Delay in Accessing and Receiving Primary Health Care and Associated Factors Among Nepalese Immigrant Patients in Canada

TL;DR

This study finds that many Nepalese immigrants in Canada face delays in accessing healthcare due to various personal and systemic factors.

Contribution

The study provides new empirical evidence on healthcare access barriers specific to Nepalese immigrants in Canada.

Findings

66.3% of Nepalese immigrants reported a delay in accessing healthcare in the past year.

Older age, lower education, and having a family doctor were associated with increased odds of delay.

Cultural and systemic factors contribute to healthcare access barriers for this immigrant group.

Abstract

Introduction: Timely access to healthcare is essential for improving population health and reducing inequities. Immigrants often experience unique cultural, linguistic, and systemic barriers that delay care-seeking and service utilization. Despite the rapid growth of the Nepalese community in Canada, there is limited empirical evidence examining their healthcare access. This study aimed to assess the prevalence and determinants of delays in accessing healthcare among Nepalese immigrants. Methods: A community-based participatory research (CBPR) framework guided a cross-sectional survey conducted between January and June 2019. The research process was co-led by academic investigators, community scholars, and local Nepalese organizations to ensure cultural and contextual relevance. A snowball sampling strategy was used to recruit 401 Nepalese adults. Data were analyzed using descriptive statistics and multivariable logistic regression to examine sociodemographic and health-related factors associated with delayed healthcare access. Results: Of the 401 respondents, 66.3% (n = 266) reported experiencing a delay in accessing healthcare within the preceding 12 months. Delays were more common among participants aged 26–45 years, those who were married, employed, or had an undergraduate degree or lower. After adjusting for covariates, older age, lower education, having a family doctor, higher income (≥$26,000), and one or more chronic conditions were associated with increased odds of delay. Family size and the number of years living in Canada have had little effect on care delay. Conclusions: Delays in accessing healthcare are common among Nepalese immigrants in Calgary, reflecting the intersection of individual, cultural, and systemic determinants. These findings underscore the importance of community-engaged, culturally responsive strategies to address barriers and promote equitable healthcare access for immigrant populations. Strengthening partnerships between health systems and immigrant communities may enhance trust, navigation, and continuity of care.