Responding to the needs of its community: Saskatchewan’s Women’s Health Centre is grounded in tradition

by admin admin | Feb 01, 2009
A 2006 review by the File Hills Qu’Appelle Tribal Council revealed a number of problems with its regional health system, which serves a population deemed “at risk.” Enter the Women’s Health Centre, a welcoming, holistic environment where nurse practitioners, midwives, and women’s helpers provide patients with a unique integration of Western healthcare and traditional First Nations healing.

Key Messages

The Women’s Health Centre of the All Nations Healing Hospital in Fort Qu’Appelle, Saskatchewan is a unique and innovative solution to improving health outcomes for aboriginal women and their children.

The nurse practitioners, midwife, and women’s helper provide access to a comprehensive range of holistic, patient-centred, and culturally responsive maternal and child care services.

By focusing on increased health promotion and disease prevention, the nurse practitioners can intervene early to help avoid deteriorating chronic conditions and costly therapy at a later date, thereby reducing healthcare costs.

In the two short years since its inception, the Women’s Health Centre is already making a huge difference in the lives of women and children in the small rural community of Fort Qu’Appelle, Saskatchewan – and its nurse practitioners are leading the way.

The centre, which specializes in primary care for women’s and children’s health, is one of a kind in the province. It is part of the All Nations Healing Hospital, one of the first healthcare facilities in Canada to be owned by First Nations – the File Hills Qu’Appelle Tribal Council and the Touch Wood Agency Tribal Council and operated by the File Hills Qu’Appelle Tribal Council.

While the Women’s Health Centre aims to improve the health outcomes of aboriginal women and their young children, the All Nations Healing Hospital’s larger goal is to ensure that all members of the community are welcome, respected, and supported in meeting their health and wellness needs. Holistic, client-centred, and culturally responsive primary healthcare is provided by two full-time and two casual nurse practitioners and a midwife, with the support of a women’s helper and administrative assistants, and in collaboration with community physicians.

Stella DeVenney, lead nurse practitioner at the centre, says that the nurse practitioners work to their full scope of practice. They provide comprehensive healthcare and case management that includes physical, social, mental and spiritual well-being, grounded within the principles of traditional beliefs and the values of respect and dignity. Women are supported in making their own informed choices.

Responding to the needs of the community

Many aboriginal women and children are living in situations that put them at risk of poor health. While acknowledging that the reasons are complex and unquestionably linked to the social determinants of health, the File Hills Qu’Appelle Tribal Council (FHQTC) wanted to do more, so in 2006 it conducted a comprehensive review to find out what was needed to improve maternal and child health services for its communities.

According to Maureen Klenk, a nurse practitioner at the Women’s Health Centre and faculty member of the Primary Care Nurse Practitioner Program at the Saskatchewan Institute of Applied Science and Technology, the results were initially less than inspiring: the FHQTC review revealed a multi-jurisdictional system with inadequate communication, referral, care management, information-sharing, and case management for a population deemed “at risk” for a number of health and socio-economic reasons.

If health outcomes were to be improved for the region’s women and their children, an innovative approach was needed – one that respected both the multi-jurisdictional nature of the health systems and the cultural dynamics of the First Nations population. In October 2006, the FHQTC and its partners successfully sought and received funding from the federal Aboriginal Health Transition Fund to consolidate women’s and children’s health services at the All Nations Healing Hospital.

The Women’s Health Centre opened its doors in August 2007. The centre serves 60 to 70 new patients per month and is accessed by women of all ages. Klenk says that at the Women’s Health Centre they make sure women get the care they need first – and worry about jurisdictional issues of who pays later.

The centre is providing patients with a unique integration of Western healthcare and traditional First Nations healing. According to Klenk, being culturally sensitive is fundamental to everything the centre does.

I value the open, heart-warming acceptance of my needs without put-downs or disdain. The friendly atmosphere relaxes many anxieties, which is very beautiful to me and which I truly appreciate.

A pivotal role is that of the women’s helper, who listens to the women, finds out what they need, and helps them on their healing journey. The role is not really new, explains DeVenney, but a revival of the “wise woman role” in the community. Many aboriginal women have moved away from their traditional cultural beliefs; the women’s helper helps them find the resources they need to return to those beliefs. “The women’s helper is the ‘ear’ of the community, which allows the healthcare staff to remain realistically connected with the community in which we practice,” says Klenk.

The centre’s patients are extremely passionate about their clinic. And it’s no wonder: most of them have never before experienced integrated, holistic, patient-centred and culturally responsive healthcare. “I am so thankful for the privilege of having a women’s health facility in my life and area,” says Ida, an 82-year-old great-grandmother.

“I value the open, heart-warming acceptance of my needs without put-downs or disdain. The friendly atmosphere relaxes many anxieties, which is very beautiful to me and which I truly appreciate.” Comments from other community members mirror these sentiments.

Providing better access to healthcare

The nurse-practitioner-led Women’s Health Centre has improved access for patients, connecting them with laboratory and diagnostic services, treatment, health and family support services, the cultural program and more, without incurring additional transportation requirements or costs.

DeVenney says that true access is “more than just the fact that we’re central in the community or that we’re easy to get to from the hospital.” She says it’s about women feeling comfortable with the services that are offered. Many of the centre’s patients, for example, appreciate the all-women environment. The clinic is reaching many First Nations women – the centre completes a high number of physical exams, up to 35 per month – and there is a high rate of return for follow-up care. The centre is also reaching out to women who aren’t accessing healthcare services or who are under-serviced, through outreach clinics in neighbouring First Nations communities and via community women’s wellness days.

Improved access also means that the centre is saving healthcare dollars. Because patients are comfortable accessing the centre’s services, they are more willing to seek care regularly, thereby preventing escalation of deteriorating chronic conditions and more serious illness. By focusing on increased health promotion and disease prevention, the nurse practitioners can intervene early to help avoid costly therapy at a later date. As well, the number of patients seen in outpatient or emergency rooms in the region has been reduced.

Looking ahead

The Women’s Health Centre and the All Nations Healing Hospital have big plans for the future. With additional funding from the Aboriginal Health Transition Fund, they are returning low-risk birthing back to the community.

Although the centre has been providing pre- and post-natal care for low-risk pregnancies, this new funding will lead to a comprehensive range of locally provided maternity services that are responsive to the specific needs of aboriginal women. Then, women of the community can feel confident that the All Nations Healing Hospital is equipped and capable of handling childbirth and that they don’t need to leave the community to deliver their babies.

Patient satisfaction with the Women’s Health Centre is extremely high, and survey results have been overwhelmingly positive. Not only are patients satisfied, but Klenk says that the centre provides a highly gratifying work environment for the nurse practitioners as well.

“It promotes personal and professional growth,” says nurse practitioner Sharon Slywka. DeVenney adds, “I have the autonomy I need to provide the type of care I believe in to the patients I care for. This is the role I have been waiting for my entire nursing career.”

Disclaimer:

Pass it on! is a publication of the Canadian Health Services Research Foundation (CHSRF). Funded through an agreement with the Government of Canada, CHSRF is an independent, not-for-profit corporation with a mandate to promote the use of evidence to strengthen the delivery of services that improve the health of Canadians. The views expressed herein do not necessarily represent the views of the Government of Canada. © CHSRF 2010