Mr. Speaker, in response to (a),the collection of maternal and infant mortality data falls within provincial-territorial jurisdictional responsibilities of health care.
Maternal mortality rates among aboriginal populations at the national level are not available due to the lack of ethnic identifiers in provincial-territorial vital statistics databases.
Information on maternal and infant mortality rates is maintained within the provincial-territorial vital statistics databases; the federal government liaises with the provinces and territories to roll up this information to the national level. The federal government funds within existing reference levels.
In response to (b),the federal government continues to work with its aboriginal and provincial-territorial partners at the regional level to improve access to aboriginal health data on a jurisdiction by jurisdiction basis. Examples of this work include the participation in the joint working group on first nations, Indian, Inuit, and Métis infant mortality data, which recently produced a report on data gaps in infant mortality rates, http://journal.cpha.ca/index.php/cjph/article/view/2370.
Efforts have been made at the federal level to improve the collection and quality of infant mortality data nationally. The joint working group on first nations, Inuit and Métis infant mortality data was initially brought together under the umbrella of Public Health Agency of Canada’s Canadian perinatal surveillance system, and supported by the Public Health Agency of Canada, PHAC, and Health Canada, to advise on data development related to aboriginal perinatal health. The joint working group, composed of representatives from PHAC, Health Canada, Statistics Canada, and some national aboriginal organizations, focused on developing an aboriginal identification question that could be included in P/T vital statistics records to facilitate the collection and capture ofaboriginal data across Canada. Implementing the collection of identifiers will require co-operation within and across jurisdictions, including aboriginal communities. PHAC and Health Canada continue exploring ways to facilitate this fundamental step to allow provision of information on national maternal and child health data specific to aboriginal populations
In response to (c), information about Health Canada supported, community-specific programs that exist to improve maternal and child health of status-Indians on reserve, including the maternal and child health program, the Canada prenatal nutrition program, and the aboriginal head start on reserve program, can be found on Health Canada’s website within the first nations and Inuit health community program’s compendium, http://www.hc-sc.gc.ca/fniah-spnia/pubs/aborig-autoch/2007_compendium/index-eng.php.
The Public Health Agency of Canada supports community-specific programs to improve maternal and child health of status Indians off reserve, non-status Indians, Inuit, Métis, and urban aboriginals through programs like the aboriginal head start urban and northern communities, http://www.phac-aspc.gc.ca/hp-ps/dca-dea/prog-ini/ahsunc-papacun/index-eng.php; the community action program for children, http://www.phac-aspc.gc.ca/hp-ps/dca-dea/prog-ini/capc-pace/index-eng.php; and the Canada prenatal nutrition program, http://www.phac-aspc.gc.ca/hp-ps/dca-dea/prog-ini/cpnp-pcnp/index-eng.php.
In response to (d), we have information on the program reach of maternal and child health programs funded by the First Nations and Inuit Health Branch of Health Canada. The maternal child health program provides home visiting by nurses and family visitors to 2,221 women and families with young children in 225 first nations communities.
The first nations and Inuit component of the Canada prenatal nutrition program, CPNP, currently reaches over 9,000 first nations and Inuit women per year at approximately 450 project sites, which serve more than 600 communities. The fetal alcohol spectrum disorder program funds approximately 36 mentoring sites across Canada, reaching more than 6000 women. In addition, there are 17 community coordinator positions to help increase families’ access to multi-disciplinary FASD diagnostic teams and related services and support. The aboriginal head start on reserve, AHSOR, program serves over 9,000 children in over 300 first nations on-reserve communities across Canada.
As indicated in PHAC's “Maternity Experiences Survey”, 2006-2007, http://www.phac-aspc.gc.ca/rhs-ssg/survey-eng.php, the provinces and territories are responsible for health care delivery for all Canadians and are therefore critical partners in maternal and child health.
In response to (e), Health Canada supports a number of initiatives directed at returning safe birthing options closer to home and to increase accessibility to midwifery for first nations and Inuit families. CPNP funds community-based groups and coalitions to provide access to culturally specific programs and services for pregnant women most at risk, including aboriginal women. CPNP aims to improve the health of pregnant women and their infants, reduce the number of babies born with unhealthy birth weights, and promote and support breastfeeding. A summative evaluation of CPNP, http://www.phac-aspc.gc.ca/about_apropos/evaluation/reports-rapports/2009-2010/cpnp-pcnp/index-eng.php, found that CPNP projects are serving approximately 50,000 women annually in over 3,000 communities across Canada, with 22% of CPNP new entrants identified as aboriginal in 2008-09. They included 3,670 women. The highest proportion of aboriginal participants was found in Saskatchewan, 79%; the territories, 66%; and Manitoba,52%. Many CPNP projects serve rural, remote and/or isolated areas where there is reduced access to health services, and strive to link vulnerable children and their families in these areas to additional community supports.