BACKGROUND

In November 2000, the Centres of Excellence for Women’s Health Research Synthesis Group, composed of representatives from each Centre, the Canadian Women’s Health Network and Health Canada’s Women’s Health Bureau, identified Aboriginal women’s health research as a priority. Accordingly, the Research Synthesis Group launched an initiative designed to capture the cumulative knowledge and experience generated through Centre activities in the area of Aboriginal women’s health, as a basis upon which to establish directions for future work in this area.This paper seeks to contribute to this process in four principal ways:

• By providing an overview of key health and health-related indicators for Aboriginal women in Canada.
• By conducting a critical review and synthesis of research and other initiatives on Aboriginal women’s health undertaken or funded by the Centres of Excellence for Women’s Health.
• By reporting on the proceedings of the National Workshop on Aboriginal Women’s Health Research, held in Ottawa in March 2001.
• By formulating recommendations to serve as the basis for priority-setting in future Aboriginal women’s health research activities

SUMMARY OF KEY FINDINGS

The Aboriginal women’s health initiatives undertaken or supported by the Centres of Excellence for Women’s Health are characterized by diversity of methodology and approach,as well as being heterogenous in the themes they address and insights they offer. In reviewing the projects,five principal theme areas were identified, encompassing Aboriginal women’s health status; violence and sexual abuse; substance abuse and maternal health; health-seeking behaviour; and access to services. While all of the initiatives undertaken or supported by the Centres probe questions of key concern to Aboriginal women, additional work is needed in a number of areas. In particular, steps must be taken to ensure that research methodologies are clearly articulated and respectful of Aboriginal women’s multiple burdens; that attention be focussed on groups of Aboriginal women whose needs and concerns have been under-represented in previous research; and that research initiatives be reflective of Aboriginal women’s linguistic and cultural diversity. Other issues identified in the paper include the lack of sufficient funding to pursue Aboriginal women’s health research, and the need to ensure adequate and appropriate followup. Also highlighted was the importance of giving Aboriginal women control over research that affects them, along with the need to enhance training and networking opportunities for Aboriginal women researchers, and to foster partnerships and collaboration with both Aboriginal and non-Aboriginal organizations.

SUMMARY OF RECOMMENDATIONS

To promote the indigenization of the research process, it is recommended that the Centres of Excellence for Women’s Health:

1. Clearly define options for doing health research on Aboriginal women.
2.  In conjunction with Aboriginal women’s health researchers and appropriate Aboriginal organizations, outline a strategy for just, sustainable and inclusive collaborations and partnerships; and educate researchers and research participants about health research and Aboriginal women.
3. In conjunction with appropriate Aboriginal and non-Aboriginal organizations and Health Canada’s Women’s Health Bureau, develop a strategy for the incorporation of Aboriginal women’s health stories, experiences and knowledge into an analytical framework that can be used as a “lens” when doing research with Aboriginal women.
4. Work with appropriate Aboriginal and non-Aboriginal organizations to promote a dialogue between academic and community researchers, and address outstanding issues related to health research on Aboriginal women, particularly as these relate to identity, culture and key social categories.

To engage Aboriginal women in the research process, it is recommended that the Centres of Excellence for Women’s Health:

1. Recognize Aboriginal women’s multiple burdens, including poor health status, poverty, violence, substance abuse, child care and over-surveillance.
2. Encourage Aboriginal women’s health researchers and appropriate Aboriginal and non-Aboriginal organizations to work with Aboriginal women in communities to promote participation in research projects; develop a strategy for re-framing issues in ways that ascribe new meanings and actions to theoretical constructs and intransigent problems; share approaches to mobilize Aboriginal women; and identify mediating structures which would strengthen community-driven research.
3. In conjunction with the Canadian Women’s Health Network, coordinate research and develope policy that would support Aboriginal women’s groups; involve researchers deemed to be personally suitable for work with Aboriginal women; protect the rights of both researchers and Aboriginal women; build upon Aboriginal women’s strong leadership role in health-related matters at the community level; recognize the evolving capacity of Aboriginal women to conduct research; and show sensitivity to diverse audience groups.
4. Work with Aboriginal women’s health researchers to develop an analytical tool which would assist in establishing research priorities in the area of Aboriginal women’s health so as to weigh the consequences of acting or not acting on key health issues; and examine the pain/health/healing paradigm that informs the provision of health care services to Aboriginal women.
5. In conjunction with the Centres of Excellence for Women’s Health, Health Canada’s Women’s Health Bureau and other relevant federal government departments, consider the feasibility of holding an annual meeting on Aboriginal women’s health research.

To address gaps and weaknesses in Aboriginal women’s health research, it is recommended that the Centres of Excellence for Women’s Health:

1. Work with Aboriginal women’s health researchers and appropriate Aboriginal and non- Aboriginal organizations to determine when, how and why academic and community methodologies should override, intersect or co-exist with one another; identify and track positive health indicators; facilitate networking by Aboriginal women’s health researchers; exploit new information technologies to disseminate and share research findings; undertake analyses which compare and contrast local, regional and international trends, issues and solutions; and articulate both gender- and Aboriginal-based analyses.
2. Work with Aboriginal women’s health researchers to develop culturally-appropriate methodologies; identify model communities such as Alkalai Lake and Hollow Water; develop aknowledge base of key Aboriginal concepts and principles (eg. respect) which may be relevant in the pursuit of health research; situate research in larger social, economic, political, legal and cultural contexts; undertake research which is sensitive to Aboriginal women’s diversity; understand the implications of the medicalization of Aboriginal women’s health; execute research which supports Aboriginal women’s programming needs. (Authors)