Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-27T12:34:31.609Z Has data issue: false hasContentIssue false

Understanding the Health of Refugee Women in Host Countries: Lessons from the Kosovar Re-Settlement in Canada

Published online by Cambridge University Press:  28 June 2012

Lynda Redwood-Campbell*
Affiliation:
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
Harpreet Thind
Affiliation:
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
Michelle Howard
Affiliation:
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
Jennifer Koteles
Affiliation:
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
Nancy Fowler
Affiliation:
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
Janusz Kaczorowski
Affiliation:
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
*
Department of Family Medicine 1200 Main St. W. HSC 2V5 Hamilton, ON L8N 3Z5Canada E-mail: redwood@mcmaster.ca

Abstract

Introduction:

Refugees from Kosovo arrived in several Canadian cities after humanitarian evacuations in 1999. Approximately 500 arrived in Hamilton, Canada. Volunteer sponsors from community organizations assisted the families with settlement, which included providing them access to healthcare services.

Hypothesis/Problem: It was anticipated that women, in particular, would have unmet health needs relating to trauma and a lack of healthcare access after experiencing forced migration.

Methods:

This study describes the results of a self-administered survey regarding women's health issues and experiences with health services after the arrival of refugees. It also describes the sponsor group's experience related to women's health care. The survey was administered to a random sample of 85 women refugees, and focus groups with 14 sponsors.Women self-completed questionnaires about their health, which included the Harvard Trauma Questionnaire for post-traumatic stress disorder (PTSD) and use of preventive health services. Sponsor groups participated in a focus group discussing healthcare needs and experiences of their assigned refugee families. Themes pertaining to women's issues were identified from the focus groups.

Results:

Preventive screening rates were low, only 1/19 (5.3%) women ≥50- years-old had ever received a mammogram; 34.1% (28/82) had ever received a Pap test); and PTSD was prevalent (25.9%, 22/85). Sponsor groups identified challenges relating to prenatal care needs, finding family physicians, language barriers to health care services, cultural influences of women's healthcare decision-making, mental health concerns, and difficulties accessing dental care, eye care, and prescriptions.

Conclusions:

Many women refugees from Kosovo had unmet health needs. Culturally appropriate population level screening campaigns and integration of language and interpretation services into the healthcare sector on a permanent basis are important policy actions to be adequately prepared for newcomers and women in displaced situations. These needs should be anticipated during the evacuation period by host countries to aid in planning the provision of health resources more efficiently for refugees and displaced people going to host countries.

