Evaluating Inequities in Refugee and Immigrant Women's Sexual and Reproductive Health Access (IRIS): A Mixed-Methods, Population-Based Study in British Columbia

In British Columbia(BC), >25% of residents are immigrants or refugees, of whom approximately half are women, primarily of reproductive age. Despite the large number of women who are immigrants to BC, few comprehensive studies have examined patterns of immigrant and refugee women's engagement with sexual and reproductive health services (e.g., cervical cancer screening, prenatal and postnatal care, contraception) within BC. Limited previous research with specific subgroups of immigrant women in Canada and the U.S. suggests that im/migrant women in BC and elsewhere often face structural vulnerabilities (eg, racialization, social isolation, language barriers) that may result in suboptimal sexual and reproductive health access and outcomes. While current research suggests that there is likely important heterogeneity in the usage and need for sexual and reproductive health services amongst immigrant and refugee women, few studies have comprehensively examined such issues amongst the broader population of immigrant and refugee women in BC. To address these gaps, we propose to conduct a series of prospective, in-depth interviews with recently arrived immigrant and refugee women in BC to understand their experiences and interactions with sexual and reproductive health services over arrival and settlement; we will also use large administrative health databases to longitudinally examine population-based patterns and determinants of sexual and reproductive health services use and unmet needs amongst immigrant women for the first time in BC (2009-2019). Our findings will inform current initiatives to develop BC's first Provincial Refugee Health Strategy and will inform the responsiveness of public health, clinical and community services to the realities of immigrant and refugee women in BC.