Electronic Thesis and Dissertation Repository

Thesis Format



Master of Science


Health and Rehabilitation Sciences


Smith, Maxwell J.

2nd Supervisor

Shelley, Jacob.



Background: During the COVID-19 pandemic, immigrants have been disproportionally affected and faced difficulties in accessing healthcare services. While it has been reported that the rate of pediatric healthcare utilization decreased during the COVID-19 pandemic, the reasons behind this decline are unclear. It has been suggested that immigrant children might be affected by the COVID-19 pandemic restrictions regarding accessing healthcare services. This study aims to understand the Middle Eastern immigrant parents’ perspectives regarding their access to healthcare services for their children in the London, Ontario, area during the COVID-19 pandemic.

Methods: This qualitative study was conducted with an interpretive description methodology and informed by the socio-ecological model. Seven participants were interviewed, and data were analyzed thematic analysis using NVivo (1.6.1).

Findings: Four main themes were generated: 1) Navigating Health Services: “Limited and Confusing”, 2) Being an Immigrant Made it Hard, 3) Less Intention of Utilizing Child Health Services, and 4) Limited/No Mental Health Utilization.

Conclusion: Educational plans for immigrants and healthcare providers, improving effective communication between immigrants and healthcare providers, transferring health information with culturally friendly sources, and collaboration between schools and health services may aid immigrants to have better access to child healthcare services, especially during public health emergencies like a pandemic.

Summary for Lay Audience

Canada is a multicultural country and a destination for immigrants from different regions of the world. In 2020, Ontario had the highest number of new immigrants among all of Canada’s provinces and territories, hosting 127,191 new immigrants. Approximately 20% of the immigrant population in Ontario live in London, making up 30% of the London population. The Middle Eastern population is one of the fastest-growing immigrant populations in recent years in London and in Ontario. Before the COVID-19 pandemic, immigrants reported particular barriers to accessing healthcare services, such as language and financial barriers, lack of knowledge, and long wait times. Immigrants have also been disproportionally affected by the COVID-19 pandemic, such as higher rates of infection and hospitalization, and they have faced challenges in accessing healthcare services during the pandemic. It has been suggested that public health restrictions and changes in healthcare services could negatively affect access to healthcare services during the pandemic, and some reports indicate lower rates of child healthcare service utilization during the COVID-19 pandemic, particularly for younger children, compared to the same period of time in the past. However, the exact reasons for this decline are still unclear, and it is important to investigate the experiences and perspectives of parents as to their healthcare service utilization for their children during the recent pandemic. This study involved interviews with Middle Eastern immigrant parents who have young children (elementary-school children) to understand their perspectives and experiences regarding their access to child healthcare services during the pandemic. This study is positioned to help understand the parents’ barriers, challenges, and expectations during the recent pandemic from their own point of view. This knowledge can be used to improve the access to child healthcare services in the future.