Navigating life: Community perceptions of MCH

Introduction: This project sought to gather community perceptions of Maternal and Child Health (MCH) related issues. Given the strong social and familial interconnectedness of these Native communities, MCH must necessarily be viewed within the context of the entire community.

Methods: An advising consortium developed potential focus group questions. Each community formed a local planning team that reviewed potential questions for relevance, significance, and cultural congruency. Key health staff were interviewed to gain understanding of local realities. Three focus groups were held in each community, one with mothers, one with fathers, and one with grandparents. Focus group participants were asked semi-structured questions with an American Indian interviewer. In a few cases, one-on-one interviews were conducted with persons who were unable to participate in focus groups. Thematic analysis was conducted using Atlas TI software.

Results: Although the communities that participated were culturally different from one another, there were universal themes. Focus group participants overwhelmingly longed for parental, community, and peer guidance around such life trajectory issues such as sexuality, breastfeeding, parenting, culture, etc. However, participants felt that their communities were uniquely placed to provide this support due to the kinship, clanship and social networks that define their communities. They also expressed the need for community action around issues, instead of third party program planning placed on top of the community. Potential future interventions should be developed by community members, and positioned within the context of the larger community.