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An understanding of the cultural context & values of indigenous women and what they chose to incorporate into their pregnancy and birthing experience

Inform future policies

and interventions

Comprehensive, holistic

& Tailored care

Improved maternal &

infant health outcomes

Supporting community & family relationships

- Part of TRC Call to Action!

Goals to help support; indigenous led initiative

Client-Centered Indigenous Maternal

Health Program

Barriers

Pitfalls

  • Need to allow Aboriginal people to guide the initiative
  • Resources available to support their lead
  • Task of providing/creating education for culturally competent care.
  • Preconceived notions, mistrust of the health care system
  • Availability of grants/funding
  • The history, reputation and relationship between the Canadian healthcare system and Indigenous communities

  • Increased stigmatization by HCP's
  • 'Special treatment', stereotyping
  • Lack of similar initiatives to provide insight with regards to similar programs’ success and limitations to address

Expected Outcomes

Leadership Application

Overall Goals

Where Funding Will

Be Directed

  • Education: seminars/courses for prospective team members
  • Rent: room space for training, interviews, meetings
  • Communications: link to North/rural communities for incoming patients being evacuated, link to patient's primary HCP from incoming location

How Funding Would Be Gained

Phase #4: Planning Stage

  • Change process is defined
  • Final draft of plan developed - Taking into account force-field analysis, change agent's status, staff attributes & cost, everyone given responsibilities, change strategies

Conclusion

Phase #5: Choosing an appropriate role for the change agent, undertake force-field analysis as resistance can intensify at this point

  • Have project approved by Ethics Board - for funding
  • Apply for Aboriginal health-related directed grants through Public Health Canada
  • Specifically through First Nations and Inuit health funding
  • Come from Indigenous and Northern Affairs Canada (INAC) and Indigenous Services Canada (ISC)
  • Look for partners
  • Congress of Aboriginal Peoples

Resources

Potential Costs

Looking at phase #3 of Lippitt's Change Theory:

  • Indigenous and Northern Affairs Canada (INAC) and Indigenous Services Canada (ISC) providing funding for programs, services, and initiatives
  • Government of Canada: First Nations and Inuit health funding
  • Public Health Canada
  • Grants & contributions
  • open = wide audience
  • targeted = specific audience/person (ex. doctor)
  • directed = specific audience and field (ex. physician working out North with indigenous populations)

Phase 3: Assessment of the change agent's motivation and resources - may individuals directly involved, but can also be external resources

Outline

Assessment: motivation to change

  • Truth and Reconciliation Council Call to Action - not only a motivated movement, but a promise.

References

Who is Involved?

Our Vision

Grossman & Valiga (2017). The New Leadership Challenge: Creating the future of nursing- Ch. 9: Shaping a Preferred Future for Nursing

Kildea, S., Tracy, S., Sherwood, J., Magick-Dennis, F.,Barclay, L. (2016). Improving maternity services for Indigenous women in Australia: moving from policy to practice. Med J Aust, 205(8), 374-379.

Kolahdooz, F., Launier, K., Nader, F., Yi, K.J., Baker, P., McHugh, T., … Sharma, S. (2016).

Canadian Indigenous women’s perspectives of maternal health and health care services: A systematic review. Diversity and Equality in Health Care, 13(5), 334-348. Retriev1ed from: http://diversityhealthcare.imedpub.com

McCalman, J., Heyeres, M., Campbell, S., Bainbridge, R., Chamberlain, C., Strobel, N., & Ruben, A. (2017). Family-centred interventions by primary healthcare services for Indigenous early childhood wellbeing in Australia, Canada, New Zealand and the United States: a systematic scoping review. BMC pregnancy and childbirth, 17(1), 71.

Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management, 20(1):32-37. Retrieved from http://home.nwciowa.edu/publicdownload/Nursing%20Department%5CNUR310%5CSelecting%20the%20Best%20Theory%20to%20Implement%20Planned%20Change.pdf

Truth and Reconciliation Canada. (2015). Honouring the truth, reconciling for the future: Summary of the final report of the Truth and Reconciliation Commission of Canada. Winnipeg: Truth and Reconciliation Commission of Canada.

1. Overview - Melissa

2. Model of Change - Malaya

3. Steps that will be taken - Nicole

4. Who will be involved - Sabrina/Nicole

5. Potential Cost - Haley

6. Implementation - Malaya

7. Expected Outcomes - Haley/Sabrina

8. Conclusion - Melissa

9. Discussion - Sabrina

Ideal Interdisciplinary team:

  • Nurses
  • Both in the community and hospital
  • OB/GYN
  • Psychologist/social worker
  • Indigenous member/elder available (via Telehealth)
  • Dietician

To create a multidisciplinary team that provides client-centered, holistic maternal health care to indigenous women

Following Hesselbein and Goldsmith’s (2009) strategies to secure our vision:

1. Follow our vision

2. Incorporate culture, values, emotions, hope, ethics, spirit and behaviour.

3. Communication

4. Collaboration

5. Culturally Competent and Client Centered Care

Client-Centered Maternal Care for Indigenous Women

Nicole Amey, Malaya Sheridan, Haley Finley, Melissa Friskney, Sabrina DaSilva

Target Group:

Indigenous Pregnant Women

Phases of Lippitt’s Change Theory

(7 phases)

Steps to be taken

Discussion

-In regards to Phase 2: Assess the motivation and capacity for change – what can we do to make this change? Who should be involved? What are the steps?

Phase 1: Diagnose the problem

Phase 2: Assess the motivation and capacity for change

Phase 3: Assessment of the change agent’s motivation and resources

Phase 4: Planning stage

Phase 5: Choosing an appropriate role for the change agent

Phase 6: Implementation stage

Phase 7: Final phase ‘terminating the process’

In regards to phase #1, we must diagnose the problem

  • Nurses' lack of knowledge and education regarding indigenous maternal health
  • We recognize a need for change in health care by providing education to nurses on indigenous maternity health and being able to support indigenous women in their maternity care
  • Our Vision is to provide maternity services designed and delivered for indigenous women
  • Bridging the gap.
  • Identify gatekeepers
  • Identify possible shareholders/interest groups
  • Past research
  • Focus groups
  • Collaboration with multidisciplinary team
  • Looking at our biases
  • Ethics Board Approval

Implementation

& Timeline

We have already diagnosed our problem, now we need to work towards implementing our project. Which is building a multidisciplinary team of Health Care Practitioners that work to provide the utmost client-centred maternal care for indigenous women to create a safer, more culturally sensitive and competent birthing experience.

Year One

  • Building trusting relationships and gaining knowledge from elders and mothers/fathers in the Indigenous communities
  • Acquire a team
  • Start small
  • Training and education on culturally safe care
  • Evaluation
  • Maintenance
  • Expanding

The next 2-4 years

  • Maintenance stage
  • Have a better understanding of the resources we need and being more culturally competent for our Indigenous populations.
  • Re-evaluate & look at how we can expand
  • Spreading our teams to different hospitals
  • Incorporating community clinics to widen our approach to reaching indigenous women
  • Expanding our program into and partnering with rural communities
  • Partnering with Trent University & implementing a more indigenous focus into the maternal care foci in 2nd year
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