Appendix 3: Provincial activity profiles

Newfoundland and Labrador

Activities

In Newfoundland, three-quarters of the organizations surveyed are engaged in activities to influence personal capacities using education, and more than half are providing support or services. Many do training, and one in three are working on public policy or research. A few organizations (for instance, the Newfoundland and Labrador AIDS Committee, the Provincial Strategy Against Violence and the Provincial Association Against Violence) use the full spectrum of mechanisms for addressing sexual and reproductive health, with activities ranging from counselling people living with HIV/AIDS and their families, to training rural trainers, to addressing policies that discriminate against gay men and lesbians, and developing a policy framework on violence.

More than half of organizations surveyed in Newfoundland are involved activities to improve access to services through public policy means. Several also provide support and services aimed at improving access. A major, multi-sectoral initiative begun in the early 1990s builds capacity in regional organizations to offer services and respond to HIV/AIDS in rural communities. This initiative (led by the Department of Health and Community Services, the Newfoundland and Labrador AIDS Committee and others) is a good example of an inter-sectoral process to improve access to services.

Many Newfoundland organizations are working to strengthen families and communities, using the range of mechanisms available. Another significant activity by organizations in the scan involves providing support and services to reduce social and economic risk conditions. The work of the Naomi Centre for Women exemplifies this activity. The Centre offers information and educational presentations on pregnancy prevention and STIs in connection with the provision of supportive housing for homeless women.

Areas

Most of the organizations surveyed in Newfoundland provide services in St. John's and the surrounding areas, although they accept referrals from elsewhere in the province. A few of these organizations serve the entire province. Major, province-wide initiatives include the Provincial Association Against Family Violence, the Provincial Strategy Against Violence, the Newfoundland and Labrador AIDS Committee and the reproductive health program of the Department of Health and Community Services. In practical terms, access to the services of most organizations in the scan is limited to the region around St. John's.

Life Stages

The greatest amount of effort in Newfoundland is directed at youth and women. Services and supports to youth include counselling victims of sexual abuse, testing and treatment for STIs and HIV, pregnancy testing, developing and distributing self-care tools for women and providing peer support to adolescent mothers. One major initiative aimed at children (Brighter Futures Coalition) is a CAPC project that works to improve outcomes for children aged 0-6, by providing support and education to parents, especially in low-income families. A number of organizations target Aboriginal people in their work, especially the province-wide activities of the Department of Health and Community Services. One organization deals exclusively with Aboriginal issues.

Upstream Focus

The organizations working on public policy are the Newfoundland and Labrador AIDS Committee, the Department of Health and Community Services, the Provincial Association Against Family Violence, the Provincial Strategy Against Violence and the Women's Health Network of Newfoundland and Labrador. These organizations are actively working to influence or create public policies in areas such as family violence, housing, social services and health care. A third of the organizations also are participating in or leading activities to advance knowledge about how to influence individuals' capacities to make healthy choices. The Women's Health Network of Newfoundland and Labrador is an example of these efforts.

Marginalized Groups

Newfoundland organizations that deal exclusively with vulnerable sub-groups are the Canadian Paraplegic Association (disabled), the Provincial Association Against Family Violence (women), Care Centre for Women, Naomi Centre for Women (e.g., young, street-involved) and the Women's Health Network of Newfoundland and Labrador. With the exception of the Care Centre for Women (which deals largely with issues surrounding unplanned pregnancies), all of these organizations have sexual violence close to the top of their agendas.

Critical Problems

In the first part of the report, information was presented on high rates of sexual assaults in Newfoundland and recent increases in HIV infections. These critical problems are already high on the agenda of health providers in Newfoundland, judging from major, province-wide strategies and upstream activities in place to deal with each.

Recent increases in chlamydia suggest that new population health strategies aimed at youth may be required to reduce unprotected sex among young people in Newfoundland.

Prince Edward Island

Activities

In Prince Edward Island, nearly all of the organizations surveyed focus their efforts at individuals, with activities to improve personal health practices and individuals' capacities. Half or more of the organizations surveyed in Prince Edward Island use every mechanism except community capacity building to achieve their aims in terms of individuals' skills, capacities and behaviours.

Half of the Prince Edward Island organizations surveyed also place emphasis on strategies involving families and communities and access to services, using support services as the principal means of implementing these strategies. In general, these organizations in Prince Edward Island do not direct attention at collective factors such as societal values, physical environment and social and economic inequities, with the exception of the AIDS PEI Community Support Group. This province-wide initiative addresses social and economic conditions of persons living with HIV/AIDS by working with employers on policies for employees with HIV/AIDS and advocates for income and social support for clients.

