The Canada Prenatal Nutrition Program (CPNP) is a community-based, culturally-appropriate support program established by the Government of Canada in1995.The program was designed to promote and improve the health and well-being of vulnerable pregnant women, mothers and babies facing challenging life circumstances that put their health at risk (Public Health Agency of Canada [PHAC], 2015). Several communities in Nunavut embraced the program for mothers experiencing poverty, poor nutrition, teen pregnancy, social and demographic isolation, smoking, alcohol, substance use and family violence (Centers for Disease Control and Prevention [CDC], 2017; Ernst,and Shabangu, 2017). Through a community development approach, one community adopted the CPNP initiatives in promoting and enhancing education and counseling programs in perinatal health and lifestyles, nutrition, food preparation, breastfeeding, and infant-and-child-rearing values and practices for this vulnerable population (PHAC, 2015; Sharp, 2017). The purpose of this participant-observational study was to determine, within the framework of family, community, and holistic health and well-being, (1) the nature, qualities, and patterns of individual and group behaviors and interactions during program sessions; (2) the influence of Inuit health beliefs and societal values on group dynamics, (3) the meaning of belongingness or affiliation with the group; and (4) the impact and implications of CPNP on the lives of the mothers and children.
Methods:
Over a three-week period in November 2017, members of two CPNP groups were observed on Tuesdays and Thursdays respectively, as they engaged in their three-hour afternoon activities of meal preparation, educational circle for information-sharing, singing, dancing, and games-for-prizes, while a baby sitter cared for their children. Each group comprised 6 to 8 mothers from diverse socio-economic, educational and parity backgrounds, including a three-generational family of mother, daughter and their newborn sons. Their ages ranged from 17 to 39 years and their infants and children remained in the Group until the age of 18 months. Educational subjects included traditional Inuit health beliefs and societal values, growth and developmental stages of life, maternal-infant nutrition and child-rearing practices, comparison of Inuit-and other traditional and cultural practices, gestational diabetes, seasonal infections, such as Influenza, lifestyle-related health issues of smoking, alcohol and drug use, sexually-transmitted infections including HIV-AIDS and Syphilis, and intimate partner violence (IPV).
Results:
Within a family and community environment, participants brought their holistic perspectives from physical, mental, emotional, social, cultural, and spiritual health and well-being, realizing each other’s true potentials and optimal human functioning (Walter, 1999; Zamanzadeh, Jasemi, Valizadeh, Keogh, and Taleghani, 2015; Inuit Societal Values, 2017). They shared a common bond of friendship, team spirit, wisdom, traditions, self-regard and mastery. They were happy, zealous, zestful, and interactive. They were also open, welcoming and inclusive, while remaining non-judgmental and respectful of each other’s uniqueness, opinions, beliefs and values (Nelson and Simmons, 2003; Inuit Societal Values, 2017). The educational circles were described as timely, practical, realistic, and enriched their knowledge, understanding and appreciation of Inuit traditional and cultural roots, and Inuit societal values. Participants found the demonstrated Inuit and other national maternal-child-rearing practices intriguing and challenging. Breastfeeding and infant care was spontaneous throughout the sessions. Family violence, particularly intimate partner violence (IPV), had the most impact on the participants, as they reflected on its short- and long-term effects on mothers, children, families and the community (CDC, 2017; Ernst and Shabangu, 2017).
Conclusion:
Evidence from the study suggests that this community's CPNP Chapter, which was conceived in 1996, has remained committed to its principle of ensuring the health and well-being of mothers and their babies. Participants described this as “meaningful, being able to let go their stressful material world and immerse themselves in a transcendental eustress world at least for two to three hours each week to renew, re-vitalize and rejuvenate their spirit as a group, a family, a community” (Walter, 1999; Nelson and Simmons, 2003; Zamanzadeh et al., 2015). Equity, accessibility, and flexibility in program delivery has helped improve mothers’ socio-economic, traditional, cultural, language and other health needs, thereby enhancing motivation, morale, confidence, and providing them with the strength to survive each day. Partnerships, referral services and support network have also helped some mothers and children to break the cycle of violence in their abusive (IPV) relationships, with hope for healing, and to start life anew in a safer and more secure environment (PHAC, 2015; CDC, 2017; Ernst and Shabangu, 2017).