CSSS de la Montagne, Montreal, Quebec

Imagine that you're pregnant and need the services of many different specialists to help you have a healthy pregnancy. Wouldn't it be great if they were all located under one roof? For the women of downtown Montréal, Quebec, this dream has become a reality through the Maternal Child and Family Program offered by local CSSS. CSSS (de santé et de services sociaux) are health care organizations funded by the Province of Quebec that focus on health promotion and disease prevention. Each CSSS provides access to a range of health professionals such as nurses, social workers, registered dietitians, doctors, dental hygienists and educators.

The purpose of the Maternal Child and Family Program is to support the health of women throughout their pregnancy and support families in raising a healthy baby. In addition to the funding received by the province, the program receives funding from the Public Health Agency of Canada through the Canada Prenatal Nutrition Program (CPNP). The CPNP funds enhance the services offered by the CSSS to better serve pregnant women experiencing poverty or other conditions of risk and to hire a part-time registered dietitian.

The program also receives funding from La Fondation OLO, a Quebec based organization which provides funding to over 140 CSSSs different sites. The aim is to provide enough calories and protein to make sure the moms are eating well and the baby is born with a healthy birth weight.

Participants join the program by going directly to their CSSS and/or through referrals from outside services, such as hospitals, clinics, unemployment services, or the Department of Youth Protection. Women are first assessed; any mother who may be at risk for nutrient deficiencies or a low weight gain during pregnancy, has a history of delivering a low birth weight baby, or is experiencing depression and/or poverty is eligible to receive food coupons and services. All women, whether they are eligible to receive the OLO coupons or not, are encouraged to meet with a nurse and other health care professionals once a month to discuss health related issues. Women are encouraged to come to the CSSS, but arrangements are made to visit them at home if that is not possible. As well, if transportation to the clinic is a problem, taxi coupons are provided. Outside of monthly visits, women can drop in or call the centre to receive any of the services they have been assessed for or if they have any further questions.

At the CSSS de la Montagne, program participants come from many different social and cultural backgrounds including a large number of Asian and Arab immigrants. Other participants faced with issues of poverty include large numbers of students. While the CPNP funds support the inclusion of women experiencing poverty and other conditions of risk, there are also a lot of financially stable and highly educated women who attend the CSSS's Maternal Child and Family Program. Being a part of this mixed population of people provides a unique opportunity for participants to learn from the experiences of others and make new friends.

The Maternal Child and Family Program also offers a 6-week series of prenatal courses in French, English, and Chinese. All program participants are encouraged to bring a partner or support person with them to these sessions. The courses are facilitated by nurses, dietitians and social workers and topics include: labour and delivery, sexuality, community resources, baby care, maternal and newborn nutrition, communication, and breast feeding. The program also plans to include a session focussing on the role of the father.

When a child is born in Quebec, the CSSS is notified and a nurse visits the family within 3 days of the child coming home. At this point, the family is encouraged to attend a growth development clinic where they can receive free vaccines required for the baby. It is also recommended that the family attend postnatal classes offered by the Maternal Child and Family Program.

An 8-week series of infant stimulation group sessions is offered to mothers with children from 0-6 months old. At these sessions, topics as varied as vaccines, infant crying, infant massage, childhood illnesses, dental hygiene, and introducing solids food are discussed. Upon completion of these classes, additional infant stimulation group sessions are offered to mothers with children from 6-12 months old and 12-18 months old. The CSSSs' team-based approach seems like an appropriate way to support moms and families in forming a new "team" with their babies.