Jessica Ball, M.P.H., Ph.D.
Early Childhood Development Intercultural Partnerships
School of Child and Youth CareUniversity of Victoria
Intersectoral Action for Indigenous Children’s Health and Development
Multiple entry points to harness the ecology of children’s health &
development
Adapted from Bronfenbrenner (1979)
CHILD
MICROSYSTEM
Schools Family
Peers
EXOSYSTEM
MACROSYSTEM
Neighbors
Policies
ExtendedFamiy
Beliefs
SocialAttitudes
MESOSYSTEM
NEIGHBORHOOD
HEALTH SERVICES
VALUES
SLP SERVICES
Daycare
MassMedia
SocialClass
PARENTCulture Culture
Key messages from researchwith First Nations in B.C.
Early Childhood Care & Development Programs can serve as a socially accessible & culturally resonant entry point for promoting health & delivery health services
Community development supports child health & development
One model does not fit all contexts (no ‘best practices’)
Research helps to identify promising practices
Some Aboriginal communities are demonstrating promising community-led, community-paced, community-fitting practices
that engage recommendations
of the AFN, NAHO & Romanow
Commission, Pop Health . .
Prevailing Individual-Centred, Fragmented Services
School
ChildCare
Centre
CommunityHealthRep.
PublicHealthNurse
Speech-LanguagePathologist
DentalHygienist
OccupationalTherapist
PhysicalTherapist
EmergencyServices
CommunityMembers
GP/MD
Parent: Good luck trying to make it to your child’s appointment with a dental hygienist
SLP: Good luck trying to find the child who has been referred for early intervention!
Community-Admin: Good luck filling out all the forms to appeal & account to many
different authorities
Single-focus programs have limited effects
Nutrition programs must be combined with stimulation (parent coaching, preschool, play spaces) in order realize significant gains in physical growth, health, learning & development
Programs to stimulate cognitive development do not have desired impacts if the child has a language delay due to hearing loss due to ear infections due to mold growing in their sub-standard housing in a wet climate.
Supporting families
• Most families want to meet ALL of a child’s many different kinds of needs
• Policies & service systems that require parents to engage many different professionals and programs create barriers (travel, scheduling, economic, organizational, social, cultural)
• Program coordination supports family life & increases the chances of children’s needs being met.
First Nations Early Learning & Child Care Action Plan (AFN – 2005)
“sustainable, flexible funding…
community driven…
Integration would empower First Nations to integrate child care services and programs across jurisdictions to create a new holistic framework of First Nations child care programming.”
Coordinated programming…
Supported by: Common sense Ecological perspective on change Population health model Cultural concepts Research Families Aboriginal recommendations
What more do we need to make it happen?
Making It Happen: ►Starts with long range VISION
Communities all had:
• VALUE that ‘Children are our future.’
• COMMITMENT to invest in early years to create a foundation for adult health, achievement and economic security
• HOLISTIC UNDERSTANDING of health & development
• PLAN for coordinated programs
• FUNDING– soft infrastructure: training, policy development,
community awareness
– hard infrastructure: buildings, equipment, buses, supplies
What is happening in these communities now?
From vision to action
► Starts with capacity building
• Community - University Partnerships
• Community-based, culturally specific as well as ‘mainstream’ training
Features of Hub Approaches
Family-centred
Relationship-oriented (cultural safety)
Population-based & streamed to target programs
Strength-focused rather than deficits oriented
Efficient
Coordinated or Consolidated funding
Partnership to develop community capacity Training – UVic partnership
Incremental implementation Starting with child care as a ‘hook’ Community kitchen & cultural events
bringing Elders to the centre Incremental addition of programs & services Creative work to push the envelope
with funders & agencies
Planned Integration, Coordination, & Co-location
School
EmergencyServices
GP/MD
HeritageLanguage Nest
Child CareCentre
HealthPromotion
Centre
After SchoolCare Centre
CommunityKitchen
Child &Family
DevelopmentServices
HealthServicesCentre
CommunityHealth Rep.
Public HealthNurse
DentalHygienist
OccupationalTherapist
PhysicalTherapist
Speech-LanguagePathologist
Specialist Diagnostic Services
CommunityMembers
From child care & community kitchento….
• Child development pre-school & after-school• Drumming, dancing, pow wow• Supported Child Care (special needs)• Uscalmicts language immersion/exposure• Early Intervention Therapists (SLP, OT, PT,
dental hygienist)• Family Wellness Worker• Community Health Representatives• Community Health Nurse• Paediatrician• Counsellors (NNADAP & Residential School)• Dentist• Chiropractor• Elders Activity
Coordinator• Home Care Nursing• Child welfare
Working together & learning across professional disciplines & services
A mutually supportive community of workers with ongoing professional development opportunities yields high staff retention
Many pathways
“Finding our way to supporting wellness among diverse communities of children and families requires many pathways. No one approach, no one program model, will reach or work for everyone.”
Meadow Lake Tribal Council Administrator
Local innovation & resourcefulness can combine the ‘right’ number & variety of people, professions, services that a community wants & needs to achieve their own ECCD goals
Research: compare remote, rural & urban hub potentials & demonstration projects
Key messages from researchwith First Nations in B.C.
Early Childhood Care & Development Programs may be an especially strategic entry point for Aboriginal health initiatives
Planned ECCD training & services are effective components of Aboriginal community development
One model does not fit all contexts (no ‘best practices’)
Research with Aboriginal communities can explore & demonstrate exciting new ways to think about community-driven designs for action to promote child & family health & quality of life