Privately sponsored refugees likely to receive better prenatal care than government-assisted refugees in Canada


Ottawa, Ontario — Monday April 3, 2023

Government-assisted refugees were less likely to receive adequate prenatal care than privately sponsored refugees, found a new study published April 3, 2023, in CMAJ (Canadian Medical Association Journal).

Canada has two main pathways to resettle refugees: government assistance and private sponsorship by family members or non-family volunteers.

To determine whether refugees receive adequate prenatal care (defined as initiation of prenatal care by 13 weeks’ gestation; receipt of a minimum number of prenatal care visits, as recommended by the Society of Obstetricians and Gynaecologists of Canada; and receipt of a prenatal fetal anatomy ultrasound between 16 and 21 weeks’ gestation), researchers looked at data from ICES on 2,775 pregnant government-assisted and 2,374 privately sponsored refugees in Ontario, the province that receives almost half of the country’s refugees.

Researchers found that over the study period (2002–2020), government-assisted refugees were less likely to receive adequate prenatal care services than privately sponsored refugees (62.3% vs. 69.3%), a difference that remained significant after adjusting for potential confounders.

“Our findings suggest that private sponsorship plays a role in facilitating prenatal care use, and that government-assisted refugees may benefit from additional resettlement support related to health care navigation,” said Dr. Astrid Guttmann, senior scientist, ICES, and a pediatrician and senior scientist at The Hospital for Sick Children (SickKids), Toronto, Ontario.

Interestingly, the researchers also found that privately sponsored refugees and non-refugee immigrants were more likely to have adequate prenatal visits than long-term residents of Canada.

“Increased visits related to perceived or higher medical need or need for counselling may be reasons for more visits in the privately sponsored refugees and nonrefugee immigrant populations,” said Dr. Andrea Evans, ICES Fellow, Investigator at the CHEO Research Institute, and pediatrician at CHEO, Ottawa, Ontario.

The authors suggest that education and language may be barriers limiting access to prenatal care for government-assisted refugees, and this finding could be useful for increasing access to health care.

Reference: Andrea Evans MDCM, Joel G. Ray MD, Peter C. Austin PhD, Hong Lu PhD, Sima Gandhi MSc, Astrid Guttmann MDCM. Receipt of adequate prenatal care for privately sponsored versus government-assisted refugees in Ontario, Canada: a population-based cohort study. CMAJ. 2023 April 3;195:E469-78. doi: 10.1503/cmaj.221207

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