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Canada has a globally recognized universal health-care system. However, immigrants experience a number of obstacles in obtaining primary health care (PHC) that may differ within various communities due to the intersection of culture, gender and other identities. To date, no research has been done on the difficulties Nepalese immigrant women in Canada may face accessing PHC. The purpose of this study was to learn about their perceptions of barriers to PHC access and to share the findings with a wide range of stakeholders, including health-care providers and policymakers.

The authors conducted a community-engaged qualitative study in Calgary, Alberta, Canada. A total of six focus group discussions (FGD) among 34 participants (each FGD consisted of 5–7 participants) were conducted. The authors collected demographic information before each focus group. The FGDs were audio recorded and transcribed verbatim. The transcriptions were coded and analysed thematically.

The focus groups identified long wait times as a major barrier to receiving PHC services. Long wait times in emergency rooms, unable to see family doctors when they were sick, tedious referral procedures, long waits at the clinic even after scheduling an appointment, family responsibilities and work all impacted their access to PHC. Further, a lack of proficiency in English was another significant barrier that impeded effective communication between physicians and immigrant women patients, thus compromising the quality of care. Other barriers mentioned included lack of access to medical records for walk-in doctors, insufficient lab/diagnostic services, a lack of urgent care services and unfamiliarity with the Canadian health-care system.

Accessible PHC is essential for the health of immigrant populations in Canada. This study recognizes the extent of the barriers among a relatively less studied immigrant population group, Nepalese immigrant women, which will help effectively shape public policy and improve access to PHC for the versatile immigrant population fabric in Canada.

This integrative review was conducted to provide an overview of existing research on digital (in)equity and the digital divide in developed countries.

We searched academic and grey literature to identify relevant papers. From 8464 academic articles and 183 grey literature, after two levels of screening, 31 articles and 54 documents were selected, respectively. A thematic analysis was conducted following the steps suggested by Braun and Clarke and results were reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

The results showed that most articles and papers were either from Europe or North America. Studies used a range of research methods, including quantitative, qualitative and mixed methods. The results demonstrated four major dimensions of the digital divide among various vulnerable groups, including digital literacy, affordability, equity-deserving group-sensitive content and availability or access to infrastructure. Among vulnerable groups, low-income people were reported in the majority of the studies followed by older adults, racial and ethnic minorities, newcomers/new immigrants and refugees, Indigenous groups, people with disabilities and women. Most reported barriers included lack of access to the internet, digital skills, language barriers and internet costs.

To the best of our knowledge, there have been limited attempts to thoroughly review the literature to better understand the emerging dimensions of digital equity and the digital divide, identifying major vulnerable populations and their unique barriers and challenges. This review demonstrated that understanding intersectional characteristics (age, gender, disability, race, ethnicity, Indigenous identity and immigration status) and their interconnections is crucial for analyzing the dynamics of digital (in)equity and divide.