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Canadian Journal of Public Health

, Volume 98, Issue 4, pp 321–325 | Cite as

‘Making a Difference’: A New Care Paradigm for Pregnant and Parenting Aboriginal People

  • Dawn A. SmithEmail author
  • Nancy C. Edwards
  • Patricia J. Martens
  • Colleen Varcoe
Article
  • 1 Downloads

Abstract

Objective

To describe community-based stakeholders’ views of how safe and responsive care “makes a difference” to health and well-being for pregnant and parenting Aboriginal people. Community-based stakeholders included community members, providers of health and social care, and health care and community leaders.

Methods

A postcolonial standpoint, participatory research principles and a case-study design were used to investigate two Aboriginal organizations’ experiences improving care for pregnant and parenting Aboriginal people. Data were collected through researcher field notes, exploratory interviews and small group discussions with purposively selected community-based leaders, members and providers. Data were analyzed using an interpretive descriptive method.

Results

Community participants’ views of “making a difference” emphasized: recognizing relevant outcomes of care; acknowledging progress over time; and using a strengths-based approach in which providers appreciate individuals’ efforts and the challenges of their contextual circumstances.

Discussion

“Making a difference” to pregnant and parenting Aboriginal people would facilitate Aboriginal peoples’ efforts to tackle the deeply embedded socio-historical determinants of well-being and capacity, and thus shift priorities for care upstream to focus on such determinants. Such a paradigm for care would integrate multiple perspectives on desirable outcomes within local frameworks based on values and priorities of Aboriginal parents, while also incorporating the benefits and wisdom of existing yet further downstream approaches to care.

Conclusion

Design and evaluation of care based on community values and priorities and using a strengths-based approach can improve early access to and relevance of care during pregnancy and parenting for Aboriginal people.

MeSH terms

Indigenous health services prenatal care postpartum programs health care quality access evaluation 

Résumé

Objectif

Décrire la façon dont les intervenants communautaires perçoivent l’importance de soins sûrs et adaptés pour « faire une différence » sur les plans de la santé et du bien être des femmes enceintes et des parents autochtones. Parmi les intervenants communautaires, on compte des membres des communautés, des fournisseurs de soins de santé et de services sociaux, ainsi que des responsables communautaires et sanitaires.

Méthodologie

Une perspective postcoloniale, des principes de recherche participative et une étude de cas ont été employés pour examiner deux expériences d’organismes autochtones pour améliorer les soins prodigués aux femmes enceintes et aux parents autochtones. Les données ont été recueillies à partir des notes des chercheurs travaillant sur le terrain, d’entrevues exploratoires et de discussions en petits groupes avec des fournisseurs ainsi que des responsables et des membres de la communauté, tous choisis à dessein. Les données ont été analysées à l’aide d’une méthode descriptive d’interprétation de données.

Résultats

Les perceptions des intervenants communautaires sur l’importance de soins sûrs et adaptés pour « faire une différence » qui ressortent sont: la reconnaissance de résultats pertinents en matière de soins, la reconnaissance de progrès graduels et l’utilisation d’une démarche axée sur les forces, laquelle permet aux fournisseurs d’apprécier les efforts déployés par les personnes et les défis posés par leur situation contextuelle particulière.

Discussion

« Faire une différence » sur les plans de la santé et du bien-être des femmes enceintes et des parents autochtones pourrait faciliter le travail entrepris par les peuples autochtones pour s’attaquer aux déterminants sociohistoriques, profondément ancrés, du bien-être et de la capacité et, par conséquent, entraîner un changement de priorités en matière de soins en amont afin de se concentrer sur ces déterminants. Un tel paradigme de soins intégrerait plusieurs perspectives quant aux résultats souhaitables à l’intérieur de cadres locaux, en fonction des valeurs et des priorités des parents autochtones, tout en intégrant les avantages et la sagesse d’approches existantes en aval en matière de soins.

Conclusion

La conception et l’évaluation de soins fondées sur les valeurs et les priorités communautaires et faisant appel à une démarche axée sur les forces peuvent favoriser l’accès rapide aux soins et la pertinence de ceux-ci pour les femmes enceintes et les parents autochtones.

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Copyright information

© The Canadian Public Health Association 2007

Authors and Affiliations

  • Dawn A. Smith
    • 1
    Email author
  • Nancy C. Edwards
    • 2
  • Patricia J. Martens
    • 3
  • Colleen Varcoe
    • 4
  1. 1.School of NursingUniversity of OttawaOttawaCanada
  2. 2.School of Nursing and Department of Epidemiology and Community MedicineUniversity of OttawaCanada
  3. 3.Department of Community Health SciencesUniversity of ManitobaWinnipegCanada
  4. 4.School of NursingUniversity of British ColumbiaVancouverCanada

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