How Indigenous mothers experience selecting and using early childhood development services to care for their infants

ABSTRACT

Purpose: Promoting a child’s healthy growth and development in the first six years of life is critical to their later health and well-being. Indigenous infants experience poorer health outcomes than non-Indigenous infants, yet little is understood about how parents access and use health services to optimize their infants’ growth and development. Exploring the experiences of Indigenous mothers who select and use early childhood development (ECD) services provides important lessons into how best to promote their access and use of health services.

Methods: This qualitative interpretive description study was guided by the Two-Eyed Seeing framework and included interviews with 19 Indigenous mothers of infants less than two years of age and 7 providers of ECD services.

Results: Mainstream (public) and Indigenous-led health promotion programs both promoted the access and use of services while Indigenous-led programs further demonstrated an ability to provide culturally safe and trauma and violence-informed care.

Conclusions: Providers of Indigenous-led services are best suited to deliver culturally safe care for Indigenous mothers and infants. Providers of mainstream services, however, supported by government policies and funding, can better meet the needs of Indigenous mothers and infants by providing cultural safe and trauma and violence-informed care.

KEYWORDS:

• Indigenous maternal/child health
• qualitative research
• community health services
• health services research
• health promotion
• equitable health care
• Canada
• infants
• culturally safe care
• early childhood development

Acknowledgments

We would like to acknowledge the mothers who bravely shared their stories to help nurses and other clinicians improve access to health care for their infants and families. We also extend gratitude to the Hamilton Indigenous Friendship Centre who supported this research and contributed to study design and recruitment. Finally, we want to acknowledge the funding received by the first author to support this research from the Canadian Institute of Health Research (CIHR) Fellowship, Priority Announcement: Research in First Nations, Metis and/or Inuit Health. FRN 146613.

Disclosure statement

No potential conflict of interest was reported by the authors.

Correction Statement

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

Additional information

Funding

This work was supported by the CIHR Fellowship, Priority Announcement: Research in First Nations, Métis and/or Inuit Health [FNF 146613];

Notes on contributors

Amy L. Wright

Amy L. Wright is a PhD student in the School of Nursing at McMaster University, and 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.