Tag Archive for: equity

Behind the Science: Investigating Maternal Nutrition and Preeclampsia in Low Income Settings

Interviewee: Maggie Woo Kinshella, PhD candidate, University of British Columbia. Authors/Editors: Romina Garcia de leon, Shayda Swann (Blog Co-coordinator).

Published: December 16th, 2022 

Could you briefly explain what your research is?

My PhD research is looking at the relationship between the food that women eat during pregnancy and our risk of developing preeclampsia, which is a serious condition during pregnancy characterized by high blood pressure in the second half of gestation alongside signs of maternal organ damage, especially in the liver and kidneys. My research is particularly looking at this relationship in Sub-Saharan Africa, where there’s a disproportionate burden of maternal deaths, as well as higher prevalence of malnutrition. 

This work is within the PRECISE Network, which is a large prospective pregnancy cohort in three countries in Sub Saharan Africa, Kenya, The Gambia and Mozambique, to give us an idea of what’s happening in East Africa, West Africa, and South Africa. The overall goal is to do research on placental conditions – including preeclampsia – in Sub-Saharan Africa, as most of the research has been done in high income settings like Canada, the United States, or the UK, where pathways of risk may be different. It’s really trying to look at within these resource limited settings, whether there are different pathways, such as a higher prevalence of malnutrition.

The research uses mixed methods, which I’m super excited about. There’s a quantitative component using the PRECISE Network surveys where they asked women about their medical history and socio-demographics, as well as did a dietary diversity score, which is the number of food groups that the woman eat in the past 24 hours. I’m going to be looking at whether a woman’s dietary diversity is linked to developing pregnancy hypertension.

I also did qualitative community-based research in each of the three countries, it was really neat! I was able to go to the three countries and it was so wonderful to be able to work with the local staff. For over a month in each country, I did focused ethnography, where we did participant observation and shadowed pregnant women and recently-delivered mothers throughout the whole day to understand where they’re getting their food, how they’re cooking it. and how they’re eating it. We also did interviews with women, as well as their male relatives, other female relatives, and community leaders.

Then we did photovoice, which is a really interesting participatory research activity that involves giving cameras to women, and they took pictures of how they made the food, where they got the food from, as well as barriers and facilitators. We then printed out the photos and we had a discussion about them afterwards. 

What led you to become interested in this women’s health issue with the maternal diet and hypertension?

I’m taking a human rights approach to health in my PhD. Really early on, looking at this research, I realized there was a there was a there was a systemic neglect of women’s health within maternal diet research.

The Safe Motherhood Initiative is really momentous in getting people to think more about maternal mortality, because they realized that there was this “measurement trap”. Maternal and child interventions ended up having a bigger benefit on child health and assuming that that would spill over into women’s health. However, that wasn’t reducing maternal mortality rates, because that reducing maternal mortality rates requires explicit interventions on facility maternity care, for example. They call this a “measurement trap” because these indicators of women’s health are systematically neglected. Similarly, nutrition programs are often intervening with pregnant women, and within mothers with small children, but they’re measuring the outcome in child growth. So, you’re intervening with the women, but you’re not measuring the outcomes in women. I think  that is a very systematic neglect and an injustice.

For example, there’s a lot of research out there are multiple micronutrients, so multivitamins, and they never measure preeclampsia as an outcome. They hardly even measure maternal mortality. It’s always low birth weights and other outcomes like that, which I think is a huge missed opportunity to look at some of these maternal indicators.

Why do you think it’s important to study women’s health?

Women are often seen in the lens of reproduction, which can be a big part of identity and things like that. However, it’s looking at women as instrumental that exploits gender norms and stereotypes, rather than being empowering. I think you cannot have community empowerment if women are systematically neglected and you can’t have women’s empowerment without our health and you can’t have health without food. I think looking at food is really fundamental. 

It seems you have been involved in a lot of community work, can you tell us a bit more about what you’ve accomplished outside of academia?

I think it’s really important to ground our academic work in terms of how it’s applied or to have an idea of how things actually are on the ground. I’ve been involved in a small NGO in Western Africa that worked with household health and gender equality projects. We had a program to raise awareness and have a community resource center to prevent sex- and gender-based violence in a small community in Western Kenya. We also had a women’s health education program. With this program, we did some fundraisers that included kayaking from Vancouver up to Alaska to raise money and awareness, as well as we cycled from Vancouver all the way down to Argentina, which was really amazing.

I’ve also spent some time in Ethiopia. I was a volunteer there as a  technical adviser on reproductive, maternal and child health communications and health promotion for the Benishangul Gumuz regional Health Bureau. I was working on was helping them reinvigorate their health promotion and health education program, particularly around understanding perspectives of the major Indigenous groups in the area.