Type
Original Research
Copyright
Copyright © World Association for Disaster and Emergency Medicine 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Amaratunga, CA, O'Sullivan, TL: In the path of disasters: Psychosocial issues for preparedness, response, and recovery. Prehospital Disast Med 2006;21:149155.CrossRefGoogle ScholarPubMed
2.Carballo, M, Grocutt, M, Hadzihasanovic, A: Women and migration: A public health issue. World Health Stat Q 1996;49:158164.Google ScholarPubMed
3. United Nations High Commissioner for Refugees (UNHCR) Canada. Available at http://www.unhcr.ca. Accessed 28 October 2007.Google Scholar
4.Henderson, S: New approaches to health care for displaced populations. JAMA 2001;285:1212.CrossRefGoogle ScholarPubMed
5. United Nations High Commissioner for Refugees: Refugees by Numbers (2006 Edition). Available at http://www.cic.gc.ca/english.resources/statistics/facts2005/temporary/01.asp. Accessed 01 April 2007Google Scholar
6. United Nations High Commissioner for Refugees: UNCHR Global Report 1999—Kosovo Emergency. Available at http://www.unhcr.org/cgibin/texis/vtx/publ/opendoc.pdf?tbl=PUBL&id=3e2d4d5f7. Accessed 01 April 2007.Google Scholar
7.Redwood-Campbell, L, Fowler, N, Kaczorowski, J et al. : How are new refugees doing in Canada? Comparison of the health and settlement of the Kosovars and Czech Roma. Can J Public Health 2003;94;381385.CrossRefGoogle ScholarPubMed
8.Ai, AL, Peterson, C., Ubelhor, D: War-related trauma and symptoms of posttraumatic stress disorder among adult Kosovar refugees. J Trauma Stress 2002;15:157160.CrossRefGoogle ScholarPubMed
9.Barnes, DM, Harrison, CL: Refugee women's reproductive health in early resettlement. J Obstet Gynecol Neonatal Nurs 2004;33:723728.CrossRefGoogle ScholarPubMed
10.Sundquist, J, Behmen-Vincevic, A, Johansson, SE: Poor quality of life and health in young to middle aged Bosnian female war refugees: A populationbased study. Public Health 1998;112:2126.Google Scholar
11.Mollica, RF, Caspi-Yavin, Y, Bollini, P et al. : The Harvard Trauma Questionnaire. Validating a cross-cultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. J Nerv Ment Dis 1992;180:111116.CrossRefGoogle ScholarPubMed
12.Mollica, RF, Sarajlic, N, Chernoff, M et al. : Longitudinal study of psychiatric symptoms, disability, mortality, and emigration among Bosnian refugees. JAMA 2001;286:546554.CrossRefGoogle ScholarPubMed
13.Lopez Cardozo, B, Vergara, A, Agani, F: Mental health, social functioning and attitudes of Kosovar Albanians following the war in Kosovo. JAMA 2000; 284:569577.CrossRefGoogle Scholar
14.WL, Miller, Crabtree, BF (eds): The Dance of Interpretation. In: Doing Qualitative Research. 2d ed.California: Sage Publications Inc., 1999, pp127144.Google Scholar
15.Fowler, N, Redwood-Campbell, L, Molinaro, E et al. : The 1999 international emergency humanitarian evacuation of the Kosovars to Canada: A qualitative study of service providers' perspectives at the international, national and local levels. Int J Equity Health 2005;4:1.CrossRefGoogle Scholar
16.Maxwell, CJ, Bancej, CM, Snider, J: Predictors of mammography use among Canadian women aged 50–69: Findings from the 1996/97 National Population Health Survey. Can Med Assoc J 2001;164:329334.Google ScholarPubMed
17.Maxwell, CJ, Bancej, CM, Snider, J, Vik, SA: Factors important in promoting cervical cancer screening among Canadian women: Findings from the 1996–97. National Population Health Survey (NPHS). Can J Public Health 2001;92:127133.CrossRefGoogle ScholarPubMed
18.Goel, V: Factors associated with cervical cancer screening: Results from the Ontario Health Survey. Can J Public Health 1994;85:125127.Google ScholarPubMed
19.Acheson, D: Health, humanitarian relief, and survival in former Yugoslavia. Br Med J 1993;307:4448.CrossRefGoogle ScholarPubMed
20.Janerich, DT, Hadjimechael, O, Schwartz, PE et al. : The screening histories of women with invasive cervical cancer, Conneticut. Am J Public Health 1995;6: 254257.Google Scholar
21.Mollica, RF, Son, L: Cultural dimensions in the evaluation and treatment of sexual trauma. An overview. Psychiatr Clin North Am 1989;12:363379.CrossRefGoogle ScholarPubMed
22.Lipson, JG, Hosseini, T, Kabir, S et al. : Health issues among Afghan women in California. Health Care Women Int 1995;16:279286.CrossRefGoogle ScholarPubMed
23.Reitmanova, S, Gustafson, DL: “They can't understand it”: Maternity health and care needs of immigrant Muslim women in St. John's, Newfoundland. Matern Child Health J 2008;12(1)101111.CrossRefGoogle ScholarPubMed
24.Hauff, E, Vaglum, P: Organised violence and the stress of exile: Predictors of mental health in a community cohort of Vietnamese refugees three years after resettlement. Br J Psychiatry 1995;166:360370.CrossRefGoogle Scholar
25. Citizenship and Immigration Canada. (2003). Designated Medical Practitioner Handbook. Available at http://www.cic.gc.ca/english/pub/dmphandbook/section-2.html. Accessed 01 April 2007.Google Scholar
26.Fowler, N, Redwood-Campbell, L, Molinaro, E et al. : The 1999 international emergency humanitarian evacuation of the Kosovars to Canada: A qualitative study of service providers' perspectives at the international, national and local levels. International Journal for Equity in Health 2005;4(1):1.CrossRefGoogle Scholar