title: Refugee claimant women and barriers to health and social services post-birth.
abstract: OBJECTIVE
  Access to services for international migrants living in Canada is especially important during the postpartum period when additional health services and support are key to maternal and infant health. Recent studies found refugee claimant women to have a high number of postpartum health and social concerns that were not being addressed by the Canadian health care system. The current project aimed to gain greater understanding of the barriers these vulnerable migrant women face in accessing health and social services postpartum.
  
  
  METHODS
  Qualitative text data on services that claimant women received post-birth and notes (recorded by research nurses) about their experiences in accessing and receiving services were examined. Thematic analysis was conducted to identify common themes related to access barriers.
  
  
  RESULTS
  Of particular concern were the refusal of care for infants of mothers covered under IFHP, maternal isolation and difficulty for public health nurses to reach women postpartum. Also problematic was the lack of assessment, support and referrals for psychosocial concerns.
  
  
  CONCLUSIONS
  Better screening and referral for high-risk claimant women and education of health care providers on claimants' coverage and eligibility for services may improve the addressing of health and social concerns. Expansion of claimants' health benefits to include psychotherapy without prior approval by Citizenship and Immigration Canada is also recommended. Interventions aimed at social determinants underlying health care access issues among childbearing refugee claimants should also be explored. These might include providing access to subsidized language courses, social housing and government-sponsored benefits for parents, which currently have restrictive eligibility that limits or excludes claimants' access.
authors.affiliation: Department of Nursing, McGill University, Montreal, QC. lisa.merry@mcgill.ca
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Merry
authors.forename: Anita J
authors.initials: AJ
authors.lastname: Gagnon
authors.forename: Nahid
authors.initials: N
authors.lastname: Kalim
authors.forename: Stephanie S
authors.initials: SS
authors.lastname: Bouris
mesh_terms: D000328:Adult; D002170:Canada; D004522:Educational Status; D005260:Female; D057220:Health Literacy; D006297:Health Services Accessibility; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D007802:Language; D009035:Mothers; D049590:Postpartum Period; D011446:Prospective Studies; D012036:Refugees; D012923:Social Class; D012944:Social Support; D012947:Social Work