Diversity is one of the key values of modern society, and health care workers have to consider it when engaging in their practice. Every patient must be approached following their cultural background to avoid imposing any norms which are inappropriate for them. Nevertheless, in reality, there are numerous problems and gaps in the provision of health care services to Indigenous peoples. Infant mortality, maternal health, and birth rates are the most pressing and well-studied ones. To address these problems, the government has to develop special programs and policies to improve Aboriginal health care.
The first issue is particularly evident in infant mortality among the Aboriginal peoples in Canada. Currently, numerous literature sources are exploring the topic of infant mortality among the first nations in Canada. Moreover, some studies gather data from certain regions in the country. For instance, Richmond and Cook (2016) write in their article that infant mortality rates among Aboriginals in British Columbia are twice as high as among other groups. A study by Xiao et al. (2016) showed that in Quebec, the incidence of death among infants was the highest among the Cree Communities, even when compared to other First-Nation peoples. Extensive research by Shapiro et al. (2018), who accumulated information across all Canada’s provinces, demonstrated that mothers living in the First Nations communities experienced disproportionately high infant mortality and especially neonatal mortality. The inequalities in infant mortality are recognized by the Canadian government, which lists low maternal education, inadequate housing, and lack of access to health care as the leading risk factors (“Infographic,” 2019). Thus, it is clear that the Aboriginal peoples of Canada are disproportionally affected by infant mortality.
The existing literature on the topic of infant mortality among the native peoples of Canada is diverse and extensive. There are quality sources that explore not only the overall mortality rates but also the regional ones, which are particularly important. Nevertheless, the main weakness of the current research is the lack of annual updates which would able to supply information on the relevant mortality rates in the Aboriginal communities of Canada.
The issue of maternal health of the women of the First Nations in Canada is partially related to the previous topic and also has been thoroughly studied. According to Wright et al. (2018), Indigenous populations are at a higher risk for HIV, drug addiction, early pregnancy, and diabetes which ultimately impact their maternal health. First Nations females who decide to have a child early in their life may lack certain knowledge in terms of pregnancy management which can lead to their health problems. Sharma et al. (2018) conducted extensive research on the perspective of Indigenous women in Canada on maternal health. According to First Nations women, some of them experienced racism when receiving medical services, and others faced stress due to the need to travel to other parts of the country to give birth. Many women reported that they encountered militated maternity care choices and challenging economic circumstances (Sharma et al., 2018). Thus, it becomes clear that the maternal health of Indigenous women constitutes a complex issue that is affected by a variety of factors, from basic health risks to negative experiences at healthcare facilities.
The existing research on the topic of maternal health among women of First Nations is substantial and enables one to gain an insight into the issue. There are plenty of literature sources featuring personal perspectives of Aboriginal women on their maternal health and the existing conditions for its promotion. The primary gap in the current research is the lack of articles on the possible solutions for the improvement of the maternal health of Aboriginal women.
Finally, the third topical issue among First Nation women is the birth rate which has been explored by many researchers. Studies show that the Aboriginal peoples in Canada tend to have high birth rates, but their life expectancy is lower than that of the rest of the country’s population (Richmond and Cook, 2016). It is possible that the low life expectancy can be attributed to the aforementioned health risks experienced by the Aboriginal populations. According to the latest data, the Indigenous populations of Canada are growing four times faster than the rest of the nation (Kirkup, 2017). There was a more than 45% increase in the number of people in the country who identified themselves as Aboriginal since 2006 (Kirkup, 2017). Studies show that the fertility rate of the Indigenous peoples in Canada is higher than that of the non-Aboriginals, and they produce 0.6 more children than the rest of the population (Morency et al., 2018). Based on the results, it is clear that the Aboriginal people in Canada do not experience any significant problems in the sphere of birth rate.
There is plenty of literature source dedicated to the topic of the birth rate among the Indigenous peoples of Canada. The main strength of the existing research is the availability of correct measures on each tribe in Canada and their fertility rates. At the same time, there is a lack of information on the perspectives of the Indigenous peoples on their high birth rate. It would be interesting to explore the main reasons and causes behind the growing number of First Nations representatives in Canada.
Implications and Recommendations
The are several implications that can be made based on the research on the topic of infant mortality among the Aboriginal peoples in Canada. First of all, the Indigenous are disproportionately affected by the issue of death among children under 12 months old. Moreover, certain peoples such as Cree are more likely to suffer from an increased infant deathrate. The Canadian government has already identified the main causes of the phenomenon, which include poor maternal education, lack of access to health care, and inadequate housing. The government must develop an initiative to educate the Aboriginal peoples, especially girls, on the basic rules of conduct when approaching family planning and pregnancy. At the same time, authorities must offer proper health care to the native women giving birth. According to the National Aboriginal Council of Midwives (2019), the Indigenous people must decide themselves when, where, and how to have children, while the government must provide them with a healthy environment. Similarly, the government has to offer better housing opportunities for the Aboriginal peoples.