I’ve also done some work in the Downtown Eastside, as a frontline mental health worker in various housing, treatment, and detox facilities, as well as doing community-based research there. I was a freelance research consultant, working with different organizations on issues that came up during clinical work that they wanted some more clarification and understanding about.

What impact do you hope to see with your work years from now?

I’m hoping to be a part of this paradigm shift to value and measure women’s health indicators.I think this neglect is systemic. As people kind of realize that, “Oh, wow. We didn’t measure this before”, hopefully, that builds momentum with more groups measuring it, focusing on it more, and realizing different areas where there might be a systemic neglect.

Overall, I really hope that this research, depending on the findings, is able to speak to the relationships between maternal diet and maternal health and hopefully support meaningful and appropriate prevention and interventions. 

Where can people find out more about your work and what you do?

You can find me on Twitter @MaggieWooK  or on our website. You can also email me at maggie.kinshella@cw.bc.ca

 

Behind the Science: Health Access of Indigenous Women


Interviewee: Chelsey Perry, M.S.c, Simon Fraser University, Authors/Editors: Negin Nia & Romina Garcia de leon (Blog Co-coordinators)

Published: July 15th, 2022

This week the WHRC spoke to Chelsey Perry, who is focusing her master’s work and research with the Centre for Gender and Sexual Health Equity (CGSHE) to examine social and structural factors that influence health access of Indigenous women, Two-Spirit and gender-diverse people. Perry has been working on several projects aiming to make a change in a colonial health system, and to amplify Indigenous voices. Read more about their work below.

Could you please tell us about the work that you do with the Centre for Gender and Sexual Health Equity?

I started my master’s degree at SFU last year and before that I started working on some projects in the summer at the CGSHE. They were about decolonizing Indigenous research methodologies and creating training for researchers who want to get involved in Indigenous research with the CGSHE and Vancouver Coastal Health. 

On the other hand, I am also working on projects with the SHAWNA (Sexual Health & HIV/AIDS: Longitudinal Women’s Needs Assessment) and AESHA (An Evaluation of Sex Workers Health Access) cohorts housed at CGSHE. In these projects we have pulled the Indigenous data from those two cohorts to specifically look at Indigenous women, Two-Spirit and gender diverse people’s experiences throughout the COVID 19 pandemic.This was to make sure that we are accurately and appropriately looking at the data from an Indigenous lens. And, also to inform on social and structural inequities during the course of the pandemic. 

My work specifically focuses on access to routine health care for Indigenous women, and gender-diverse people during the pandemic. But, also how Indigenous communities have come together and how that’s impacted access to health services among Indigenous women, Two-Spirit and gender diverse people.

And how does this tie into your master’s thesis?

My master’s work is nested within a larger project called the Amplify project at CGSHE, which looks at equitable and culturally safe sexual and reproductive health services among Indigenous women, Two-Spirit and gender-diverse people. This is where my master’s work and my research work are really intertwined. My master’s research focuses on that access to routine health care, access to sexual reproductive, and health services. But I also do work on other projects for the Amplify project and the AESHA cohort as well. 

What got you interested in this type of research in the field of women’s health?

I have always been interested in health research because of my family experiences and just wanting to make change in a colonial health system. There is a lot of room to bridge gaps between a colonial health system and Indigenous ways of knowing. I have mixed Nisga’a, Haida, Scottish and French ancestry and I’m a member of the Nisga’a First Nation – and I think my varying identities can bring a unique perspective to this work.

I also believe that it is so important to be amplifying Indigenous voices to inform actionable change — and I want to be a part of supporting change. And I really wanted to work with the supervisors I’m working with, because they have all been doing excellent work within this field and really inspire me. 

What are some long-term goals for your research?

In my thesis research, each objective is tied to the calls to action and recommendations from the Truth and Reconciliation, In Plain Sight, and the Inquiry into Missing and Murdered Indigenous Women and Girls reports. So, this research addresses calls to action and recommendations from these reports to look at gaps within health outcomes between Indigenous and non-Indigenous peoples as well as social and structural factors that impact Indigenous women, Two-Spirit and gender diverse peoples health.

I hope this research will support policy changes to address the urgent need for culturally safe care and anti racism legislation, here in BC, but also broader in Canada, too. And to address health gaps that are caused by social and structural inequities.

Where can people find you and your work?

People can learn more about me and my work @chelseyllperry on Twitter and on LinkedIn.

