Informed Moms, Healthy Moms

Pregnant Indigenous people in Canada receive inadequate prenatal care relative to the general Canadian population, resulting in significant disparities in maternal and pregnancy health outcomes. This lack of access to prenatal healthcare services, specifically services delivered in a culturally-sensitive manner at the community level, represents a significant barrier impacting maternal and pregnancy health among Canadian Indigenous populations. Pregnant Indigenous women in Canada are at higher risk of preterm birth, stillbirth and infant mortality. Shockingly, Indigenous women in Canada are twice as likely to die during pregnancy, relative to non-Indigenous women.

Colonial policies, including separation from families through residential schooling, marginalization of languages and spiritual beliefs, assaults on dignity and autonomy through the introduction of assimilation policies, and racial discrimination, have had significant negative impacts on the health of Indigenous people in Canada. 

When pregnant people do not feel fully informed, they are not empowered to to make decisions that impact the health of themselves and their babies.

The Informed Moms, Healthy Moms initiative provides culturally-sensitive health information to pregnant Indigenous people in the rural First Nations community Algonquins of Barrière Lake at the community level. The components of this initiative include:

1) Facilitation of dialogue within Algonquins of Barrière Lake to identify relevant issues and provide meaningful engagement of elders, community leaders, those with lived/living experience, and researchers.

2) Establishing and operating a monthly virtual health seminar series that provides maternal and pregnancy health information to pregnant Indigenous people, with opportunities for discussion and questions. Each seminar topic will be informed by Indigenous community members. The seminar series will be delivered virtually in a collaborative format with maternal health experts from Mount Sinai Hospital in Toronto, Ontario (a tertiary maternal referral centre) and Indigenous health leaders and teachers in the rural First Nations Algonquins of Barrière Lake community. Teachings will include a combination of Western medicine and traditional Indigenous teachings and wellness strategies.

3) Generating social media content and web-based information informed by the health seminars to disseminate to pregnant Indigenous people across Canada.

This initiative is designed by Indigenous people, for Indigenous people, and led by Indigenous people in their own community. It provides pregnant Indigenous people who experiences barriers to accessing prenatal care the opportunity to engage with healthcare experts in a culturally-sensitive manner in their own community. The Informed Moms, Healthy Moms initiative works to close the gaps in health outcomes between First Nations, Inuit and Métis and non-Indigenous communities (Truth and Reconciliation Commission’s call to action #19).

The Informed Moms, Healthy Moms initiative serves pregnant Indigenous people in Canada, who experience structural, racial and ethnic inequities of health originating from multigenerational effects of colonialism.

There are many complex barriers that prevent pregnant Indigenous people from receiving high quality and culturally appropriate maternal care in Canada, including geographical distribution of healthcare facilities, lack of cultural sensitivity, distrust between patients and healthcare providers, and lack of Indigenous healthcare providers. This initiative reduces barriers pregnant Indigenous people experience when accessing prenatal health services. 

This pilot initiative will provide a national framework for improving the health of pregnant Indigenous people through the establishment of respectful partnerships, supporting Indigenous healthcare providers in a leadership capacity, and facilitating the exchange of both Western and Indigenous health teachings in a culturally-safe, collaborative manner.

Improving the health of pregnant individuals leads to improvements in the lifelong health of moms and babies, as well as the community.

The Informed Moms, Healthy Moms initiative is a pilot initiative taking place in the First Nations community of Algonquins of Barrière Lake in Quebec, Canada.

This initiative was developed through dialogue with Indigenous community members, Indigenous community leaders and Indigenous community healthcare providers regarding concerns for pregnant Indigenous people accessing prenatal care and a critical need to improve the health of moms and babies. Further engagement and direction will be provided by community members as outlined in the first initiative component, where community dialogue will be facilitated to identify relevant issues and provide meaningful engagement of elders, community leaders, those with lived/living experience, and researchers.

Indigenous healthcare leaders and community leaders are members of the Informed Moms, Healthy Moms team. This is an Indigenous-led initiative that will directly benefit and will take place within an Indigenous community.

