A unique Indigenous-led, community-hospital-university-private sector partnership to enhance Indigenous maternal and child health will address some of the underlying causes of health inequity through an innovative new action-research project.
The “Kind Faces Sharing Places: An Action Research Project for Indigenous Families During and After Pregnancy and Birth” project will aim to address some of the social determinants of health and break the multi-generational impacts of family disruption in Toronto. This project is supported by a $2.6 million grant from Merck Canada Inc. through its Merck for Mothers program, a 10-year, $500-million initiative with a focus on improving the health and well-being of mothers during pregnancy and childbirth.
“We must break the unacceptable cycle of Indigenous family disruption using Indigenous values and practice to deliver family and community-centred, culturally-appropriate care to Indigenous families,” said Dr. Janet Smylie, Director of the Well Living House Action Research Centre for Indigenous Infant, Child and Family Health and Wellbeing at St. Michael’s Hospital and Associate Professor at the University of Toronto’s Dalla Lana School of Public Health.
Dr. Smylie and a team of Indigenous researchers and community partners from the University of Toronto’s Waakebiness-Bryce Institute for Indigenous Health, Well Living House, Seventh Generation Midwives Toronto and Nishnawbe Homes will lead the project. The team will draw on the success of the Australian Stronger Families Program, which supports Indigenous families in Brisbane to keep children safely at home and cope with challenges.
Despite a growing recognition that the lack of culturally appropriate services, racism and traumatic housing environments negatively impact Indigenous people’s health, the rate of Indigenous infants taken from their mothers at birth is at an all-time high with dozens of Indigenous infants apprehended every year in Toronto. Indigenous infants are also two to four times more likely to die at birth compared to non-Indigenous infants.
“This partnership will leverage Indigenous knowledge and research methods to improve outcomes and create solutions that close the gap in maternal and child health between Indigenous and non-Indigenous families,” said Dr. Suzanne Stewart, Director of the Waakebiness-Bryce Institute for Indigenous Health, based at the University of Toronto’s Dalla Lana School of Public Health.
The research team will recruit 100 mothers and their families to take part in the three-year study where they will receive care from an interdisciplinary team led by Indigenous midwife Sara Wolfe at Seventh Generation Midwives Toronto. Participants will be connected to mental health care providers, social service agencies and child protection organizations, as needed. They will also have access to housing transition support, traditional counselling and healing, individual and family therapy, treatment for addictions if needed, and support to navigate Toronto’s vast number of maternal health programs and services.
“Maternal health and well-being is a critically important issue that Merck has dedicated itself to improving, in association with many partners equally committed to the cause,” said Mr. Chirfi Guindo, President and Managing Director of Merck Canada Inc.
“Working alongside some of Ontario’s top Indigenous health and research leaders, this new project marks an important step towards reaching our ultimate goal of improving maternal health and providing culturally-secure care for Indigenous families, both on a global scale and right here at home in Toronto.”
Project evaluation will compare results at one, two and three years into the study to baseline measurements of the number of infant apprehensions, the proportion of mothers accessing adequate prenatal care; maternal outcomes; and how many families have reduced the complexity of their needs.
This paper is an example of how St. Michael’s Hospital is making Ontario Healthier, Wealthier, Smarter.
About St. Michael’s Hospital
St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 29 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Center, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.
About Well Living House
Well Living House is an action research centre for Indigenous infants, children, and their families’ health and well-being. Our focus is on gathering, using, sharing, and protecting Indigenous health and well-being knowledge and practices. We draw on both Indigenous and public health knowledge to inform cutting edge scholarship and best practices. At the heart is an aspiration to be a place where Indigenous people can gather, understand, and share what it means to be a healthy child, family, and community – building a “Well Living House.” Visit the website.
About Nishnawbe Homes
Since 1984, Nishnawbe Homes has provided safe, affordable housing for under-housed and homeless Indigenous people in an environment that promotes and cultivates Indigenous culture and values. Nishnawbe Homes, an experienced housing provider, currently owns 17 properties in the Greater Toronto Area and Brampton, Ontario with more than 200 dwelling units. Visit the website.
About Seventh Generation Midwives Toronto
Seventh Generation Midwives Toronto (SGMT) is a group of midwives who offer maternity care to women from the City of Toronto, particularly those from the downtown area, and from the Indigenous community. We have privileges at Sunnybrook Health Sciences Centre and the Toronto Birth Centre. We provide midwifery care throughout pregnancy, labour, birth, and the first 6 weeks postpartum. Visit the website.
About the Waakebiness-Bryce Institute for Indigenous Health
At the Waakebiness-Bryce Institute for Indigenous Health (WBIIH), researchers and educators from across the University of Toronto work with community partners and Indigenous peoples to address the complex factors that underlie disparities in health between Indigenous and non-Indigenous people. The Institute is engaged in research, education and service initiatives to overcome health challenges and evaluate interventions to prevent disease and improve health. Its scholars study health policy and administration to improve the delivery and quality of Indigenous health care, and educate Indigenous and non-Indigenous students, so that each year more Canadians and citizens of the world can recognize, reduce and eliminate health inequities. We invite you to learn and explore how together, we can create thriving Indigenous communities in Canada and around the globe. Visit the website.
About Merck for Mothers
Merck for Mothers is a 10-year, 500 million dollar initiative that applies Merck scientific and business expertise – as well as its financial resources and experience in taking on tough global healthcare challenges – to end preventable maternal mortality worldwide. To achieve this, Merck for Mothers is providing transformational and sustainable solutions focused on improving the quality of maternal health care women receive at health facilities and increasing women’s access to family planning. Merck for Mothers focuses on helping countries reduce maternal mortality and improve maternal health with the overall aim of supporting United Nations’ Sustainable Development Goal (SDG) 3.1, which calls for a global reduction in the maternal mortality ratio to fewer than 70 maternal deaths per 100,000 live births by 2030. Visit the website.
About Merck
For more than a century, Merck, a leading global biopharmaceutical company known as MSD outside of the United States and Canada, has been inventing for life, bringing forward medicines and vaccines for many of the world’s most challenging diseases. Through our prescription medicines, vaccines, biologic therapies and animal health products, we work with customers and operate in more than 140 countries to deliver innovative health solutions. We also demonstrate our commitment to increasing access to health care through far-reaching policies, programs and partnerships. Today, Merck continues to be at the forefront of research to advance the prevention and treatment of diseases that threaten people and communities around the world – including cancer, cardio-metabolic diseases, emerging animal diseases, Alzheimer’s disease and infectious diseases including HIV and Ebola. Visit the website.