Virtual Care and Social Support for Refugee Mothers during COVID-19:  A Qualitative Analysis

Katherine McGuire; Michaela Hynie

doi:10.25071/1929-8471.111

Authors

Katherine McGuire York University https://orcid.org/0009-0001-7861-9415
Michaela Hynie https://orcid.org/0000-0002-9266-9902

DOI:

https://doi.org/10.25071/1929-8471.111

Keywords:

Women, Refugee mothers, Resettlement, Social Support, Virtual Services, COVID-19

Abstract

Introduction: The intersection of gender, motherhood, and migration status creates distinct challenges for refugee mothers, but social support can facilitate their navigation of migration and motherhood. Taking a Salutogenic Theory approach (Antonovsky, 1979), we examined refugee mothers’ access to virtual social support during the COVID-19 pandemic. Our objective is to understand the provision of virtual social support for refugee mothers from the perspective of service providers and recently arrived refugee mothers to Canada. Methods: Virtual semi-structured interviews were conducted with three service providers and five refugee mothers in one settlement agency in Ontario, Canada. Data were subjected to thematic analysis. Six main themes emerged. Results: From interviews with service providers the themes include: virtual adaptation of services; unique barriers to virtual services emerging from the intersection of gender, culture, and migration status; and supporting women’s agency and independence. From interviews with mothers, we identified the following themes: gratitude for instrumental support; organization as a link between self and society; and usefulness of virtual support, but preference for in-person support. Discussion: Providers acknowledged clients’ diverse circumstances. They developed flexible strategies to identify client needs and help them build skills. Clients found virtual services essential to resettlement, if not ideal. Conclusion: With tailored programming, virtual services can be effective in providing support. Moreover, refugee mothers acquired digital skills to independently navigate virtual resources, despite limited digital literacy. This demonstrates the value of using of virtual services for vulnerable or hard to reach populations.

References

Antonovsky. (1979). Health, stress, and coping (1st ed.). Jossey-Bass.

Benjamen, J., Girard, V., Jamani, S., Magwood, O., Holland, T., Sharfuddin, N., & Pottie, K. (2021). Access to refugee and migrant mental health care services during the first six months of the COVID-19 pandemic: A Canadian refugee clinician survey. International Journal of Environmental Research and Public Health, 18(10), 5266–. https://doi.org/10.3390/ijerph18105266 DOI: https://doi.org/10.3390/ijerph18105266

Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative Research in Psychology, 3(2), 77-101. https://doi.org/10.1191/1478088706qp063oa DOI: https://doi.org/10.1191/1478088706qp063oa

Browne, D. T., Smith, J. A., & Basabose, J. de D. (2021). Refugee children and families during the COVID-19 crisis: A resilience framework for mental health. Journal of Refugee Studies, 34(1), 1138–1149. https://doi.org/10.1093/jrs/feaa113 DOI: https://doi.org/10.1093/jrs/feaa113

Cohen, S., Underwood, L. G., & Gottlieb, B. H. (2000). Social support measurement and intervention: A guide for health and social scientists. Oxford University Press, Incorporated. DOI: https://doi.org/10.1093/med:psych/9780195126709.001.0001

Denzin, N. & Lincoln, Y. (2008) (Eds.). Collecting and interpreting qualitative materials, 3rd edition. Thousand Oaks, CA: Sage publications.

Hartley, Tomlinson, M., Greco, E., Comulada, W. S., Stewart, J., le Roux, I., Mbewu, N., & Rotheram-Borus, M. J. (2011). Depressed mood in pregnancy: prevalence and correlates in two Cape Town peri-urban settlements. Reproductive Health, 8(1), 9–9. https://doi.org/10.1186/1742-4755-8-9 DOI: https://doi.org/10.1186/1742-4755-8-9

Hawkins, M. M., Schmitt, M. E., Adebayo, C. T., Weitzel, J., Olukotun, O., Christensen, A. M., Ruiz, A. M., Gilman, K., Quigley, K., Dressel, A., & Mkandawire-Valhmu, L. (2021). Promoting the health of refugee women: A scoping literature review incorporating the social ecological model. International Journal for Equity in Health, 20(1), 45–45. https://doi.org/10.1186/s12939-021-01387-5 DOI: https://doi.org/10.1186/s12939-021-01387-5

Hennink, M. M. (2008). Language and communication in cross-cultural qualitative research. In Doing Cross-Cultural Research (pp. 21–33). Springer Netherlands. https://doi.org/10.1007/978-1-4020-8567-3_2 DOI: https://doi.org/10.1007/978-1-4020-8567-3_2

Heslehurst, N., Brown, H., Pemu, A., Coleman, H., & Rankin, J. (2018). Perinatal health outcomes and care among asylum seekers and refugees: A systematic review of systematic reviews. BMC Medicine, 16(1), 89–89. https://doi.org/10.1186/s12916-018-1064-0 DOI: https://doi.org/10.1186/s12916-018-1064-0