The BC Women’s Health Foundation on Embedding Equity

 

Author: Mita Naidu, Senior Manager, Public Engagement + Education, BC Women’s Health Foundation Editors: Negin Nia & Romina Garcia de leon (Blog Co-coordinators)

Published: June 3rd, 2022

“We do not learn from experience. We learn from reflecting on experience.” – John Dewey

BC Women’s Health Foundation (BCWHF) is a medium-sized philanthropic organization dedicated to advancing the full spectrum of women’s health. We help ensure women have equitable access to the highest quality healthcare when, where, and how they need it.

While our mission is clear, the work can be complicated when put into practice — especially when viewed through the lens of underrepresented communities. At BCWHF, we recognized we had work to do and committed to a journey of learning how to meaningfully embed equity and equality practices throughout our organization.

We knew that Equity, Diversity, and Inclusion (EDI) training would help provide clarity, support, and a sense of safety to our team. So, we began this journey with dialogue and exploration — and speaking truth to power.

The Path

This year, we honoured Black History Month, which was a new experience for us. With no organizational blueprint, our approach was experimental but not haphazard. For such a significant month, we wanted to ensure that we were on the right trajectory in approaching equity and inclusion at an organizational level, first and foremost. Not just in how we show up internally but also alongside the communities we collaborate with. 

We began our process months prior and kept two questions at the forefront. How can we meaningfully engrain the foundations of equity and inclusion in our organizational DNA? And why does it matter in the first place?

We asked these questions reflectively while also looking forward and considering the trajectory of BCWHF. Primarily, we wanted to assess if/how equity existed in our organization, policies, and culture and where we needed to fill gaps with action. We knew this internal ‘unpacking’ was a critical step towards earning the right to join conversations surrounding equity and inclusion. 

This is what we learned:

1) Stop stalling and start.

Our organization, like most non-profits, has a big mission with finite resources and capacity. This creates the perfect conditions for pre-empting equity work with “what-ifs.” Moving beyond fear and courageously addressing the gaps is crucial. Not starting can undermine organizational trust, especially among IBPoC staff who don’t get to walk away from inequality because it gets “uncomfortable.”

2) It starts at the top.

It is critical to collaborate on equity work across the organization. But EDI is transformational and, therefore, must start at the top. Leaders have to take charge in guiding through potential discomfort, friction, and difficult conversations, which requires a considerable investment of time. Leaders must also provide adequate support and feedback and not place this responsibility on IBPoC staff. This investment from leadership is essential, no matter how difficult the journey.

3) Authenticity is more than a buzzword.

Bringing our truths (safely) to EDI work reveals our privileges, biases, values and power dynamics. In doing so, we can build trust and connection through our actions. This is the nexus where EDI work takes hold. Through transparency, discomfort, and mistakes, impactful change can yield positive ripple effects that become organizational best practice. No longer considered a “soft skill,” — being an authentic organization can help develop community engagement. 

4) Be on the same page.

An organization may have many different voices, but having a unified institutional voice is vital in EDI work. Partners, staff, and community must know that an organization proactively drives forward initiatives that bring about parity and inclusion. This voice demonstrates that an organization is serious – and that there are no debates when it comes to fairness. Additionally, while workplace consensus is important, so is striving to understand the legacies and histories of systemic oppression and instilling those learnings within the organization.

5) Be consistent.

Being consistent is more difficult than it seems, but with consistency comes hope. Anti-oppressive language, strategies for all teams, inclusive branding, revising policies, recruiting IBPoC staff, check-ins and call-ins, and measuring outcomes are tools that can help an organization remain on track with EDI goals. Unyielding effort is required for organizations to transform a commitment to EDI into action. 

6) Community engagement is key.

Primarily, it’s to walk the talk of equity and earn public trust. Communities best understand real and tangible action and know when their voices show up in policy. They also know when they’re being tokenized and when EDI actions feel performative and temporary. Authentic community engagement, deep listening, creating space for dialogue, and committing to action matter most.

7) Mistakes are inevitable.

No organization has ever gotten it right. But for many IBPoC, just knowing an organization is applying these lessons is significant. While mistakes bring discomfort, this can be a good thing. It allows individuals to learn, adapt, and potentially change their perspectives. As staff, community stakeholders, and the public watch your EDI journey unfold – remaining open to criticism, dialogue, and assessment is paramount.  

Equity work takes consciousness, commitment, and consistency while recognizing that equity work isn’t for IBPoC. Ultimately, it is a chance for organizations to catch up and mitigate systemic gaps. At BCWHF, we have learned that the journey is as meaningful as the outcome. And this makes us better advocates as we undertake the actions in serving, supporting, and growing the community.