Government-assisted refugees were less likely to receive adequate prenatal care than privately sponsored refugees, found a new study published in the Canadian Medical Association Journal.

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

To determine whether refugees receive adequate prenatal care (defined as the 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,” explained Dr Astrid Guttmann, senior scientist, ICES, and a paediatrician and senior scientist at The Hospital for Sick Children (SickKids), Toronto, Ontario, with coauthors.

Interestingly, the researchers also found that privately sponsored refugees and nonrefugee 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,” noted Dr Andrea Evans, ICES fellow, a paediatrician at CHEO, and investigator at the CHEO Research Institute, 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 healthcare.