Assessments of Refugee Patients' Complex Care Needs and Quality of Care

Refugees and asylum seekers arriving in Canada often face untreated chronic disease, trauma-related mental health conditions, and limited access to care. The Calgary Refugee Health Clinic (formerly Mosaic Refugee Health Clinic) is a multidisciplinary clinic that provides specialized primary care to newly arrived refugees in Calgary for their first two years post-arrival. This study examines the clinic’s electronic medical records and Alberta Health Services data from 2011–2025 to characterize patients, their conditions, and the barriers they face — informing MH2C clinical guidance for refugee primary care across Canada.

Duration: April 2016 – Present

Research objectives

• Examine electronic medical records and Alberta Health Services data of patients seen at the Calgary Refugee Health Clinic between 2011 and 2025.
• Better understand the patients, the health conditions they present with, and the barriers they face accessing care.
• Inform MH2C-developed clinical guidance to help clinicians at the Calgary Refugee Health Clinic and across Canada deliver more effective, targeted care to newly arrived refugees.

Research questions

• What medical conditions are most common among refugee patients?
• Do these medical conditions differ by refugee category or region of origin?
• How do social and environmental determinants of health affect health outcomes across different refugee groups?
• How often do patients use outpatient and emergency care after joining the clinic?
• How well does the clinic's comprehensive care model meet refugees' primary and specialty health needs?

Study team

Principal Investigator: Dr. Gabriel Fabreau

Co-Investigators

Publications

• Norrie E, Holdbrook L, Grewal R, Talavlikar R, Essar MY, Williamson T, Coakley A, McBrien K, Fabreau GE — "Refugee healthcare resilience and burdens: a 10-year mixed-methods analysis of system shocks in Canada."
  The Lancet Americas · December 2025
• Davidson MB, Brown G, Street L, McBrien K, Norrie E, Talavlikar R, Holdbrook L, Fabreau GE — "Iron deficiency, anemia and association with refugee camp exposure among recently resettled refugees: A Canadian retrospective cohort study."
  PLOS One · December 15, 2022
• "Health status and care utilization among Afghan refugees newly resettled in Calgary, Canada between 2011–2020."
  medRxiv · 2024
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• "Cervical Cancer Screening by Refugee Category in a Refugee Health Primary Care Clinic in Calgary, Canada, 2011–2016."
  Journal of Immigrant and Minority Health · 2022
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• "Stunting and Overweight Prevalence Among Resettled Yazidi, Syrian, and Iraqi Pediatric Refugees."
  JAMA Pediatrics · 2022
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• "Common Hematologic, Nutritional, Asthma/Allergic Conditions and Lead Screening/Management."
  Current Problems in Pediatric and Adolescent Health Care · 2021
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• "Antenatal Care Utilization and Obstetric and Newborn Outcomes Among Pregnant Refugees Attending a Specialized Refugee Clinic."
  Journal of Immigrant and Minority Health · 2019
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• "Caring for pregnant refugee women in a turbulent policy landscape: perspectives of health care professionals in Calgary, Alberta."
  International Journal for Equity in Health · 2018
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• "Parasitic stool testing in newly arrived refugees in Calgary, Alberta."
  Canadian Family Physician · 2017
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Posters

• Walsh E, Leung A, Coakley A, Aucoin M, Vaughan S, Fabreau GE — "Comparison of Serological and Stool Testing in the diagnosis of Strongyloidiasis and Schistosomiasis among recently arrived refugees to Canada."
  2017 North American Refugee Health Conference · June 2017
• Malebranche M, Nerenberg K, Metcalfe A, Fabreau GE — "Are Pregnant Refugee Women Receiving the Prenatal Care They Need?"
  2017 North American Refugee Health Conference · June 2017
• Norrie E, Leung A, McBrien K, Coakley A, Fabreau GE — "Hypertension Prevalence, Treatment, and Control at a Specialized Refugee Clinic in Calgary, Alberta, Canada."
  2017 North American Refugee Health Conference · June 2017
• Fabreau GE, Walsh E, Coakley A, Yu S, Kamal el Din M, Lienhard K, McBrien K — "Medical complexity and intensity of dedicated refugee clinic use among newly arrived refugees and refugee claimants to Canada."
  2016 North American Refugee Health Conference · June 2016

Oral presentations

• Norrie E, McBrien K, Ronksley P, Montesanti S, Ip A, Grewal R, Holdbrook L, El-Shazly N, Coakley A, Fabreau GE — "Decade of turmoil: a characterization of a specialized refugee health clinic 2011–2020."
  North American Refugee Health Conference · June 2023
• Hwang L, DeVetten G, Talavlikar R, Hetherington E — "Vitamin B12 deficiency in newly-arrived pregnant refugee patients in Calgary, Canada from 2017–2019."
  North American Refugee Health Conference · June 2023
• Norrie E, McBrien K, Montesanti S, Ronksley P, Brown G, Fabreau GE — "Clinic Utilization at a Specialized Refugee Health Clinic in Calgary, Canada: before, during and after the Syrian Refugee Initiative."
  North American Refugee Health Conference, Toronto ON · June 2019
• Malebranche M, Norrie E, Hao S, Nerenberg K, Metcalfe A, Talavlikar R, Hull A, De Vetten G, Fabreau GE — "Health Care Utilization Patterns among Pregnant Refugee Women attending a Dedicated Refugee ‘Medical Home’ in Calgary, Canada."
  North American Refugee Health Conference, Portland OR · June 2018
• Whalen Browne M, Talavlikar R, Norrie E, Hao S, Kamal el Din M, Fabreau GE — "Effective Cervical Cancer Screening among Recently Resettled Refugee and Asylum Claimant Women to Canada: A Dedicated Refugee Medical Home Model."
  North American Refugee Health Conference, Portland OR · June 2018
• Davidson M, Street L, Norrie E, Kamal el Din M, Hao S, McBrien K, Coakley A, Fabreau GE — "Prevalence and Determinants of Anemia in Recently Resettled Refugees to Canada."
  North American Refugee Health Conference, Portland OR · June 2018
• Norrie E, Boyce M, Walsh E, Leung A, Coakley A, Fabreau GE — "Mental Health and Hypertension Prevalence among Refugees and Refugee Claimants in Canada."
  North American Refugee Health Conference · June 2017
• Walsh E, Vaughan S, Coakley A, Yu S, Kamal el Din M, Lienhard K, Williamson T, Fabreau GE — "Strongyloidiasis and Schistosomiasis Screening and Prevalence among Refugees and Refugee Claimants in Canada."
  North American Refugee Health Conference Annual Meeting, Niagara Falls NY · June 2016

Media coverage

• UCalgary News — UCalgary-led research transforms understanding of refugee health in Canada (Brittany DeAngelis)
  February 18, 2026
• CityNews — Calgary Refugee Health Clinic facing closure after $1.6M in funding pulled (Alejandro Melgar and Nadia Moharib)
  October 27, 2024
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• Global News — Calgary refugee health clinic turns to crowdfunding after losing operational funding (Drew Stremick)
  October 26, 2024
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• CBC News — Calgary Refugee Health Clinic could shut down with majority of funding pulled, doctor warns (Jennifer Lee)
  October 25, 2024
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Funding

Partners

Calgary Refugee Health Clinic