Developing a Health Equity Impact Assessment 'Indigenous Lens Tool' to address challenges in providing equitable cancer screening for indigenous peoples.

BACKGROUND: In spite of past efforts to increase screening uptake, the rates of screening-detectable cancers including breast, cervical, colorectal and lung are rising among Indigenous persons in Ontario compared to other Ontarians. The Ontario Ministry of Health has an equity framework, the Health Equity Impact Assessment (HEIA) Tool, that was developed to guide organizations in the provision of more equitable health and social services. Although the HEIA Tool identifies that the health of Indigenous persons may benefit from more equitable provision of health and social services, it provides very little specific guidance on how to apply the HEIA Tool in a culturally relevant way to policies and programs that may impact Indigenous peoples. DISCUSSION: Guided by the Calls to Action from the Truth and Reconciliation Commission of Canada and the United Nations Declaration on the Rights of Indigenous Peoples, an Indigenous Lens Tool was developed through a collaborative and iterative process with stakeholders at Cancer Care Ontario and with representatives from Indigenous community-based organizations. The Indigenous Lens Tool consists of four scenarios, with supporting documentation that provide context for each step of the HEIA Tool and thereby facilitate application of the equity framework to programs and policies. The document is in no way meant to be comprehensive or representative of the diverse health care experiences of Indigenous peoples living in Canada nor the social determinants that surround health and well-being of Indigenous peoples living in Canada. Rather, this document provides a first step to support development of policies and programs that recognize and uphold the rights to health and well-being of Indigenous peoples living in Canada. CONCLUSIONS: The Indigenous Lens Tool was created to facilitate implementation of an existing health equity framework within Cancer Care Ontario (now Ontario Health). Even though the Indigenous Lens Tool was created for this purpose, the principles contained within it are translatable to other health and social service policy applications.

A Canadian survey of postgraduate education in Aboriginal women's health in obstetrics and gynaecology.

OBJECTIVE: To assess Canadian obstetrics and gynaecology residents' knowledge of and experience in Indigenous women's health (IWH), including a self-assessment of competency, and to assess the ability of residency program directors to provide a curriculum in IWH and to assess the resources available to support this initiative. METHODS: Surveys for residents and for program directors were distributed to all accredited obstetrics and gynaecology residency programs in Canada. The resident survey consisted of 20 multiple choice questions in four key areas: general knowledge regarding Indigenous peoples in Canada; the impact of the residential school system; clinical experience in IWH; and a self-assessment of competency in IWH. The program director survey included an assessment of the content of the curriculum in IWH and of the resources available to support this curriculum. RESULTS: Residents have little background knowledge of IWH and the determinants of health, and are aware of their knowledge gap. Residents are interested in IWH and recognize the importance of IWH training for their future practice. Program directors support the development of an IWH curriculum, but they lack the resources to provide a comprehensive IWH curriculum and would benefit from having a standardized curriculum available. CONCLUSION: A nationwide curriculum initiative may be an effective way to facilitate the provision of education in IWH while decreasing the need for resources in individual programs.

Objectif : Évaluer les connaissances des résidents canadiens en obstétrique-gynécologie en matière de santé des femmes autochtones (SFA) et leur expérience dans ce domaine (y compris une auto-évaluation de la compétence), et déterminer la capacité des directeurs de programme de résidence d'offrir un curriculum en SFA et d'évaluer les ressources disponibles en vue de soutenir cette initiative. Méthodes : Des sondages destinés aux résidents et aux directeurs de programme ont été distribués dans tous les programmes de résidence agréés en obstétrique-gynécologie du Canada. Le sondage destiné aux résidents comptait 20 questions à choix multiple couvrant quatre domaines clés : connaissances générales au sujet des peuples autochtones du Canada; les effets du système de pensionnat; l'expérience clinique en SFA; et une auto-évaluation de la compétence en SFA. Le sondage destiné aux directeurs de programme comptait une évaluation du contenu du curriculum en SFA et des ressources disponibles en vue de soutenir ce curriculum. Résultats : Les résidents détiennent peu de connaissances préalables au sujet de la SFA et des déterminants de la santé, et sont conscients de ces lacunes. Ils s'intéressent à la SFA et reconnaissent l'importance de pouvoir disposer d'une formation dans ce domaine pour leurs activités professionnelles à venir. Les directeurs de programme soutiennent l'élaboration d'un curriculum en SFA, mais ne détiennent pas les ressources nécessaires pour offrir un curriculum exhaustif dans ce domaine et tireraient avantage de la disponibilité d'un curriculum standardisé. Conclusion : La mise sur pied d'une initiative nationale en ce qui concerne l'élaboration d'un curriculum pourrait constituer une façon efficace de faciliter l'offre d'une formation en SFA, tout en atténuant la nécessité pour chacun des programmes de chercher à obtenir des ressources à cette fin.

Assessment of the ideal body image of women in Accra, Ghana.

The hypothesis tested in this study was that the 'traditional build' is the culturally valued body shape by Ghanaian women. Culturally sensitive figural stimuli were designed to assess the current body image (CBI) and the ideal body image (IBI) of Ghanaian women. The most frequently selected model for the CBI was one that represented a slightly overweight woman; the IBI selected was consistent with a representation of normal body mass index; and the least healthy image was that figure that represented morbidly obesity.