What are some of the issues for First Nations Communities?
Evidence shows that First Nations women do not enjoy the same level of access to prenatal health care as other women in British Columbia, particularly those living in rural communities. The Transformative Change Accord First Nations Health Plan commits to bringing “Birth closer to home and into the hands of women.” BC First Nations have urged the mainstream health care system to recognize the unique place of midwifery in First Nation communities and the role of midwifery in the holistic view of childbirth. Midwifery is not accessible to most First Nations women living in poverty or in rural areas. Many of the women are forced to leave home to give birth to their babies in regional hospitals, great distances away from their families.
For children, oral health is a key issue despite some of the successful initiatives and practical measures like the dental therapists program of FNIHB and Head-start programs. Hearing and vision screening services are not equitably provided to First Nations communities. Injuries caused to children through lack of routine seatbelt use by caregivers is a major issue.
What is our Strategic Goal?
The strategic goal of the Maternal & Child Health ‘cluster’ is to improve geographic and equitable access to all relevant services (including those delivered by Government, mainstream agencies and First Nations communities); work to ensure services are culturally responsive and safe for First Nations consumers and to focus on prevention & public health while improving ‘front line’ early intervention; treatment, referral and follow up services.
Tripartite Strategy Council Terms of Reference | pdf download |
Maternal and Child Health Committee
One of the most significant gains for First Nations in the area of Maternal and Child Health was the establishment of the Aboriginal Maternal and Child Health Committee in 2008. This Committee, which includes representation from First Nations as well as the tripartite partners, has a role of assisting in enhancing and integrating culturally appropriate health services to Aboriginal children, women and communities in BC and providing direction and leadership around Aboriginal maternal and child health initiatives. The committee set strategic direction to look at three key action areas articulated in the TFNHP:
- Ensuring vision, hearing and dental screening for Aboriginal children
- Improving access to (the full range of) maternity services for Aboriginal women
- Addressing issues arising from the BC Coroner’s office Child Death Review Report
Aboriginal Maternal and Child Health Committee Terms of Reference| pdf download |
First Nations feedback on maternal and child health serves as a foundation for the future direction of the Committee’s work and strategic planning. In reviewing the BC First Nations Submission on Blueprint for Aboriginal Health (AFN) 2005, Gathering Wisdom Forums 2007-2009, Health Director’s Forum (2008) and Regional Caucus Sessions (2008-10), some of the key themes and priorities identified by First Nations communities regarding maternal and child health are as follows:
Maternal and Child Health
- Cultural competency, holistic and wellness focused services are needed – ensure traditional teachings, language and culture; elders knowledge and experience and community-driven models are supported
- Focus on prevention and promotion in child and maternal health – not just screening and treatment
- Infant mortality should include CDRU; SIDS; SBS and other causes of child death
Child Health
- Focus on pre-conception through to infant/child development
- Screening should look beyond hearing, dental and vision to other screening (e.g. TB)
- Include a family focus – parenting, fatherhood and ensure Early childhood development is prioritized
Maternal Health
- Bring maternity services closer to home for mothers in remote and rural areas particularly
- More training for Aboriginal midwives and support people (Doula)
In terms of next steps, the Committee remains focused on the strategic priorities that have been identified in the area of maternal and child health and will continue to work with First Nations and tripartite partners to address the many issues facing First Nations with respect to maternal and child health.
Specific Health Actions from the TCA: FNHP and TFNHP
TCA # 10 - To improve child vision, hearing and dental screening for First Nations children
TCA # 11 - Follow up on the 2005 Child Death Review report with the BC Coroner’s office
TCA # 21 - Improve access to maternity services for Aboriginal women