overcome these challenges. The research involved in-depth, semi-structured interviews with 20 refugees who had experienced homelessness. The findings reveal that refugees face multiple challenges, including language barriers, lack of social support, and limited access to resources. Social justice-oriented counselling was found to be effective in helping refugees overcome these challenges and find a better life. The study offers insights into how counselling can be tailored to meet the unique needs of refugees and promote social justice. The study explores the challenges faced by refugees and how social justice-oriented counselling can help them overcome these challenges. The research involved in-depth, semi-structured interviews with 20 refugees who had experienced homelessness. The findings reveal that refugees face multiple challenges, including language barriers, lack of social support, and limited access to resources. Social justice-oriented counselling was found to be effective in helping refugees overcome these challenges and find a better life. The study offers insights into how counselling can be tailored to meet the unique needs of refugees and promote social justice.
This publication has no Abstract to dispaly

‘And when a certain health issue happen, they try to cover it’: Stakeholder perspectives on the health of temporary foreign workers and their families

This study examines stakeholders’ perspectives on the health and well-being of temporary foreign workers (TFWs) and their families in Alberta, Canada. Stakeholders involved in providing services to TFWs perceived that the workers experience (1) barriers in accessing mental health services, (2) mental health challenges, (3) family health challenges, (4) occupational health challenges, and (5) income and social status as a social determinant of health. Immigration and class status intersect to influence the health of this vulnerable population in Canada. This study examines stakeholders’ perspectives on the health and well-being of temporary foreign workers (TFWs) and their families in Alberta, Canada. Stakeholders involved in providing services to TFWs perceived that the workers experience (1) barriers in accessing mental health services, (2) mental health challenges, (3) family health challenges, (4) occupational health challenges, and (5) income and social status as a social determinant of health. Immigration and class status intersect to influence the health of this vulnerable population in Canada.
This publication has no Abstract to dispaly

Uninsured Maternity Patients in Calgary: Local Trends and Survey of Health Care Workers

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.
This publication has no Abstract to dispaly

Effectiveness of Canada’s tuberculosis surveillance strategy in identifying immigrants at risk of developing and transmitting tuberculosis: a population-based retrospective cohort study

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

The Oral Health of Preschool Children of Refugee and Immigrant Families in Manitoba

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