Unpacking the mystery of the Canadian healthcare system: Ukrainian refugees and healthcare system navigation

Project Title

_{Unpacking the mystery of the Canadian healthcare system: Ukrainian refugees and healthcare system navigation}

Researchers

_{Principle Investigator: Dr. Kateryna Metersky}

_{Co-Investigators: Dr. Areej Al-Hamad, Dr. Yasin Yasin, Dr. Margareth Zanchetta, Valerie Tan}

_{Student Researcher: Tetiana Podobailo}

Funder

_{Faculty of Community Services KT grant}

Research Question

_{In addition to sharing knowledge, the project also sought to identify participants’ challenges and successes in navigating the healthcare system, as well as their informational needs, in order to bring about effective and sustainable changes for this population and the healthcare components and/or providers that they interact with.}

Methodology

_{The project was conducted between November and December 2023. A workshop was developed based upon a thorough review of the literature on the topic of refugees and healthcare system navigation, as well as the findings from Dr. Metersky’s, Dr. Al-Hamad’s, and Dr. Zanchetta’s programs of research. The workshop lasted approximately 2 hours in length, and consisted of three sessions; each session of the workshop included a presentation in Ukrainian, a group discussion question, and a group empowerment exercise that utilized artistic self-expression. Specifically, the workshop draws upon the Narrative Reflective Process (Schwind, 2008), a creative self-expression tool, while the larger group discussions were inspired by Social Empowerment Theory and the Population Health Promotion Model.}

_{The key workshop topics were: 1) presentation and discussion of the differences and similarities between the Ukrainian and Ontario healthcare systems (with an emphasis on health and health-related behaviours), 2) presentation and discussion of roles participants want to play in their healthcare, as well as the roles of patients in care delivery in the Ontario healthcare system, and 3) presentation and discussion of active and productive collaboration with healthcare professionals for personal and familial wellbeing.}

Background

^{Events such as the full-scale invasion of Ukraine, that began on February 24, 2022, have contributed to a significant increase in the percentage of Ukrainian refugees arriving in Canada. The recent influx of Ukrainian refugees who have settled in Ontario has contributed to additional demand on the healthcare system, as the population will require long-term access to health services in order to manage pre-existing and newly developed health conditions (Murphy et.al., 2023). While refugees arriving in Ontario can obtain the Ontario Health Insurance Plan (OHIP) (Government of Ontario, 2022), there are several barriers that newcomer populations face in order to utilize healthcare services. These challenges include language barriers, inability to understand treatment plans, time delays, and limited appointment availability (Pandey et al., 2022). Therefore, Ukrainian refugees must rely on their Canadian sponsors and/or communities for support in navigating the Ontario healthcare system (Greenaway et al., 2022).}

Findings

_{Key themes emerged from the voices of recent Ukrainian refugees who participated in the KTr workshops: 1) concerns regarding accessibility and wait times; 2) difficulties navigating the Canadian healthcare system, 3) transnational healthcare, and 4) a desire for increased involvement in the plan of care.}

Keywords

_{refugees, health, healthcare system navigation, Ontario, knowledge transfer}

References

^{Government of Ontario. (2023, July 7). Coming to Ontario from Ukraine. https://www.ontario.ca/page/coming-ontario-ukraine} 

^{Greenaway, C., Fabreau, G., & Pottie, K. (2022). The war in Ukraine and refugee health care: Considerations for health care providers in Canada. Canadian Medical Association Journal, 194(26), E911–E915. https://doi.org/10.1503/cmaj.220675}

^{Murphy, A., Bartovic, J., Bogdanov, S., Bozorgmehr, K., Gheorgita, S., Habicht, T., Richardson, E., Azzopardi-Muscat, N., & McKee, M. (2023). Meeting the long-term health needs of Ukrainian refugees. Public Health (London), 220, 96–98. https://doi.org/10.1016/j.puhe.2023.04.015}

^{Pandey, M., Kamrul, R., Michaels, C. R., & McCarron, M. (2022). Identifying barriers to healthcare access for new immigrants: A qualitative study in Regina, Saskatchewan, Canada. Journal of Immigrant and Minority Health, 24(1), 188–198. https://doi.org/10.1007/s10903-021-01262-z}

^{Schwind , J. K. (2008). Accessing humanness: From experience to research, from classroom to praxis. In J. K. Schwind & G. M. Lindsay (Eds.), From experience to relationships: Reconstructing ourselves in education and healthcare (pp. 77-94). Information Age Publishing Inc.}