Access to Prenatal Care for Pregnant Refugee Women in Toronto, Ontario, Canada: An Audit Study.

We assessed whether eligible refugee claimants faced barriers to accessing prenatal care in the context of changes to Canadian health care policy that generated multiple categories of refugee health care eligibility.

METHODS: Prenatal care providers in Toronto were contacted twice using standardized scripts to book appointments for a pregnant non-refugee and refugee claimant, both eligible for prenatal care.

PRIMARY OUTCOME: unequivocal offer of appointment. Secondary outcome: reasons for refusal of prenatal care.

RESULTS: There was a statistically significantly lower rate of offering prenatal care (34%) to refugee claimants compared with non-refugees (95%) (p < .001). Lack of knowledge, confusion about policies, time-consuming administrative requirements, and slow reimbursement processes were cited as reasons for refusal of care.

CONCLUSIONS: Our results highlighted barriers to accessing prenatal care for refugee women. There are important future policy implications when considering the numerous changes to refugee health care policy in the last five years.