Building a sexual and reproductive health program

Aboriginal Nurse, The, 2002

Introduction

This Sourcebook is for both Aboriginal and non-Aboriginal health and social service providers - nurses, community health representatives, teachers, public health workers, counsellors and community developers - who work with First Nations, Inuit or Metis people in Northern, rural or urban settings. The many connections among aspects of the individual, family, community and nation are important themes to remember as you work on sexual and reproductive health. The rest of Part 1 explains ways that you can build these themes into the way that you do your work and the programs and services that you offer. Here are some basics - how to get started, barriers to services for Aboriginal clients, how to make programs and services culturally appropriate, and tips on working with different age groups. And for those who have had more experience, we can all gain from a reminder about the basics!

You can apply many of the suggestions in this section no matter what kind of service you provide, what health issues you want to work on, or who your audience is.

Specific suggestions for different age groups and for school settings are mentioned later in this section. Activities and handouts which have been taken from other resources are also featured. These resources are full of great ideas, far too many to include in this section. You can find out more about these resources by checking the Resource Information section at the end of the Sourcebook.

Involving Community Members

When working in the sensitive area of sexual and reproductive health, as in all other health issues, you will get the best results when community members are active in the design of your program.

However, it is not easy to get people to talk openly until they trust that you will respect them and understand their feelings. So much depends on relationships. Developing trust takes time, especially where cultural differences exist. If you have not established trust in the community, the information you provide may not be accepted or believed. If possible, take time to experience and appreciate life in the communities as a way to build trust.

Talking to each other or to trusted service providers about sexual and reproductive health concerns is an important step for individuals, families and communities to heal. This may be difficult at first because, for many Aboriginal people, talking about sex has become taboo often because of experiences in the residential schools -- what the schools taught about sex, and the sexual abuse which some children suffered there.

They say in the old days there was a way to talk about this sex business. But I don't remember anyone showing me. The mission school just told us sex was bad.

What some of the pilot coordinators told us:

At the Grand Council level, we have learned that the success of our Sexual Wellness Program depends on: identifying "movers and shakers" in the community, modeling a good interagency approach and supporting community efforts. You must have a shared belief and common concern, address contributing factors such as addictions, abuse and self-esteem and be willing to think "outside the box." Don't forget to include the target group in planning! Tamma Seime, Sexual Wellness Program, Prince Albert Grand Council, Prince Albert, Saskatchewan

... I think a key learning for me was that so many families are broken and hurt. After much discussion I have found that focusing on the healing of the family will contribute most to healthy sexuality. In my dealings with clients, I have found that abuse is a main factor for so many dysfunctions within the family. If even one family member can break the cycle of abuse, it will result in healthier lifestyles for others.

Julie Borle, Metis Child and Family Services Society, Edmonton, Alberta

When working with the community, it is important to always keep in mind the issues that may be facing them. Sometimes meeting basic needs is just as important as getting a message across. For instance, at Ma Mawi, we offer transportation, snack or supper and child care in order to increase attendance. Regardless if people are just attending for the food, they might hear the message and come back in the future for support.

Willow Boulanger, Positive Adolescent Sexuality Support Project, Ma Mawi Wi Chi Itata Centre Winnipeg, Manitoba

We used the Sourcebook as a focus of several meetings with local Aboriginal and non-Aboriginal agencies to explore the community's capacity to deliver appropriate sexual health services to Aboriginal people in the city. The meetings were extremely beneficial to everyone involved as they provided an opportunity to connect with other organizations, share concerns, brainstorm solutions and create lasting relationships.

Barb McWatters, Planned Parenthood Regina, Regina, Saskatchewan

Respecting Cultural Differences

People from different cultures have different ways of looking at the world and different traditions that affect how they feel, think and act. The differences between cultures based on individualism and those based on interconnectedness have already been discussed. Respecting other cultures is essential whether you are teaching, counselling, providing health services or running workshops. Your program needs to be culturally appropriate - it is important to learn about the history, culture and traditions of the people you are going to work with. This is not a quick and simple task. Each Nation and community is different. You have to be open and work at it.