Indigenous mothers’ experiences of using primary care in Hamilton, Ontario, for their infants

ABSTRACT

Purpose: Access to primary care can help mitigate the negative impacts of social inequity that disproportionately affect Indigenous people in Canada. Despite this, however, Indigenous people cite difficulties accessing care. This study seeks to understand how Indigenous mothers—typically responsible for the health of their infants—living in urban areas, experience selecting and using health services to meet the health needs of their infants. Results provide strategies to improve access to care, which may lead to improved health outcomes for Indigenous infants and their families.

Methods: This qualitative interpretive description study is guided by the Two-Eyed Seeing framework. Interviews were conducted with 19 Indigenous mothers and 5 primary care providers.

Results: The experiences of Indigenous mothers using primary care for their infants resulted in eight themes. Themes were organized according to three domains of primary care: structural, organizational and personnel.

Conclusions: Primary care providers can develop contextual-awareness to better recognize and respond to the health and well-being of Indigenous families. Applying culturally safe, trauma and violence-informed and family-centred approaches to care can promote equitable access and positive health care interactions which may lead to improved health outcomes for Indigenous infants and their families.

KEYWORDS:

• Primary health care
• health services
• Canada
• qualitative research
• health equity
• maternal/child health
• Indigenous mothers and infants

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Early childhood development services consist of parenting supports that promote parent-infant attachment and healthy infant growth and development.

Additional information

Funding

This work was supported by the Canadian Institute of Health Research (CIHR) Fellowship, Priority Announcement: Research in First Nations, Métis and/or Inuit Health [FRF 146613].

Notes on contributors

Amy L. Wright

Amy L. Wright is an Assistant Professor in the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto. She is also a Neonatal Nurse Practitioner, with a research focus on improving access to health care for Indigenous mothers and children.

Susan M. Jack

Susan M. Jack is an Associate Professor in the School of Nursing as well as an Associate Member in the Department of Clinical Epidemiology & Biostatistics at McMaster University. She has extensive research experience in family health, vulnerable populations, and knowledge translation.

Marilyn Ballantyne

Marilyn Ballantyne is an Adjunct Professor in the School of Nursing at McMaster University, Adjunct Professor at the Lawrence S. Bloomberg Faculty of Nursing at the University of Toronto, and Chief Nurse Executive and Clinician Investigator at Holland Bloodview Kids Rehabilitation Hospital. Her research program addresses how infant-parent interventions and improved access to follow-up programs can achieve healthy outcomes for children at high risk of developmental delay and their families.

Chelsea Gabel

Chelsea Gabel is an Assistant Professor at McMaster University in the Department of Health, Aging and Society and cross-appointed with McMaster’s Indigenous Studies Program. She is an emerging Indigenous scholar with a strong research and teaching background in the field of Indigenous policy, including Indigenous politics, health policy, social policy, and community-based participatory research.

Rachel Bomberry

Rachel Bomberry is a PhD student at McMaster University and an emerging Indigenous scholar. Rachel is First Nations, Mohawk, and resides with her family within Six Nations of the Grand River, Ontario.

Olive Wahoush

Olive Wahoush is the Associate Director, Newcomer Health, Community and International Outreach, in the School of Nursing at McMaster University. Her research interests include access to health care for vulnerable populations such as immigrant and refugee populations.