669 - Exploring the experiences of refugee claimant youth and their caregivers with navigating healthcare in Canada

Sunday, April 30, 2023

3:30 PM – 6:00 PM ET

Poster Number: 669
Publication Number: 669.318

Chioma Nwebube, MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada; Puneet Parmar, St. Michael's Hospital, Unity Health Toronto, Toronto, ON, Canada; Martha Taylor, MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada; Shazeen Suleman, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada

Presenting Author(s)

CN

Chioma Nwebube, B.Sc (Hons) (she/her/hers)

Research Assistant
MAP Centre for Urban Health Solutions, Unity Health Toronto
Toronto, Ontario, Canada

Background: In 2022, 27,000 refugee claimants (RCs) entered Canada seeking protection. Although RCs are ineligible for provincial health insurance programs, the Interim Federal Health Program (IFHP) provides coverage for basic medical care and supplemental services. Previous studies have shown that only 24% of pediatricians are registered for IFHP, suggesting limited access for refugee claimant youth (RCYs), whom are already at increased risk of poor health outcomes. It is important to understand the perspectives and needs of RCYs and their caregivers to improve their access to care, but to date, no study has examined their experiences directly.

Objective:

We explored how RCY, their caregivers, service providers and health care providers understand and utilize the healthcare system after arrival in Canada.

Design/Methods:

This was a qualitative study using community-based participatory action methodology. In-depth interviews (IDIs) were conducted with RCYs (10-18y), their caregivers, community service providers and health care providers (HCPs) that worked with RCYs in a large urban Canadian city in English or with an interpreter, recorded and transcribed. Transcripts were coded using inductive coding methods, and analysed within and across stakeholder groups using thematic analysis.

Results:

A total of 27 IDIs were conducted (8 HCPs, 9 community service providers, 5 caregivers, and 5 RCYs). RCYs and caregivers had little to no understanding of how the healthcare system operated in Canada, including how IFHP provided coverage. Most explained that their limited knowledge about the healthcare system was provided by informally by through social contacts, or their community service providers, who in turn expressed limited understanding of IFHP coverage and difficulty finding IFHP registered providers. Although healthcare providers similarly found IFHP difficult to navigate, they did not appreciate how little RCYs and their families understood the healthcare system, nor the difficulties placed on community service providers. RCYs stated that a youth-oriented, multi-lingual resource that explained how to access care in Canada would be a useful tool to help them feel empowered to advocate for themselves and their families.

Conclusion(s):

Although policies exist to provide coverage for medical care for RCYs, there are many barriers that prevent them from accessing care, including limited knowledge of the system and few navigation supports. Our findings suggest that working with RCY themselves to co-develop a youth-centered approach to understanding the healthcare system may increase youth empowerment and access to care.