Areas

The majority of Prince Edward Island organizations surveyed are based in Charlettown, though they serve the entire province. Exceptions are the East Prince Women's Information Centre located in Summerside, serving Prince County, the Evangeline Community Health Centre which serves francophone areas of the province, and the Inner City Youth Connection which serves just the Charlottetown area.

Life Stages

The lion's share of activity devoted to influencing personal capacities is directed at youth in Prince Edward Island. Two major, province-wide initiatives (Prince Edward Island Reproductive Care Program and the Prenatal Nutrition Intervention Program) are aimed at improving early child health outcomes, and the AIDS PEI Community Support Group targets education and capacity building at children as well as youth and adults. The Inner City Youth Connection is a major youth-led initiative for street-involved youth based in Charlottetown. It provides support and skills development training to 13 to18 year olds, with the goal of helping them to reach their maximum potential.

Upstream Focus

Several organizations in Prince Edward Island engage in planning (e.g., Reproductive Care Program - developing guidelines for HIV screening of pregnant women) and lobbying (e.g., East Prince Women's Health Centre - presenting briefs to provincial politicians regarding women's health policies) to influence public policy regarding opportunities for individuals to make healthy choices.

The AIDS PEI Community Support Group creates partnerships with church groups, schools and community organizations to build capacity for supporting persons with HIV/AIDS. Otherwise, public policy, capacity building and advancing knowledge are generally not used by these Prince Edward Island organizations as mechanisms for achieving sexual and reproductive health goals.

Marginalized Groups

Prince Edward Island groups dedicated to the needs of vulnerable sub-groups in the population include the East Prince Women's Resource Centre, PMS/Menopause Self-Help Resource (women), Inner City Youth Connection (street-involved youth), Mi'kmaq Family Resource Centre (Aboriginal people) and Evangeline Community Health Centre (francophones).

Critical Problems

Prince Edward Island, like the other Atlantic provinces has high rates of sexual violence. The organizations surveyed almost all include violence in their mandates, but none are comprehensive or work upstream to eliminate violence.

It is difficult to know whether HIV and teenage pregnancies are increasing or decreasing in Prince Edward Island, given available information, but chlamydia has been rising steadily in recent years. This may indicate changes in unprotected sexual activity that would increase risks for other sexual health problems. On the other hand, it may signify changes in detection or reporting practices. It will be difficult to understand and address these issues without more attention to advancing knowledge in these areas.

Nova Scotia

Activities

Following the pattern of the other provinces, Nova Scotia organizations also focus the largest portion of their efforts on influencing personal health practices, capacities and coping skills. Nearly two-thirds of organizations provide support/services and more than half offer education to improve individuals' capacities. Several are engaged in training activities, research and/or the influencing of public policy. Access to services is the next most significant direction for Nova Scotia organizations, with less attention being given to strategies involving families and communities, and only a few organizations explicitly addressing societal values.

Areas

Nova Scotia initiatives in the scan are spread across the province, with a high concentration of activity located in Halifax and the northern counties of Cumberland, Pictou and Antigonish. Eight of the organizations serve the entire province. Planned Parenthood Nova Scotia, a provincial organization, has five local affiliates around Nova Scotia. Cape Breton has a range of organizations, including youth health centres, Planned Parenthood and AIDS community-based organizations. The area least represented by organizations in the scan is southwestern Nova Scotia.

Life Stages

A majority of Nova Scotia organizations have a youth and/or adult focus. Somewhat less emphasis is placed on children, or child health in families. Nevertheless, in this scan, a major public policy initiative directed at children in Nova Scotia is the provincial education curriculum involving health (Gr. P-12), personal development and relationships (Gr. 7-9), and career and life management education (Gr. 11), mandated by the Department of Education and Culture. Another major initiative directed at youth (Amherst Association for Healthy Adolescent Sexuality) has the goal of enhancing community resources by building capacity to improve the sexual, physical and emotional health of adolescents.

Upstream Focus

Several Nova Scotia organizations are engaged in activities to influence the broad causes of sexual and reproductive health problems. Those involved in influencing policy, for example, are lobbying governments about social assistance policies, working on interagency committees to improve services to sexually abused women and advocating with school boards for policies sensitive to gay and lesbian issues.

Capacity building and influencing values are also important themes. The Atlantic First Nations AIDS Task Force trains service providers to be sensitive to the needs of Aboriginal clients with HIV/AIDS. The Nova Scotia Roundtable on Youth Sexual Health is an inter-sectoral initiative which aims to influence attitudes and make communities more receptive to youth sexuality by developing community capacity. Likewise, the Lesbian, Gay and Bisexual Youth Project also works to change values and attitudes. They have created interactive workshops to reduce homophobia which they offer to schools, group homes, universities and law enforcement personnel. To date, they have conducted over 600 workshops.

