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��Beryl, Toni, Zarana, Vinanti, Hemangkumar.�� Presented to: Prof. Therese Bernier�

MATERNAL AND CHILD HEALTH IN CANADA AND FRANCE.

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Description (Maternal and Child health)
Strengths and weaknesses (Canada and France)
Barriers
Strategies to overcomes barriers
Conclusion
References

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Description: Maternal & Child Health (MCH)

A sub-field in public health focusing on a mothers and children.

Maternal health definition (WHO 2022)

National focus MCH (US 1912) by President Taft

Several factors affecting maternal side of equation

Addressing inequalities that affect health outcomes

MCH Bureau / MCHB

Description- Canada: Beryl

Also known as MCH is a sub-field in public health that focuses on specific population namely mothers and children. Maternal, perinatal, and newborn health is of significant importance to every individual, society, and country. They should be observed as highly important topics from both a human rights and wellbeing perspective.

Maternal health refers to the health of women during pregnancy, childbirth, and the postnatal period. Each stage should be a positive experience, ensuring women and their babies reach their full potential for health and well-being. (WHO, 2022)

The effort to protect children who were vulnerable to morbidity, mortality, and/or social events like child labor was consistent with the national focus on MCH in the US which began in 1912 when President Taft established the Children’s Bureau. The Government interests were then extended to mothers who were the essential and primary child caregivers.

There are several factors that affect the maternal side of this equation which could in turn, by extension affect child health. These are maternal injuries and death which are mostly caused by excessive blood loss, unsafe abortion, obstructed labor, infection, high blood pressure, as well as indirect causes such as malaria, anemia, and heart disease. Most of these deaths are preventable if intervened in a timely manner by a skilled health professional. It is therefore critical to expand the efforts to reduce maternal injury and disability to promote the health and well-being of mother and child.

It is of utmost importance to address inequalities that affect health outcomes, especially sexual and reproductive health and rights and gender. This is fundamental to ensuring all women have access to equal, respectful, and high-quality maternity care.

Today, The MCH Bureau’s work is not just limited to mothers and children, but also promotes the health of families, adolescents, children, and women (which includes mothers and pregnant women).

The MCHB also reflects concerns about health equity and the reduction of health disparities for everyone, not just mothers and children. The ability to demonstrate “cultural competence” is, in fact, considered critical for MCH leaders. Beyond the US, it is also difficult to disentangle health equity from global MCH advocacy and program development. (Wendy, 2016)

In France Maternal and child health is also known as “Protection maternelle et infantile (PMI)

Maternal and child health are accorded National priority through the creation of four universal partnerships between society and families (Health insurance, family allowances, paid maternity leaves, and childcare and education)

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Description: Maternal & Child Health (MCH) cond....

MCH France = "Protection maternelle et infantile" (PMI)

Four universal partnerships

French government initiative. 1945

"Points fixes de consultations"

Network provides free range of services

4th among EU member states

Stakeholder engagement

Description-France: Beryl

In France Maternal and child health is also known as “Protection maternelle et infantile” (PMI)

Maternal and child health are accorded National priority through the creation of four universal partnerships between society and families (Health insurance, family allowances, paid maternity leaves, and childcare and education).

The French government introduced the PMI in 1945, to provide free, high-quality medical and social care to all the mothers and their young children (up to six years old). It aims to be accessible to all French women, whatever their geographical location and/or social background via over 5,000 PMI centres, supported by a network of free points of contact.

This network consists of 5,100 “points fixes de consultations”, which are centres that offer consultations and guaranteeing the accessibility of its services throughout France. It offers multidisciplinary care as well as addressing medical, social, and educational needs. It also serves to reduce unequal access to healthcare and social inequality.

The network plays a significant role in providing an extensive range of free services which include access to social services, contraception, and tailor-made solutions in PMI offices or even at home. The available services are provided by a wide range of professionals, including doctors, nurses, midwives, relationship counsellors, child psychologists, and early childhood educators.

France is ranked the 4th among EU member states when it comes to post-natal mortality rate during the first month post-partum being 2.1 per 1000.

Looking at stakeholder engagement, there are 101 internal stakeholders that fund and administer the scheme including the French government and individual departments. A national budget of €700 million per year has been dedicated to the PMI initiative. These stakeholders also include the PMI users themselves, health and social services professionals. The external stakeholders are principally NGOs.

