Medical Interpreting Services for Refugees in Canada – Current State of Practice and Considerations in Promoting this Essential Human Right for All (2024) 

What is this research about? 

This research examines the current state of medical interpreting services for refugees in Canada. Limited English or French language proficiency can create significant barriers to healthcare access and quality.  The authors make the case that these services are an essential human right while analyzing implementation challenges and opportunities across different jurisdictions.  

What do you need to know? 

The study provides an examination of medical interpreting services across Canada’s provinces and territories, analyzing various models of service delivery and funding mechanisms. Authors also explore the increase in telephone-based and video-conferencing interpreting services as a result of the COVID-19 pandemic. They raise questions about how and when remote interpreting can and should be used as an effective alternative to in-person interpreting. 

To make the case for the funding and provision of medical interpreting services, particularly for refugees, authors combine ethical arguments based on human rights principles with practical considerations of implementation and cost-effectiveness.  

What did the researchers do? 

Researchers conducted an analysis of medical interpreting services across Canada’s healthcare system. They reviewed current medical interpreting options available and key considerations in their adoption. They make recommendations for the implementation of interpreting services at the individual, provider, and system levels. 

Their methodology included:  

• Consulting with colleagues from the Canadian Refugee Health Network 
• Gathering direct information from healthcare professionals across provinces who represented diverse healthcare roles. 

What did the researchers find? 

The authors describe the state of medical interpreting services across Canada including inconsistencies and current gaps. Over time, they find, there has been relatively little progress in reducing language-related barriers to health services. They argue that interpreting services is a right and obligation, not a privilege, and that the provision of interpreting services makes economic sense.  

The research revealed significant disparities in medical interpreting services across Canada:  

• Funding is inconsistent across the country in terms of allocation value, mechanism, oversight, and promotion.   
• There is confusion about how interpreting service should be provided and in what format (eg. Remote vs in-person, and by whom). 
• Data collection practices vary widely (e.g., lack of consistency in preferred language screening and utilization of language support)   

How can you use this research? 

This research provides specific recommendations for different stakeholders. 

For Government/Policymakers:  

An accessible and inclusive health system requires the provision of medical interpreting. Government should: 

• Ensure national standards for professional interpreters are adopted across the industry, including for community interpreting services. 
• Create comprehensive funding strategies. 
• Include mandatory interpreter utilization in healthcare provider regulatory guidelines. 

The table below summarizes findings from Access Alliance’s 2021 literature review Investing in Language Access to Optimize Health System Performance. It demonstrates how investments in language access in general, and professional interpreting in particular, contribute to a higher performing health system. 

For Healthcare Organizations:  

Healthcare organizations should provide a safe, welcoming and culturally responsive environment. Healthcare organizations should: 

• Establish mandatory cultural competence training. 
• Integrate interpretation interpreting access into EMR systems. 
• Develop language access plans, including how and when interpreter services will be available and used. 
• Implement decision support tools to decide when interpreter services are needed. 

For Frontline Healthcare Service Practitioners:  

Individual service providers and clinics have many demands on their time and resources, but can be supported and encouraged in the uptake and use of medical interpreting. Practitioners should: 

• Receive training on working with medical interpreters. 
• Participate in cultural competency courses. 
• Empower refugee patients to advocate for their right to interpreting services, including participating in the development and evaluation of interpreting programs. 
• Be informed about effective and promising practices from peers, as well as research on interpreting service access. 

Study authors and journal/book name 

Authors: Akshaya Neil Arya, Ilene Hyman, Tim Holland, Carolyn Beukeboom, Catherine E. Tong, Rachel Talavlikar, and Grace Eagan 

Publication: International Journal of Environment Research and Public Health (original link)

Related Access Alliance Activities & Products 

Investing in Language Access to Optimize Health System Performance – A Review of the Literature (2021) 
This literature review explores findings from over 120 sources, examining research done in Canada and around the world. It organizes the literature in alignment with the four goals of the Quadruple Aim Framework: Better Health Outcomes, Improved Patient Experience, Improved Staff Experience, and Lower Cost of Care. The report makes the argument that language interpreting services lead to a higher performing Canadian healthcare system. The report provides an update on previous research from 2009, making a business case for investing in professional interpreting services. 

RIOMIX Multilingual Information Library 
A collaborative, centralized and accessible repository of translated materials and multilingual websites relating to health and community care and support. The library can be searched by language, topic, category and keyword. Items in the library include the English source and information about the publication (e.g., author, date, translation methodology). 

Access Alliance Language Services 
Established in 1990, Access Alliance Language Services (AALS) delivers high quality language access services to Access Alliance and a diverse range of health, social, and public sector organizations. We provide a wide range of services including interpreting (on-site and remote), translation, audio/video language recordings, interpreter professional development training, and consulting and training services to support organizations achieve their language access goals and meet the language needs of the individuals, families, and communities they serve. 

Community Interpreting in Canada: An Information Session for Afghan Interpreters and Language Assistants 
Presentation slides from 2021 providing information about Interpreter Accreditation and Certification Organizations, Interpreting Initiatives happening across Canada, Overview of College Language Interpreter Training Programs. 

For more info contact: research@accessalliance.ca