Marginalized Groups

Nova Scotia also has strong representation of organizations in this scan dedicated to the needs of certain vulnerable sub-groups, in particular, Aboriginals (Atlantic First Nations AIDS Task Force -- a regional initiative based in Halifax), injection drug users (Mainline Needle Exchange), gay and lesbian youth (Lesbian, Gay and Bisexual Youth Project), women (Antigonish Women's Resource Centre, Avalon Sexual Assault Centre) and francophones (Association des Acadiennes de la Nouvelle-Écosse). Notably absent among these initiatives are organizations addressing the sexual and reproductive health needs of Nova Scotians of African descent, who constitute an important cultural minority group in the province.

Critical Problems

In Nova Scotia, rates of teenage pregnancies, STIs, HIV and AIDS infections are higher than in the other Atlantic provinces. The youth focus of most Nova Scotia initiatives in the scan and the level of attention to vulnerable sub-populations is consistent with these problems. Given the extent of the problems, however, more resources may need to be devoted to population health strategies for reducing unprotected sexual activity that results in STIs, HIV and adolescent pregnancy. The same can be said for eliminating the use of contaminated needles.

The high rate of sexual assaults in Nova Scotia, relative to the rest of the country, calls for a more comprehensive, strategic approach to violence reduction than exists currently in the province.

New Brunswick

Activities

Among the Atlantic provinces, the surveyed organizations in New Brunswick stand out for the level of effort and the range of mechanisms devoted to strengthening the capacity of families and communities to maintain and improve sexual and reproductive health. Half or more of the New Brunswick organizations in the scan work to influence families and communities by providing support/services, education and training; nearly one-third have activities to improve personal health practices and capacities by building community capacity. In addition, a few of the New Brunswick organizations in the scan use advancing knowledge and policy means to achieve their aims with families and communities.

Less attention is given to strategies involving personal health practices and access to services by New Brunswick organizations than in other provinces. In contrast, more effort is spent promoting sexuality-positive societal values. Additionally, four major initiatives are actively engaged in influencing policy, either through planning or advocacy: the Coverdale Centre, SIDA/AIDS Moncton, VON New Brunswick and the Coalition Against Abusive Relationships.

Areas

Most of the New Brunswick organizations surveyed are not province-wide. Rather, they serve the areas where they are located, with the exception of the New Brunswick Public Health Sexual Health Program (with nine Sexual Health Centres around the province), the Clinique de Reproduction and Parents and Families of Lesbians and Gays, which have province-wide mandates. In general, New Brunswick organizations in the scan are located in the cities of Moncton, St. John and Fredericton, and serve the southern and southeastern regions of the province, especially the southern Acadian shore. The northern counties are not served by most of these organizations. At least one organization, the Clinique de Reproduction, includes Prince Edward Island in its scope.

Life Stages

Like the other provinces, organizations surveyed in New Brunswick devote considerable attention to issues of youth and children, but the focus is much more on supporting families than in the other provinces. Organizations such as Parents and Families of Lesbians and Gays, the Beausejour Family Crisis Resource Centre, the VON Lifestyle Education for Adolescent Parents Program and the New Brunswick Public Health Sexual Health Program all provide support/services, education and training with a focus on youth and/or children in families.

Upstream Focus

In New Brunswick, the organizations surveyed are not currently directing their efforts at policy or advancing knowledge. In terms of community capacity, however, the Beausejour Family Crisis Resource Centre is one of several local partners in a province-wide "Caring Partnerships" campaign to eliminate family (including sexual) violence. Their efforts in community mobilization include using the Internet to distribute a kit on developing community organizations.

Marginalized Groups

New Brunswick organizations dedicated to working with vulnerable sub-groups in the population include Parents and Families of Lesbians and Gays, Coverdale Center (women involved with the justice system) and the Multicultural Association of the Greater Moncton Area (immigrants).

Critical Problems

Given data that show a substantial increase in HIV infections in New Brunswick in the past year, as well as historically high risk of exposure from injection drug use, there is a clear need for a comprehensive strategy to address HIV/AIDS in the province. The recent introduction of anonymous HIV testing, a network of AIDS community-based organizations and provincial sexual health centres will be key to such a strategy. High levels of sexual assaults are being addressed by the work of most organizations, which includes upstream capacity building and research to advance knowledge about sexual violence.

 

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