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Strengths and weakness of implementation

Canada

France

Receive all medically necessary and hospital physician services

Everyone is automatically insured

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Canadian Healthcare system

Addressed social determinants
Lack of employment
Food insecurity
Discrimination
Initiative for increasing breastfeeding rates
Midwifery services
Immunization programs

Andermann, A. (2016)

Chabot, G., & Lacombe, M. (2014)

Benoit, C. (2005)

Gagnon, D., Dube, E., Kaminsky, K., Green, C., & Quakki, M. (2020)

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��Weakness of Canadian healthcare system�

Canadian Indigenous populations

( Highest percentage of population in Nunavut (NU), The Northwest Territories (NT) and Yukon)

Diet and lifestyle
Accessibility to healthcare services
Lack of awareness about SDOH
Mental Health problems

Malla, A. (2018)

Kolahdooz, F. (2016)

Mikkonen, J., & Raphael, D. (2010)

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Pros of The France healthcare system

Birth in France

Dental Coverage for children

(Children’s checkups are reimbursed 100%)

Gynecologist for pregnant women

The French Healthcare System. Expatica. (2022)

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Cons of France Healthcare system

Need implementation in Vaccine policies

Lack of funding for mental Health

The French Healthcare System. Expatica. (2022)

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Barriers of implementing the health service selected in Canada

This Photo by Unknown author is licensed under CC BY-SA.

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Interpersonal Communication:

Difficulties in conversation between the care provider and the patient introduce the opportunity of increased threat or harm to the person who recieves health services.

Communication troubles can moreover exist between patient and care-giver who talk the identical native language however come from vastly one of a kind socio‐economic backgrounds.

This equal language hole can give up result in the incapacity to talk effectively due to the truth of low health literacy.

This Photo by Unknown author is licensed under CC BY-SA.

(Nair, et al., 2014)

Streatfield, P. K., Koehlmoos, T. P., Alam, N., & Mridha, M. K. (2008).

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Language:

Language barriers and lack of qualified interpreters could also pose a challenge to effective communication.
The greatest benefits were observed when a decision support technique was implemented in the form of counselling from a care provider involving information, discussion of options and clarification of values.
Regular frequent discussions with healthcare providers were more effective than a one-off contact.

This Photo by Unknown author is licensed under CC BY-SA.

(Nair, et al., 2014)

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Patient Engagement and Satisfaction:

Obstructions to patient were absence of wellbeing education, information and mindfulness about wellbeing administrations, absence of chance for shared choice making and absence of trust and trust in the medical services suppliers.
Clients' disappointment was principally connected with the cutthroat, rude, uncaring, and oppressive disposition of care suppliers, yet it was likewise observed to be related with rehearses that were not viable with their way of life and ideas of wellbeing.

(Nair, et al., 2014)

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Train Staff:

An Organization should assess the effect of standard consideration practices like Emergency Obstetric Care (EmOC), talented birth participation, standard bundles of care during birth.
Absence of normal quality oversight and assessment was a significant hindrance to working on the viability of standard consideration practices.

(Nair, et al., 2014)

This Photo by Unknown author is licensed under CC BY-SA-NC.

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Audit and feedback:

Audit and Feedback could be a valuable device in further developing adherence to guidelines and standard consideration and working on their adequacy across nations worldwide yet there are difficulties connected with quality, supportability, and acknowledgment of review, particularly when upheld by an outside organization.
Absence of adequacy of suggested standard consideration systems could relate to various design related and process-related issues.

(Nair, et al., 2014)

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Geographic access:

Geographic access depends on the actual connection between the area of the consideration searcher and the area of the wellbeing administrations and the capacity to conquer that distance to look for care.
The issue of geographic access is normal across the range of low-, middle-, and high-income nations.
As depicted underneath the issue of geographic access is occasionally tended to through outreach administrations.

Streatfield, P. K., Koehlmoos, T. P., Alam, N., & Mridha, M. K. (2008).

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Strategies our Group would use to Overcome these Barriers

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Interpersonal Communication:

Patient provider communication should be incorporated with maternal patient care as it aids in :
Health Literacy
Knowledge
Take part in decision making for their children and themselves

(Nair, et al., 2014)

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Language:

Our group thinks that qualified interpreters should be hired at hospitals.

(Nair, et al., 2014)

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Patient Engagement and Satisfaction:

Providers attitude, behavior, sensitivity, and attention must be priority as it relates to the prospective of the patient.

Patients will communicate with their care givers by:

Expressing their feelings about their quality of care .
fears about being a new mother.

(Nair, et al., 2014)

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Continuous Staff Training:

Continue to train staff on the importance of effective communication
Culturally sensitive
Improve technical communication
Be competent

(Nair, et al., 2014)

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Audit and Feedback:

Develop a tool where patients can measure their quality of care in hospitals.