As mentioned above, the problem of high infant mortality is related to the issue of maternal health among the Aboriginal peoples. The research showed that the maternal health of Indigenous women is subject to numerous challenges, including a higher risk for drug addiction, HIV, and early pregnancy. Moreover, according to the women themselves, they often face racism and poor medical services, as well as the need to travel long distances to receive healthcare. For instance, there is an inherently discriminatory practice of issuing birth alerts issued by social workers which often leads to child apprehension (Vikander, 2021). Thus, the recommendations in terms of maternal health must concern the introduction of better access to healthcare services for native women and the prohibition of practices such as birth alerts. There are already government programs such as Merck for Mothers program led by Indigenous midwife Sara Wolfe who said that Culturally-appropriate care for Indigenous people was necessary (Whalen, 2017). Aboriginal women must have full support from public institutions.
Finally, the birth rates of the Indigenous peoples are a topic that also must be addressed by the government yet from the perspective of the aforementioned infant deaths. As research demonstrates, the First Nation representatives demonstrate a high fertility rate which is even higher than that of the rest of the population. Yet, the existing problem with infant mortality remains a topical issue that in many cases negates the increasing rate of fertility. Therefore, the government has to focus on the provision of proper medical facilities to Aboriginal women and people in general. According to the calls to action of the Truth and Reconciliation Commission of Canada (2015), all healthcare workers must be provided with cultural competency training. To ensure complete decolonization of the healthcare system in Canada, Indigenous females must have access to culturally-appropriate services which value their dignity.
The research demonstrated that the Indigenous populations experience significant problems in the spheres of infant mortality and maternal health but have positive results in terms of birth rates. The Aboriginal peoples face an extremely high number of deaths among children under one year old. Such a situation can be explained by the poor maternal health of Indigenous women due to the lack of access to healthcare services. Even though the relatively high birth rates can be viewed as a positive phenomenon, the two aforementioned problems must still be addressed. The primary solution here should be based on the provision of culturally-appropriate health care to the Aboriginal women and expanding their access to it.
Infographic: Inequalities in infant mortality in Canada. (2019). Government of Canada. Web.
Kirkup, K. (2017). Global News. Web.
Morency, J., Caron-Malenfant, E., & Daignault, D. (2018). Fertility of Aboriginal people in Canada: An overview of trends at the turn of the 21st century. Aboriginal Policy Studies, 7(1), 34–61. Web.
Richmond, C., & Cook, C. (2016). Creating conditions for Canadian Aboriginal health equity: the promise of healthy public policy. Public Health Reviews, 37(2), 1–16. Web.
Shapiro, G.D., Sheppard, A.J., Bushnik, T., Kramer, M., Mashford-Pringle, A., Kaufman, J., & Yang, S. (2018). Adverse birth outcomes and infant mortality according to registered First Nations status and First Nations community residence across Canada. Canadian Journal of Public Health, 109, 692–699. Web.
Sharma, S., Kolahdooz, F., Launier, K., Nader, F., June Yi, K., Baker, P., McHugh, T., &, Vallianatos, H. (2016). Canadian Indigenous women’s perspectives of maternal health and health care services: A systematic review. Diversity and Equality in Health and Care, 13(5), 334–348. Web.
The National Aboriginal Council of Midwives. (2019). Guided by our ancestors: Indigenous midwives and advocacy. Web.
Truth and Reconciliation Commission of Canada. (2015). Truth and Reconciliation Commission of Canada: Calls to Action. Web.
Vikander, T. (2021). Several Canadian provinces still issue birth alerts, deemed ‘unconstitutional and illegal’ in B.C. APTN National News. Web.
Whalen, J. (2017). ‘We can’t do it alone’: Indigenous maternal health program aims to address inequality of health care. CBC. Web.
Wright, A., Wahoush, O., Ballantyne, M., Gabel, C., & Jack, S. M. (2018). Selection and use of health services for infants’ needs by Indigenous mothers in Canada: Integrative literature review. Canadian Journal of Nursing Research, 50(2), 89–102. Web.
Xiao, L., Zhang, D., Torrie, J., Auger, N., McHugh, N., & Luo, Z. (2016). Macrosomia, perinatal and infant mortality in Cree communities in Quebec, 1996-2010. Plos One, 11(8), 1–12. Web.