The Informed Moms, Healthy Moms initiative is led by a unique team of maternal health experts at Mount Sinai Hospital in Toronto, Ontario (a tertiary maternal referral centre) and Indigenous healthcare leaders and providers from the First Nations community of Algonquins of Barrière Lake in Quebec, Canada. 

Early in the COVID-19 pandemic, the Indigenous leaders of Algonquins of Barrière Lake felt that an Indigenous-led community response would be the most effective strategy to minimize the potentially devastating effects. This strategy included: 1) community COVID-19 testing and public health response led by the nursing team and support staff of Algonquins of Barrière Lake Health Centre, and 2) COVID-19 vaccine community clinics led by Algonquins of Barrière Lake Health Centre. These activities enforced the rights of Indigenous peoples to self-determination and territorial sovereignty.

Since then, Indigenous healthcare leaders in Algonquins of Barrière Lake have leveraged relationships with federal, provincial, and local leadership partners to develop a number of ongoing health promotion and prevention programs addressing SARS-CoV-2, HIV/AIDS, sexual health, and gender-based violence. The Informed Moms, Healthy Moms initiative represents an organic next step to address the needs of pregnant Indigenous members of the community.

This initiative is designed to leverage existing relationships, experiences, skills, and traditional teachings from the Algonquins of Barrière Lake community and Mount Sinai Hospital to improve the health of pregnant Indigenous people in Canada.

Informed Moms, Healthy Moms is a pilot initiative that leverages existing connections between maternal health experts at Mount Sinai Hospital in Toronto, Ontario and Indigenous health leadership in Algonquins of Barrière Lake, Quebec. We are applying to Solve to advance our solutions to Indigenous health inequities through joining the powerful Solve network of innovators. The opportunity to learn and grow as members of the Solve network would provide our team with the support necessary to expand into new Indigenous communities across Canada with our solutions. Our team's objective is to become Canadian leaders in Indigenous maternal health. We believe that engaging with members of the Solve network will provide unique perspective and solutions to improving the health of rural populations facing barriers to accessing appropriate healthcare.

In addition, we believe that our team can provide unique perspectives to the members of the Solve network. The Algonquins of Barrière Lake community represents a very traditional Indigenous community with rich culture. For example, there is a 100% fluent level of Algonquin proficiency in the Anishnaabe Nation, with Algonquins of Barrière Lake being the leader at preserving the language. As part of the Solve network, we are also eager to contribute an Indigenous perspective and solutions to current challenges.

Kelsey McLaughlin is an Assistant Professor in Obstetrics and Gynecology at the University of Toronto. Her research program is focused on developing clinical strategies and therapies to improve health outcomes in high-risk pregnancies. In this role, Kelsey works alongside the high-risk obstetrics clinical care team, including national and international experts in maternal health.

Kelsey is also the Scientific Advisor of Algonquins of Barrière Lake, where she provided scientific and health care expertise to improve physical, mental, social and life health of the community. Kelsey collaborates with community and federal public health leads to develop, implement, and monitor health promotion and prevention programs addressing SARS-CoV-2, HIV/AIDS, sexual health, and gender-based violence. 

Overall, Kelsey is uniquely placed to facilitate partnerships between maternal health experts in Toronto and Indigenous healthcare providers and leaders in Algonquins of Barrière Lake to improve the health of pregnant Indigenous people in Canada.

The Informed Moms, Healthy Moms initiative represents a novel approach to challenging maternal health inequities in Indigenous communities in Canada. The innovative aspect of this initiative is the meaningful partnership between health experts and Indigenous health leaders to provide culturally-appropriate health information to Indigenous communities through a modern interface. This Indigenous informed, Indigenous led and Indigenous guided approach to community-based research is novel in Canada. It builds upon traditional knowledge and technology to address health inequities.

Establishment of trusting, respectful relationships between Indigenous community members and healthcare providers generates opportunities to address additional health inequities. This initiative was designed to be disseminated to sister Algonquin communities, as well as other First Nations, Metis and Inuit communities in Canada. Recognizing the manner in which pregnant Indigenous people in Canada consume health information is critical to disseminate accurate health information.  

