Methods: Immigrant women from South Asia and China who were providing unpaid care to a family member were the focus of the study. Participants were recruited in Edmonton, Alberta via media advertising and informal means. Twenty-nine women were interviewed individually about assistance they had received from other family members and community organizations; problems faced when accessing this support; and their desires for other types of assistance they were not receiving. Seven women participated in two subsequent focus groups to discuss the implications of these interviews, emphasizing the challenges and necessary changes to achieve this preferred assistance. Two further focus groups were conducted with 15 policy makers and health care providers to discuss the findings.

Findings: More than half of the women interviewed did not receive any support from community agencies for their unpaid care work. Many did not seek support out of fear of violating terms of the family sponsorship immigration policy, where the ultimate consequence could be return to one's country of origin. Many were also discouraged from seeking health and social service support because they did not speak adequate English. Some participants felt that services were not provided in a linguistically or culturally sensitive manner, making the presence of such providers in the home uncomfortable. Problems with transportation, inconvenient hours of service, or competing time demands also discouraged service use. In addition to providing translation services, women recommended peer support groups comprised of other immigrant women, and the assistance of peer mentors (or multicultural brokers) who could assist them to navigate and access the system of social and health care supports. Health and social agencies participating in focus groups felt that these women may have lacked the social networks required to make their service needs known, and suggested producing literature in various languages as a potential solution. They also noted the need for better collaboration between different sectors of care. Both sets of participants agreed that respite services were needed in these ethno-cultural communities.

Conclusions: Many of the service needs expressed by these immigrant women are similar to those of Canadian citizens providing unpaid family care. However, these immigrants' inability to speak English or to navigate the social and health systems compounded their accessibility problems. Major recommendations included offering culturally sensitive outreach services; providing information and literature in various languages; offering transportation assistance; creating multicultural broker programs; establishing respite services and eldercare day programs; offering cultural sensitivity training to health professionals; and hiring foreign-trained health workers. Findings from the study may be unique to the experiences of South Asian and Chinese women in Edmonton. Relevance to other regions in Canada may vary according to the immigrants' countries of origin, city population size, and the multiculturalism of local service provider networks.

Reference: Stewart, MJ., Neufeld, A., Harrison, MJ., Spitzer, D., Hughes, K., Makwarimba, E. "Immigrant women family caregivers in Canada: implications for policies and programmes in health and social sectors." Health and Social Care in the Community. 2006; 14(4) 329-340.

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