The past two decades have seen an incrementally steady development in maternal and infant health programming targeted to Aboriginal communities. This paper reviewed existing maternal and infant health programs and guidelines as administered under the First Nations and Inuit Health Branch. While the aim here is help assess the extent to which populations may be under-served or un-served by current Aboriginal maternal and infant programming, it is by no means intended to discredit the efforts of FNIHB, but simply to highlight where further spending could lead to better health outcomes for a greater number of people.
Although improvements were noted in most cases over the years, a quantitative and qualitative analysis of data sources revealed that varying levels of gaps in service still remained for these programs, including: Aboriginal Head Start On-Reserve; Brighter Futures; Canada Prenatal Nutrition Program; Fetal Alcohol Spectrum Disorder Program; Maternal Child Health; Targeted Immunization Strategy; and the Children’s Oral Health Initiative. These gaps in service generated 14 recommendations for future consideration, as follows:

RECOMMENDATION: That increased, multi-year funding for all Aboriginal maternal and infant health programs be offered across a greater number of First Nations and Inuit communities in order to close the gap in health outcomes for women and children in these communities.

RECOMMENDATION: That community-based focus groups/dialogues be held, alongside one-to-one interviews, in order to incorporate and give voice to the concrete experiences and perspectives of First Nations and Inuit women on current maternal and infant programming.

RECOMMENDATION: That a fuller, wider scan and gaps analysis, with a specific focus on universal provincial and territorial programs, be conducted for a truly complete picture of the scope and scale of maternal and infant health programming reaching First Nations and Inuit communities.

RECOMMENDATION: That a research methodology be designed and implemented to capture the use, limitations and experiences of urban Aboriginal populations in accessing universal provincial and territorial maternal and infant programs.

RECOMMENDATION: That analysis be conducted as to the budget actually spent on the direct, ‘front-line’ delivery of Aboriginal maternal and infant health programming, i.e., distinguishing federal program administration costs from what actually reaches the communities.

RECOMMENDATION: That training be made available closer-to-home in remote and rural areas and incentives investigated for retaining/recruiting trained workers in their communities.

RECOMMENDATION: That funding for Aboriginal maternal and infant health programs be moved to a multi-year arrangement with more streamlined application/reporting procedures.

RECOMMENDATION: That partnerships be encouraged and explored with cultural and educational organizations to create culturally- and linguistically-appropriate materials for health-related purposes.

RECOMMENDATION: That a review of best practices in cultural competency within other global indigenous contexts (e.g., New Zealand and Maori) be undertaken, including cost/benefit and impact assessment elements of culturally-relevant health information.

RECOMMENDATION: That communities be encouraged to develop specific metrics for gauging cultural success in their proposals, based on criteria that they themselves determine.

RECOMMENDATION: That Jordan’s Principle be implemented by all levels of government, and that it be heralded as a best practice in child-centered care.

RECOMMENDATION: That the Society of Obstetricians and Gynecologists of Canada’s Aboriginal Birthing Initiative be looked upon as a best practice in moving Aboriginal midwifery forward toward the repatriation of birthing to Aboriginal communities.

RECOMMENDATION: That the “creation of an accurate, rigorous, data-gathering mechanism for maternity care,” as called for by the SOGC be extended to all First Nations, Inuit and Métis communities.

RECOMMENDATION: That midwifery be promoted and supported as an educational and career choice for Aboriginal people.

RECOMMENDATION: That Aboriginal maternal and infant health programs integrate and promote the participation of fathers, and/or other male supports, throughout the pre-, peri- and post-natal continuum.

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