Immigrant women are at greater risk for postpartum depression (PPD) compared
to non-immigrant women and experience multiple barriers to accessing health
services to address their needs. This mixed method study explored the multi-level
factors that contribute to the postpartum mental health of immigrant women in
Canada and their ability to access requisite health services. In the quantitative
phase, data from a longitudinal prospective cohort survey of women were used to
examine predictors of PPD over the first postpartum year for a sample of women
who delivered at two hospitals in Toronto, Ontario. In the qualitative phase, an
interpretive descriptive design shaped by an integrated knowledge translation
approach was used to understand the factors immigrant women living in
Scarborough, Ontario (a region of Toronto) perceive as contributing to their
postpartum emotional health and the factors immigrant women and care
providers perceive as influencing access to health services. Across quantitative
and qualitative findings, factors contributing to PPD among immigrant women
included a lack of social support, individual and community-level challenges
faced in terms of the social health determinants, physical health status, and
client-provider relationships. Factors contributing to reduced access to health
services included: lack of system knowledge, social health determinants,
organizational and system barriers, limited access to treatment, and a need for
service integration and system navigation support. Immigrant women in Canada
experience numerous health inequities that increase their risk for PPD and
v
prevent them from accessing service supports to address PPD concerns. The
Canadian health care system needs to be responsive to individual needs in order
to facilitate equitable access and address the health needs of Canadian
immigrant women and their families. The diversity and proportion of immigrants in
Canada calls for a linguistically and culturally supportive health care system with
a strategic approach to enhancing accessibility to address health inequities. / Dissertation / Doctor of Philosophy (PhD) / Immigrant women have a 2-3 times higher risk for postpartum depression (PPD)
than native-born women. This study explored the factors that contribute to PPD
among immigrant women in Canada and how health services can help them get
the care they need, from the perspective of immigrant women and care providers.
This study found increased PPD risk when women lacked social support, had
physical health issues, and faced challenges such as low income and lack of
English language skills. Working with care providers could help address these
challenges or make it more difficult to get care. Immigrant women had more
difficulty getting services when they lacked knowledge about the health care
system, faced social, financial, and language-based barriers to care, and
experienced barriers when using available services. The findings from this
research can inform the design and delivery of health care to best meet the
needs of immigrant women with PPD.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/18583 |
| Date | 06 1900 |
| Creators | Ganann, Rebecca |
| Contributors | Sword, Wendy, Nursing |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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