(Nair, et al., 2014)

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Geographic Access:

Encourage community health nurses to work specifically rural area where transportation is less feasible
Encourage physicians to open more clinics in rural areas

(Nair, et al., 2014)

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Conclusion:

Maternal and child health is important for every individual, society, and country as well. Several factors can affect maternal health, but it can be prevented with proper intervention by health professionals. MCHB is responsible for health promotion to the families, adolescents, children, and women including mothers as well as pregnant women. Whereas in France, PMI centres provides medical care to the mothers and their young children.
For the maternal and child health in Canadian Healthcare system several measures have been taken to improve the maternal and child health including promotion to increase breastfeeding rate by the BFHI (Baby Friendly Hospital Initiative), midwifery integration process and vaccination program by federal, provincial, and territorial governments.
On the other side lack of awareness about SDOH, traveling stress for Inuit community to give birth as well as mental health concerns are few drawbacks in Canadian Healthcare System.
In terms of France Healthcare System, cost for compulsory prenatal test, delivery, epidurals and screening for diseases covered by the government. Insurance covers majority of pregnancy cost in France. Apart from this, France also has drawbacks in vaccination policies and mental health services.

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While talking about barriers, interpersonal communication and language are main issues in implementation of health service, but with health literacy and knowledge about decision making as well as qualified interpreter at hospital can assist patient in understanding their own and their child’s health.
Patient satisfaction and engagement can be achieved by making safe environment where they can speak without judgement about their feelings of being a new mother.
Training staff about better communication to be culturally sensitive as well as establishing a system for patients to give feedback about improving medical care is also important.
People living in rural areas are still facing challenges in medical care for mothers and their child because of transportation to the community healthcare unit.

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References

Wendy, L. (2016). What is maternal and child health?. [Master of public health program]. University of Minnesota. https://mch.umn.edu/wp-content/uploads/2016/04/What-is-MCH-Article.jpg
World Health Organization. (2022). Maternal Health and newborn health. https://www.euro.who.int/en/health-topics/Life-stages/maternal-and-newborn-health/maternal-and-newborn-health
Gail, R. (1994). A welcome for Every Child: How France Protects Maternal and Child Health. A Report of the French American Foundation. https://eric.ed.gov/?id=ED383469
Kolahdooz, F. (2016). Canadian Indigenous Women’s perspectives of maternal Health and Health Care Services: A Systematic Review. Retrieved April 6, 2022, from https://www.researchgate.net/profile/Fariba-Kolahdooz/publication/323804366_Canadian_Indigenous_Womens_Perspectives_of_Maternal_Health_and_Health_Care_Services_A_Systematic_Review/links/5ab911fd45851515f59fee34/Canadian-Indigenous-Womens-Perspectives-of-Maternal-Health-and-Health-Care-Services-A-Systematic-Review.pdf?origin=publication_detail
The Centre for Public Impact, a BCG Foundation. Free antenatal and postnatal care: Seventy years of the Protection Maternelle et infantile (PMI). (2016, March 29^th) https://www.centreforpublicimpact.org/case-study/public-care-of-young-children-france
Mikkonen, J., & Raphael, D. (2010). Social Determinants of Health: The Canadian facts. Retrieved April 7, 2022, from http://torontohealthequity.ca/wp-content/uploads/2017/05/Social-Determinants-of-Health.pdf
The French Healthcare System. Expatica. (2022, April 1). Retrieved April 6, 2022, from https://www.expatica.com/fr/healthcare/healthcare-basics/a-guide-to-the-french-healthcare-system-101166

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References

Andermann, A. (2016, December 6). Taking action on the social determinants of Health in Clinical Practice: A Framework for Health Professionals. CMAJ. Retrieved April 6, 2022, from https://www.cmaj.ca/content/188/17-18/E474.short
Malla, A. (2018, March 11). Youth Mental Health should be a top ... - sage journals. Retrieved April 6, 2022, from https://journals.sagepub.com/doi/10.1177/0706743718758968
Chabot, G., & Lacombe, M. (2014, July 2). Factors influencing the intention of perinatal nurses to adopt the baby-friendly hospital initiative in southeastern Quebec, Canada: Implications for practice. Nursing Research and Practice. Retrieved April 6, 2022, from https://www.hindawi.com/journals/nrp/2014/603964/#methods
Benoit, C. (2005, November 11). Understanding the social organization of maternity care systems: midwifery as a touchstone. Retrieved April 7, 2022, from https://onlinelibrary.wiley.com/doi/10.1111/j.1467-9566.2005.00471.x
Gagnon, D., Dube, E., Kaminsky, K., Green, C., & Quakki, M. (2020, April 9). Vaccination during pregnancy: Canadian Maternity Care Providers' opinions and practices. Taylor & Francis. Retrieved April 6, 2022, from https://www.tandfonline.com/doi/full/10.1080/21645515.2020.1735225
Nair, M., Yoshida, S., Lambrechts, T., Boschi-Pinto, C., Bose, K., Mason, E. M., & Mathai, M. (2014, May 1). Facilitators and barriers to quality of care in maternal, newborn and child health: A global situational analysis through metareview. BMJ Open. Retrieved April 7, 2022, from https://bmjopen.bmj.com/content/4/5/e004749#ref-102