The Informed Moms, Healthy Moms initiative works to close the gaps in health outcomes between First Nations, Inuit and Métis and non-Indigenous communities (Truth and Reconciliation Commission’s call to action #19).

Our goal in the next year is to establish the Informed Moms, Healthy Moms initiative. We will host a virtual health seminar series once a month, informed by and designed for pregnant Indigenous people in the rural First Nations Algonquins of Barrière Lake community. Our team will recruit the leading national maternal health experts responsible for writing national guidelines to participate as speakers in the seminar series, as well as Indigenous leaders in maternal health. We will be disseminating this health information further through generating social media content and posting the seminars on a website for public viewing. 

Our goal in the next five years is to establish ourselves as a Canadian leader in the health of pregnant Indigenous people. Following the first year, in which we will generate significant amounts of health content tailored for pregnant Indigenous people, we will leverage our existing networks in the Algonquin nations and Indigenous leaders across Canada to grow our network. We will also be focused on disseminating content, experiences and feedback to healthcare providers outside of Indigenous communities to tailor traditional healthcare systems and approach to Indigenous health. Our team will leverage existing networks in maternal health across Canada to disseminate this information, as well as publish in national academic journals. 

In the first year, we will be measuring our progress through the following specific indicators:

• Number of pregnant Indigenous people in the Algonquins of Barrière Lake Lake community who join each virtual seminar series
• Number of pregnant Indigenous people from any community in Canada who join each virtual seminar series
• Increase in pregnant Indigenous people receiving prenatal health information in the Algonquins of Barrière Lake community
• Increase in pregnant Indigenous people receiving prenatal health information from any community in Canada
• Number of visits to Informed Moms, Healthy Moms website from Algonquins of Barrière Lake
• Number of visits to Informed Moms, Healthy Moms website from across Canada
• Number of views on social media content generated from virtual health seminar series (Instagram, TikTok, Twitter)

In the first five years, we will be measuring our progress through the following specific indicators:

• Maternal mortality ratio
• Proportion of births attended by skilled health personnel
• Neonatal mortality rate
• Coverage of essential health services
• Proportion of women aged 15-49 years who make their own informed decisions regarding sexual relations, contraceptive use and reproductive health care

The Informed Moms, Healthy Moms initiative will immediately address the lack of prenatal health information provided to Indigenous pregnant people in the rural First Nations community of Algonquins of Barrière Lake. Through the dissemination of an Indigenous-informed virtual health seminar series, as well as associated social media content, this initiative will have wider impacts on pregnant Indigenous people living in Canada. 

The longer-term outcomes of the Informed Moms, Healthy Moms include supporting the rights to self-determination of health, the establishment of meaningful relationships of Indigenous people with healthcare providers, and addressing barriers that impact physical and mental health of Indigenous people in Canada. The Informed Moms, Healthy Moms initiative works to close the gaps in health outcomes between First Nations, Inuit and Métis and non-Indigenous communities (Truth and Reconciliation Commission’s call to action #19).

This initiative is based on the concept of empowerment. 

• Pregnant Indigenous people in Canada will receive relevant maternal health information from Canadian maternal health experts and Indigenous health leaders, empowering them to make their own health decisions
• Pregnant Indigenous people will have the opportunity to inform the virtual health seminar series topics, empowering them to guide their own learnings
• Indigenous healthcare leaders will lead the initiative, empowering them to develop community-based health initiatives
• The Algonquins of Barrière Lake community will be provided the opportunity to share traditional teachings and knowledge, empowering them to participate in the health and wellness of community members
• Maternal health experts at Mount Sinai Hospital in Toronto, Ontario will be offered the opportunity to participate in this initiative, empowering them to have meaningful interactions with Indigenous populations that will carry forward in their medical practice

The core technology that powers the Informed Moms, Healthy Moms initiative is the leveraging and sharing of knowledge, including both Western medicine and Indigenous healing. This initiative is addressing barriers to healthcare experienced by pregnant Indigenous people in Canada. 

