|
| Main
| français
| CWHN home |
|
Download the PDF (413 KB, 18 Pages)
Health Care Reform Serving Diversity Unpaid Caregiving Midwifery
|
|
Marginalized Voices from Vancouver’s Downtown Eastside: Aboriginal Women Speak about Their Health Care Experiences Cecilia Benoit, Department of Sociology, University of Victoria and Dena Carroll, Aboriginal Health Consultant
Canada is not unique among high-income countries in its current efforts to restructure health and social welfare systems to control costs, while at the same time trying to provide its citizens with opportunities for greater control over their health care. Despite efforts from various quarters to "give voice" to the country’s marginalized populations, research on general health service delivery in urban areas of British Columbia and other Canadian cities shows that Aboriginal women face formidable barriers in accessing provincial health services. This study seeks to document the voices of Aboriginal women living in Vancouver’s impoverished Downtown Eastside as they assess the effectiveness of Native health services in their community. The few research reports that are available indicate that Aboriginal women make relatively low use of preventative screening services for women such as Pap smears, mammogram screening, and breast exams by a health practitioner (BC Provincial Health Officer, 1996; BC Women’s Health Bureau, 1999). Further, Aboriginal women tend to have great difficulty finding adequate care during pregnancy; this has been especially true for those using substances of one kind or other (Poole, 2000). While these few studies are revealing, a lack of general knowledge of urban, Aboriginal women’s access to health services limits our ability to improve health service delivery, policy development, and program planning. Over the past decade, urban Aboriginal health centres controlled by Aboriginal people have emerged to address the unmet health concerns of Aboriginal people living in metropolitan areas. The purpose of our research was to address the gap in social science literature on how Aboriginal health centres are accomplishing this. Specifically, the aim of our research was to give voice to Aboriginal women by asking them to identify whether the service delivery model employed at the Vancouver Native Health Society (VNHS), an Aboriginal health centre located in Vancouver’s Downtown Eastside, currently provides them with the appropriate professional services and educational programs that they need to take control of their health. We conducted focus groups with Aboriginal women who were either clients of VNHS, or of Sheway, a program for pregnant, substanceusing women, or were residents of the Downtown Eastside. Additional individual interviews were held with VNHS staff, health professionals, and community leaders in health care. From the focus groups with Aboriginal women the two most significant issues that emerged were access to and availability of support services. In terms of access, the women emphasized the importance of a non-judgmental, encouraging, informal environment, greater gender sensitivity, and a more women-centred focus. In addition, they expressed a need for a more central service focus on Aboriginal women’s health concerns, for more culture-based programming including traditional healing methods and therapies, and for more personal security and assurance of anonymity. Although some women also identified the need for Aboriginal-only services and programs, there was no consensus on whether this was a critical issue in the Downtown Eastside. Some of the support service needs that women identified were enhanced services for children, access to parenting support and education programs, access to food, supplies and other assistance during emergencies, access to better dental care, and access to integrated community health support networks. Health service providers and administrators we interviewed supported many of the concerns articulated by Aboriginal women. They also raised concerns about the impact of the regionalization of health services on the delivery and control of Aboriginal health services and programs. Although there was overwhelming support from administrators and service providers to develop a new, comprehensive Aboriginal Healing Centre in Vancouver, a number of outstanding questions about location and access, types and control of services and programs, and ways to build on the current success of VNHS were raised. Another equally important question was how Aboriginal people themselves, as well as administrators, caregivers and families, would be consulted and involved in exploring and addressing these questions. The women using VNHS and Sheway recommended greater formal and informal participation by Aboriginal women in the decision-making processes of the services. Other recommendations included the need to enhance internal organizational structures to increase communication among staff, to change staff hiring strategies in order to recruit more Aboriginal personnel, to expand services to include exclusive access times for Aboriginal women, to create educational programs for mothers parenting older children, and to increase attention to preventative health and advocacy needs. Aboriginal women are experts on their own health care. This report integrates what we have learned from their expertise and provides recognition and support for future health service delivery strategies that would help improve Aboriginal women’s health status. References BC Ministry of Health and Ministry Responsible for Seniors (1996). Policy Manual for Regional Health Boards. Victoria, BC. BC Women’s Health Bureau (1998). Minister’s Advisory Council on Women’s Health. Women’s Health in the Context of Regionalization. Victoria, BC. Poole, N. (2000). Evaluation Report of the Sheway Project for High- Risk and Parenting Women. Prepared for the BC Centre of Excellence for Women’s Health, Vancouver, BC. For a full copy of the report contact: |
| This page updated |
