Exploring Barriers Refugees and Refugee Claimants Experienced Accessing Reproductive Health Care Services in Toronto

A qualitative feminist study was conducted to explore the access barriers to three reproductive health care services: prenatal care, postnatal care, and screening for cervical cancer, experienced by women refugee claimants in Toronto, Ontario, Canada. The study was informed by social constructionist epistemology and antiracist and intersectional perspectives, and focused on the social, political, economic, and historical contexts of the participants lives and their experiences with migration and the Canadian health care system. Sixteen women refugee claimants and 6 service providers were interviewed individually. The study explored how the systems, structures, and policies of Canadian society shaped refugee claimants womens use of these services, or lack thereof, and shaped their everyday life experiences. The research findings indicated that the study participants immigration status, lack of health coverage, living arrangements, absence of service provider support, degree of health care knowledge, discrimination, and having suffered pain, discomfort, or trauma in the past impacted their use or lack of use of prenatal care, postnatal care, and cancer screening services. An intersectional analysis revealed that the gendered and racialized immigration and integration policies, and neoliberal ideologies and practices intersected to locate the participants in racialized and disadvantaged situations as the other wherein access to these services became challenging. Women refugee claimants access to these and other reproductive healthcare services needs to be understood beyond the attempts to know their cultural health beliefs and practices, and beyond the neoliberal ideas of self-care, individual responsibility, and culturally sensitive care. Equitable access to healthcare cannot be ensured without resisting these womens racialized position as the other while addressing the social, political, historical, and structural inequities in Canadian society. To ensure barrier-free, full health care coverage to women refugee claimants, as well as other refugee claimants and immigrants, social inequities need to be addressed coupled with instituting broader structural changes federally and provincially in policies, funding, procedures, and practices