The Informed Moms, Healthy Moms initiative will build upon the pandemic-driven shift to virtual medicine and sharing of health information across social media platforms. The virtual health seminar series will overcome physical barriers to healthcare by connecting maternal health experts at Mount Sinai Hospital in Toronto, Canada and pregnant Indigenous people in Algonquins of Barrière Lake. It will also disseminate the teachings from these seminars across Canada through through generated social media content.

The Informed Moms, Healthy Moms team is diverse, with representative across many walks of life. We are focused on listening, seeking to understand and building the foundation for systemic and transformational change.

• Kelsey McLaughlin: Assistant Professor in Obstetrics & Gynecology at the University of Toronto with over 10 years of experience developing clinical programs, strategies and therapies to improve the health of high-risk pregnant people in Canada. She is the Scientific Advisor for the rural First Nations community of Algonquins of Barrière Lake.
• Nicole Ratt: an Indigenous community leader from the Algonquin community of Algonquins of Barrière Lake, Quebec, she has been the health director of the Algonquins of Barrière Lake Health Centre for 5 years.
• Jamie Carle: an Indigenous nurse from the Algonquin community of Kitigan Zibi Anishinabeg, Quebec, she has been a nurse for 12 years, with experience in the hospital setting, acute care, medicine, palliative, and psychiatry. She was also a nurse within Kitigan Zibi Anishinabeg doing nurse in charge work, maternal child health & community health. She is currently work as a clinical nurse at the Wanaki Centre (treatment centre for substance misuse for First Nation people).
• Brianna Decontie: an Indigenous nurse from the Algonquin community of Kitigan Zibi Anishinabeg, Quebec, she has been a nurse for 5 years in various Indigenous communities. Her nursing experience includes acute care, community care, family health, maternal child health, and management within remote and rural Indigenous communities. She is an Indigenous doula and a second attendant to Kitigan Zibi’s midwife. She currently works at the Kitigan Zibi Health and Social Services as the nurse in charge.
• Rachel Spitzer: Obstetrician and Gynaecologist at Sinai Health System and Vice Chair of Global Women's Health and Advocacy in the Department of Obstetrics and Gynaecology at the University of Toronto. She has a concentration in International Health and Women and Gender Health.

Our collective experience working to improve the health of pregnant people from diverse and high-risk communities have contributed to our experiences of developing inclusive health, research, and education strategies. The majority of the Informed Moms, Healthy Moms team self-identify as Indigenous (First Nations), with support from applicants who have had meaningful and culturally safe involvement with Indigenous Peoples at a patient, community and federal level. This proposal 1) prioritizes the First Nations community of Algonquins of Barrière Lake, 2) promotes cultural safety of and appropriate engagements working with Indigenous Peoples in meaningful ways to ensure that respectful relations are established, and 3) adds value to the research through the use of Indigenous culturally relevant theoretical and conceptual frameworks.

This proposal outlines Indigenous health research; it is community-based research focused on Indigenous health that is conducted by, grounded in, and engaged with a First Nations community with their wisdom, cultures, experiences or knowledge systems, as expressed in their dynamic forms, past and present. This proposal embraces the intellectual, physical, emotional and spiritual dimensions of knowledge in creative and interconnected relationships with people, places and the natural environment. 

This initiative is run by a non-profit organization. The products generated by the Informed Moms, Healthy Moms initiative include:

• Virtual health series seminars for pregnant Indigenous people in the rural First Nations community of Algonquins of Barriere Lake
• Social media content summarizing the knowledge shared in the seminar series for pregnant Indigenous people across Canada

These products will be provided in partnership with maternal health experts at Mount Sinai Hospital in Toronto, Ontario and Indigenous healthcare leaders in Algonquins of Barriere Lake, as well as the Informed Moms, Healthy Moms team.

The design of these products was informed directly through community dialogue with pregnant Indigenous people and healthcare workers in Algonquins of Barriere Lake.

This initiative is run by a non-profit organization. We require grants and donations to fund the Informed Moms, Healthy Moms initiative. We are currently exploring and completing for local, departmental, federal and international competitions for financial support of these products.

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