New Maternal-infant Support Worker Program Provides Extra Support for Pregnant Women in First Nations

The first Maternal-infant Support Worker graduates. The program was developed in collaboration with a number of organizations in northwestern Ontario and provides holistic, ground-up professional development for health care workers in First Nations.


When the first cohort of the Maternal-infant Support Worker (MiSW) program graduated this past April, it was a culmination of research, educational partnerships, and grassroots health programming that has the potential to make a profound impact on Indigenous health in northwestern Ontario.

The 20-week program was developed initially from research to help opioid-involved expectant mothers. But MiSW evolved into a more comprehensive – and much needed – approach, providing prenatal care using a blend of Western and traditional approaches.

“There’s a disconnect sometimes with the Western, colonizer, Euro-centric approach versus an Indigenous approach,” said Leanne Tyler, MiSW instructor and implementation coordinator. The issue is complicated by the fact that barriers to care are different for every First Nation, and each has access to different services and funding models.

Tyler, who has worked as a nurse in Sioux Lookout and some First Nations in the region for more than 20 years, said that solutions have to be driven by each First Nation. There isn’t a cookie-cutter solution to suit all needs. “It’s about meeting people where they are at.”

Program development was through collaboration between the Sioux Lookout Area Aboriginal Management Board, Sioux Lookout Meno Ya Win Health Centre, Confederation College, and the Centre for Rural and Northern Health Research at Lakehead University.

Each of the six graduates of the Confederation College-accredited course was already employed as a health worker within her community: Summer Barkman of Kitchenuhmaykoosib Inninuwug First Nation, Julie Kenequanash of Weagamow Lake First Nation, Priscilla King of Kingfisher Lake First Nation, Carmel Meekis of Sandy Lake First Nation, Dolly Nymark of Mishkeegogamang First Nation, and Edna Winter of Kingfisher Lake First Nation.

The certificate program in that sense is essentially continued professional development, taking a bottom-up, grassroots approach to provide learners with enhanced skills to help meet the health needs of expectant women in their communities. It covers prenatal and maternal care as well as training to help graduates address the realities of providing prenatal services in remote First Nations and overcoming barriers to care.

Substance use including opioids is another of those realities some women face. A research study found that up to 80 per cent of adults in First Nations in the area formerly called the Sioux Lookout Zone were substance involved with prescription drugs. ( & However, there wasn’t a clear treatment path for substance-involved women who were pregnant. The first line of treatment for opioids – methadone – isn’t available in remote communities.

Dr. Naana Jumah, a clinical researcher associated with several health care organizations in northwestern Ontario, wanted to find best practices for opioid treatment for expectant women in rural and remote communities.

Dr. Jumah along with Dr. Christopher Mushquash and others researched the complex issues and barriers to care that First Nations continue to face. The MiSW program is a result of that research. She said that graduates of the program provide another level of support to women once they leave Sioux Lookout’s Meno-Ya-Wen Health Centre.

“As a physician, we can do so much in our office, but you know there is so much more going on for the women once they leave your office,” Dr. Jumah said. “Through this research project, I’m able to help make an impact for them at home as well. That’s particularly rewarding.”

Dr. Jumah said that the program also has a positive impact on the graduates and their families. “They are so enthusiastic and it’s just contagious,” she said. “Many of them are looking to enroll in more post-graduate education that they never would have considered otherwise.”

“‘We’re giving them the opportunity to return to education,’” Dr. Jumah said, a quote she attributed to former Confederation College President Dr. Jim Madder. “It’s just such an amazing example for their children, their grandchildren, their communities.”

Tyler echoed those sentiments, saying that the program has helped the women who graduated to grow in confidence.

“The Maternal-Infant Support Worker program has allowed for confidence in skill, in ceremony, in tradition, in language – over and above the primary prevention messages of a healthy pregnancy, it has helped grow confidence for the next generation.”

She added that it’s also an excellent example of supporting First Nations in developing the health care they need from the ground up.

“The health workers in the communities really do know what they are doing,” Tyler said. “They just need to be funded adequately, and then we can just let go and let self-determination drive the direction for these communities.”

A second cohort of MiSW learners is expected to graduate in August 2019.

Filed in: Education, First Nations, News

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