Abstract
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.
Highlights
The social determinants of health such as income, education, gender and access to health care, play a key role in the health of individuals (Reading & Wien, 2009)
Results speak to the challenges experienced by mothers, which we believe may be mitigated by taking an approach to primary care that intersects culturally safe, trauma and violence-informed (TVIC), and family-centred care (FCC) models (Figure 1)
Through the Truth and Reconciliation Commission of Canada (TRC) and its mandated Calls to Action, health providers are encouraged to engage in education to enhance their awareness of how colonization has resulted in social inequities, structural violence and trauma for Indigenous people
Summary
The social determinants of health such as income, education, gender and access to health care, play a key role in the health of individuals (Reading & Wien, 2009). Adequate access to primary care is one important way to mediate the effects of inequities that result in higher rates of disease, injury and mortality for some Indigenous infants (Reading & Wien, 2009; Reading & Halseth, 2013; Smylie et al, 2010). Despite these potential benefits, 13% of mothers in Canada report difficultly accessing care for their infants (Brandon et al, 2016). An earlier study with First Nations parents in Hamilton, Ontario, reported barriers that included long wait lists, transportation problems and an inability to afford health services (Smylie et al, 2011)
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