Submission ID 131535
| Issue/Objective | Forced migration is escalating amid global polycrises marked by conflict, climate change, and shrinking social protection systems. Perinatal refugee women are disproportionately affected by these dynamics, experiencing elevated mental health needs while facing systemic barriers to care. In a global moment characterized by fragmented governance, declining funding, and attacks on human rights, there is an urgent need for evidence that moves beyond rhetoric toward grounded, equity‑oriented action. The objective of this review was to synthesize qualitative evidence on perinatal refugee women's lived experiences of accessing mental health care services and social supports, with attention to upstream determinants of health inequities relevant to global health policy and practice. |
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| Methodology/Approach | This recently published qualitative systematic review followed Joanna Briggs Institute methodology and PRISMA guidelines. Searches were conducted across five databases and gray literature sources from January 2011 to June 2024. Forty‑one qualitative studies conducted across diverse global contexts were included. Meta‑aggregation was used to synthesize findings, and confidence was assessed using the ConQual approach. An intersectionality lens informed analysis to examine how migration status, gender, race, language, and socioeconomic conditions shape access to care. |
| Results | Two synthesized findings emerged. First, perinatal refugee women's access to mental health services is profoundly shaped by upstream social determinants, including precarious migration status, poverty, racism, language exclusion, stigma, and fear of surveillance or deportation. These structural conditions often deter help‑seeking and undermine the right to health. Second, health systems functioned as both barriers and facilitators. While women commonly experienced discriminatory, trauma‑insensitive care, facilitators included cultural navigators, faith‑based and community networks, trauma‑ and violence‑informed practices, and equitable use of digital tools to bridge information and access gaps. |
| Discussion/Conclusion | Findings show perinatal mental health inequities among refugee women are driven upstream by migration governance, poverty, racism, language exclusion, and stigma-not individual vulnerability. Equity-oriented action should embed culturally safe, gender-responsive, trauma- and violence-informed care, and reduce fear linked to precarious status. For Canada, a major resettlement country, this synthesis offers a blueprint to operationalize the right to health through scalable cultural navigator models, partnerships with settlement and faith organizations, and equitable digital supports. By translating domestic learning into global health diplomacy, humanitarian programming, and health-system strengthening, Canada can contribute actionable leadership-advancing equity amid constrained resources and ensuring no one is left behind. |
| Presenters and Affiliations | Dr. Shahin Kassam University of British Columbia Okanagan Dr. Joyce O'Mahony Thompson Rivers University Dr. Lenora Marcellus University of Victoria |
