Patient and caregiver perspectives of health provision practices for First Nations and Métis women with gestational diabetes mellitus accessing care in Winnipeg, Manitoba.

Hannah Tait Neufeld

doi:10.1186/1472-6963-14-440

Abstract

BackgroundMore North American Indigenous women are diagnosed with gestational diabetes mellitus (GDM) than the general population. Despite the number of health problems associated with GDM, few studies have been conducted that explore Indigenous women’s understandings of GDM in an effort to develop appropriate and effective health strategies.MethodsA qualitative investigation was conducted to describe the experiences of First Nations and Métis women with GDM. Unstructured interviews and focus groups initially took place with 25 advisors such as maternal care providers and community representatives. Semi-structured explanatory model interviews were subsequently carried out with 29 First Nations and Métis women in Winnipeg, Manitoba, Canada.ResultsDivisions in health services, communication and cultural barriers exist, and limit prenatal care access as well as the consistent interpretation of diabetes education messages.ConclusionsCollectively the results suggest living with GDM can be overwhelming and underscore the need for health care providers to encourage self-efficacy towards effective management practices in the context of cultural safety.

Highlights

IntroductionMore North American Indigenous women are diagnosed with gestational diabetes mellitus (GDM) than the general population
The Report of the Royal Commission on Aboriginala Peoples chronicled the lasting influence of past discriminatory policies on the lives of Indigenous peoples in Canada
This paper presents women’s perspectives on the prenatal care they received

Summary

Introduction

More North American Indigenous women are diagnosed with gestational diabetes mellitus (GDM) than the general population. First Nations women are at more than twice the risk of developing GDM, and have higher rates of pre-existing type 2 diabetes in pregnancy [4]. The overall health of First Nations women and their families continues to be impacted through assimilative action taken by the federal government to disconnect communities from their traditional lands and knowledge systems. These complex and continuing colonial policies have resulted in profound social and cultural disruption including the exploitation of lands, resources, and cultural practices [11]. The loss of language, ties to Elders, and traditional teachings isolated children from their cultural roots [13], which has had negative consequences for the health and wellbeing of many communities

Methods

Results

Discussion

Conclusion