Department of Health and Science Education, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Int J Equity Health. 2018 Jun 26;17(1):91. doi: 10.1186/s12939-018-0801-5.
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, taking into consideration recent contextual changes to the refugee landscape in Canada.
We conducted ten semi-structured interviews with health care professionals who provided regular care for pregnant refugee women at a refugee health clinic and major hospital in Calgary, Alberta. Interviews were recorded, transcribed, and analyzed using an interpretive description methodology.
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 strategies including 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.
Health care providers caring for pregnant refugee women faced complex cultural and system-level barriers, and used multiple strategies to address these barriers. Additional system strains add extra pressure on health care professionals, requiring them to quickly adjust and accommodate for new demands.
女性难民可能是一个弱势群体，她们经常经历创伤事件，这对她们的健康构成风险，尤其是在怀孕期间。怀孕可以成为进入医疗保健系统的一个切入点，为医疗保健专业人员提供赢得妇女信任、为难民提供资源并优化母婴健康的机会。围绕向难民提供和资助医疗保健服务的政策会影响获得和护理的质量。我们的研究旨在了解在艾伯塔省卡尔加里为怀孕难民妇女提供护理的医疗保健专业人员的经验，同时考虑到加拿大难民情况的近期变化。
我们对在卡尔加里一家难民健康诊所和一家大医院为怀孕难民妇女提供常规护理的 10 名医疗保健专业人员进行了十次半结构化访谈。采访进行了录音、转录，并使用解释性描述方法进行了分析。
医疗保健提供者在为怀孕难民提供护理时描述了一些障碍，包括语言障碍、难以在医疗保健系统中导航以及管理传统性别动态、只想要女性提供者和医疗实践差异等文化障碍。提供者通过使用团队护理方法、协调患者与其他服务的护理以及解决患者的医疗和社会需求等策略来应对这些障碍。联邦资金削减增加了额外的挑战，因为许多难民没有足够的健康保险，而且系统很难理解。医疗保健提供者制定了创造性的策略来最大限度地为其患者提供保险，包括自掏腰包或依赖捐款为未投保的难民提供护理。最后，最近叙利亚难民的涌入增加了对服务提供者的需求，并进一步使已经有限的资源紧张。
为怀孕难民妇女提供护理的医疗保健提供者面临复杂的文化和系统层面的障碍，并采用多种策略来解决这些障碍。额外的系统压力给医疗保健专业人员带来了额外的压力，要求他们迅速调整并适应新的需求。
