Barriers and facilitators to accessing community-based health and social services among mothers experiencing social and structural disadvantage: a mixed-methods study

A community-partnered mixed-methods study in Greater Vancouver, British Columbia, identified interconnected barriers to community-based health and social services among mothers experiencing social and structural disadvantage. Participants described unstable housing, mental health challenges and experiences of maltreatment, alongside gaps in access, coordination and continuity between services. Their accounts also highlighted the importance of safer service environments and an approach oriented toward whole health.

The research focused on mothers of young children who had recently used services through a community-based nonprofit organization, including emergency shelters and substance use treatment. Between April and November 2022, investigators collected survey data from 38 participants and then conducted in-depth, semi-structured interviews with 20 mothers. The study combined survey analysis using descriptive statistics with reflexive thematic analysis of the interviews, allowing the researchers to examine both the characteristics of the group and participants’ detailed experiences of service access and use.

Analysis identified three themes: understanding and addressing access limitations, providing safer services, and orienting services toward whole health. The first theme captured barriers arising across systemic, structural and interpersonal levels, including limited connections between community-based organizations and formal health and social systems. The theme of providing safer services reflected participants’ concern with the conditions under which assistance was delivered.

Participants identified supports and system-level solutions alongside the barriers they encountered, providing a service-delivery perspective grounded in the experiences of mothers with recent contact with community services. The study was conducted with mothers of young children who had recently accessed services through one community-based nonprofit organization in a single metropolitan area. Its 38 survey participants and 20 interviewees provide detailed accounts of barriers and facilitators rather than a population-wide estimate of their prevalence.

The authors said the findings have implications for similar community-based organizations and for broader efforts to improve health service delivery for mothers and children facing intersecting disadvantages. The research was published as an early, peer-reviewed version in BMC Health Services Research on 21 October 2026 and was subject to further edits before replacement by the final Version of Record.

Subject of Research: Community health and social service access among mothers experiencing social and structural disadvantage

Article Title: Barriers and facilitators to accessing community-based health and social services among mothers experiencing social and structural disadvantage: a mixed-methods study

Article References: Catherine, N. L. A., Blyth, E. R., Moloney, M., White, O., Tang, J., Barican, J., Patrick, L., Urbina-Beggs, M., & Thomson, K. (2026). Barriers and facilitators to accessing community-based health and social services among mothers experiencing social and structural disadvantage: a mixed-methods study. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15834-y

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15834-y

Keywords: maternal health, service access, social disadvantage, housing instability, community health services, service coordination, structural inequity, mixed methods, Greater Vancouver, whole health, Barriers, facilitators