Im, H., & George, N. (2022). Impacts of COVID-19 on refugee service provision and community support: A rapid assessment during the pandemic. Social Work in Public Health, 37(1), 84–103. https://doi.org/10.1080/19371918.2021.1974639 DOI: https://doi.org/10.1080/19371918.2021.1974639

Kirmayer, L. J., Narasiah, L., Munoz, M., Rashid, M., Ryder, A. G., Guzder, J., Hassan, G., Rousseau, C., & Pottie, K. (2011). Common mental health problems in immigrants and refugees: General approach in primary care. Canadian Medical Association Journal, 183(12), E959–E967. https://doi.org/10.1503/cmaj.090292 DOI: https://doi.org/10.1503/cmaj.090292

Liem, A., Natari, R. B., Jimmy, & Hall, B. J. (2021). Digital health applications in mental health care for immigrants and refugees: A rapid review. Telemedicine Journal and e-Health, 27(1), 3–16. https://doi.org/10.1089/tmj.2020.0012 DOI: https://doi.org/10.1089/tmj.2020.0012

Lukawiecki, J., Khan, A., & Bedi, G. (2022). Newcomer families in Canada and the digital divide. Guelph, ON: Community Engaged Scholarship Institute. https://atrium.lib.uoguelph.ca/xmlui/handle/10214/2501

O’Mahony, J., & Donnelly, T. (2010). Immigrant and refugee women’s post-partum depression help-seeking experiences and access to care: A review and analysis of the literature. Journal of Psychiatric and Mental Health Nursing, 17(10), 917–928. https://doi.org/10.1111/j.1365-2850.2010.01625.x DOI: https://doi.org/10.1111/j.1365-2850.2010.01625.x

O’Mahony, J., Kassam, S., Clark, N., & Asbjoern, T. (2023). Use of participatory action research to support Syrian refugee mothers in the resettlement period in Canada: A longitudinal study. PloS One, 18(2), e0281765–e0281765. https://doi.org/10.1371/journal.pone.0281765 DOI: https://doi.org/10.1371/journal.pone.0281765

Perez-Botella, M., Downe, S., Meier Magistretti, C., Lindstrom, B., & Berg, M. (2014). The use of salutogenesis theory in empirical studies of maternity care for healthy mothers and babies. Sexual & Reproductive Healthcare, 6(1), 33–39. https://doi.org/10.1016/j.srhc.2014.09.001 DOI: https://doi.org/10.1016/j.srhc.2014.09.001

Priebe, S., Giacco, D., & El-Nagib, R. (2016). Public health aspects of mental health among migrants and refugees: A review of the evidence on mental health care for refugees, asylum seekers and irregular migrants in the WHO European Region. Copenhagen: WHO Regional Office for Europe.

Stewart, M., Anderson, J., Beiser, M., Mwakarimba, E., Neufeld, A., Simich, L., & Spitzer, D. (2008). Multicultural Meanings of Social Support among Immigrants and Refugees. International Migration, 46(3), 123–159. https://doi.org/10.1111/j.1468-2435.2008.00464.x DOI: https://doi.org/10.1111/j.1468-2435.2008.00464.x

The UN Refugee Agency (2021). Refugee Data Finder. Retrieved from https://www.unhcr.org/refugee-statistics/download/?url=2Tpn3I

The UN Refugee Agency (2022). Refugee Statistics. Retrieved from https://www.unhcr.ca/in canada/refugee-statistics/

Thomas, S. & Thomas, S. D. (2004). Displacement and health. British Medical Bulletin, 69(1), 115–127. https://doi.org/10.1093/bmb/ldh009 DOI: https://doi.org/10.1093/bmb/ldh009

Umuziga, M.P., Adejumo, O., & Hynie, M. (2020). A cross-sectional study of the prevalence and factors associated with symptoms of perinatal depression and anxiety in Rwanda. BMC Pregnancy and Childbirth, 20(1), 68–68. https://doi.org/10.1186/s12884-020-2747-z DOI: https://doi.org/10.1186/s12884-020-2747-z

Viken, Lyberg, A., & Severinsson, E. (2015). Maternal Health Coping Strategies of Migrant Women in Norway. Nursing Research and Practice, 2015, 878040–11. https://doi.org/10.1155/2015/878040 DOI: https://doi.org/10.1155/2015/878040

Williamson, D. L., Choi, J., Charchuk, M., Rempel, G. R., Pitre, N., Breitkreuz, R., & Kushner, K. E. (2011). Interpreter-facilitated cross-language interviews: a research note. Qualitative Research: QR, 11(4), 381–394. https://doi.org/10.1177/1468794111404319 DOI: https://doi.org/10.1177/1468794111404319

World Health Organization (2020). ApartTogether Survey: Preliminary Overview of Refugees and Migrants Self-Reported Impact of COVID-19; World Health Organization: Geneva, Switzerland.