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Canadian Public Health Association Halifax, June 3, 2008

Enhancement of Prenatal Programming for First Nations: Two Approaches to the Roll-Out of the Maternal Child Health Program. Canadian Public Health Association Halifax, June 3, 2008. Maternal Child Health Program (MCH).

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Canadian Public Health Association Halifax, June 3, 2008

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  1. Enhancement of Prenatal Programming for First Nations: Two Approaches to the Roll-Out of the Maternal Child Health Program Canadian Public Health Association Halifax, June 3, 2008

  2. Maternal Child Health Program (MCH) • 2005 Federal budget new health investments to improve the health of Aboriginal People • Maternal Child allocated $110M over 5 years (Up Stream investment) • Goal is to support pregnant First Nations Women and families with infants and young children to reach fullest developmental and lifetime potential

  3. MCH Program Description cont: • Provide Home Visits by nurses and lay family visitors during pregnancy, postpartum and early childhood • Links children and families with special needs to services • Enhances Health Promotion programming • Returns safe birthing closer to the communities/enhancement of traditional beliefs and practices

  4. Two Regions,Two Different Approaches • Atlantic Region: population 27K over four provinces • Family Health Team made up of AHSOR, FASD, CPNP, Injury prevention and MCH • Co management Structure Mi’kmaq and Maliseet Atlantic Health Board (MMAHB) • Child and Youth Health Advisory Committee

  5. Atlantic Region Process • Presentations to and support from both All Chiefs and MMAHB • Mandated to have a minimum of one project per province • Full participation of MMAHB Child and Youth Health Advisory Committee • Agreement of the C&Y committee to support the following: • Max 150K per project • Min one project per province • To cluster wherever possible • Funds to support planning

  6. Atlantic Region Roll-out • Proposal handbook based on baseline data requirements and goals of the program • Need a combined population of 400 as minimum for project • Facilitated workshop to review proposal handbook • 6 projects approved: 2 stand alone and 4 cluster • All received funds to support development of project workplan

  7. Project implementation Atlantic • All projects have coordinators in place • Each cluster has coordinator plus HV in each site • All participants have been offered Growing Great Kids HV training as the platform for programming (used in NS) • Several sites have integrated their program with FASD/CPNP programming to provide seamless services

  8. Looking Forward Atlantic • Ensure staff are trained • Full implementation of home visiting program • Develop and or enhance linkages with the provinces • Look at projects for communities without MCH program • Provide training to any communities that are interested • Annual networking sessions

  9. BC Region Demographics and Organization • Population on-reserve 65K in 204 communities • Community population range 30-2,500 • 45 remote-isolated /isolated • 78 semi-isolated • 81 non-isolated • ECD Program unit comprises MCH,FASD and AHSOR • Guided by Tripartite Health MOU-FNIH/Province/FN leadership Council

  10. BC Region Process • Ad hoc committee from interested communities • Development of selection criteria • Funding criteria • TOR for ongoing Advisory Committee • Regional Advisory Committee • Communities, FN organizations, gov’t staff, technical experts • 2 rounds of funding allocation

  11. BC Region Roll-out • Round 1 – minimum population of 80 (age 0 – 6) • Round 2 – Smaller communities, less capacity • Selection based on service gaps, funding inequities, feasibility, variety • 16 sites selected (6 cluster + 10 individual) serving 43 communities • Funding levels $75,000 - $250,000

  12. BC Project Implementation • Workplans completed • Family visitors in place • Training offered, including: • Invest in Kids • Motivational Interviewing • Ages and Stages screening

  13. Looking Forward in BC • Addition of 3 – 5 new projects • Doula training • Ongoing training – basic, case management, enrichment • Annual resource fair • Development of new advisory based on tripartite relationships

  14. Recommendations/Lessons Learned • Provide training earlier • Provide suggestions for activities between hiring and training • Significant support required for some communities to develop and implement • Need for early exploration of linkages and partnerships and clarification of roles

  15. Recommendations/Lessons Learned (cont) • Successful implementation depends on stable nursing support • Program addresses needs and is enthusiastically received

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