Determinants and Inequities in Sexual and Reproductive Health (SRH) Care Access Among Im/Migrant Women in Canada: Findings of a Comprehensive Review (2008–2018)

This comprehensive review synthesized 38 peer-reviewed studies published between 2008 and 2018 to examine the determinants and lived experiences of im/migrant women accessing sexual and reproductive health (SRH) services in Canada. The authors utilized an intersectional and structural determinants approach to move beyond individual-level explanations, focusing instead on how macro-structural factors, immigration status, and health system design shape healthcare engagement.

The study identified eight primary determinants of SRH access. A major barrier is the complexity of the Canadian health system, where difficulties in finding family doctors, long wait times, and confusing insurance coverage often delay or prevent care. Language barriers and a lack of culturally safe, language-specific services were consistently reported as critical obstacles. Furthermore, the review highlighted that negative experiences with healthcare personnel—including judgmental attitudes, violations of privacy, and racial or religious prejudice—significantly undermine trust and engagement. Conversely, social support from family, community organizations, and culturally sensitive providers were identified as key facilitators that help women navigate these systemic challenges.

Immigration-specific factors play a profound role in health equity. Women with precarious immigration status, such as asylum seekers and undocumented individuals, face unique vulnerabilities, including fear of deportation, lack of health insurance, and financial barriers. These factors often lead to delayed prenatal care, higher rates of unplanned cesarean sections, and reduced access to mental health support for conditions like postpartum depression. The review emphasizes that these are not merely individual health choices but are structural inequities exacerbated by policy environments.