Garry Shen, MD, PhD - Four Arrows Regional Health Authority

Garry Shen MD PhD

Title Of The Project:

To assess the impact of COVID-19 on prenatal education and pregnancy outcomes in mothers and children in remote First Nations communities

Principal Investigator: Garry Shen MD PhD

Affiliation: University of Manitoba

Partner: Four Arrows Regional Health Authority (FARHA)

Significance of the study and benefits for residents in Island Lake communities

During last several years, COVID-19 caused a large amount of death and sickness of people in the world. The travel restriction and social isolation due to the pandemic seriously interrupted the regular medical service, education and normal life for all residents in communities. Pregnant women living in remote communities received even more severe impact due to the geographical barriers and inappropriate access to medical service and education partially due to lack of high speed Wi-Fi service. This will not only affect the long-term health of mothers, but also their bearing children.

We propose this project to use both database and survey in pregnant women living in all regions in the province, and focus on pregnant women living in Island Lake communities, since our previous studies demonstrated women and children in Island Lake communities under high risk of diabetes and its complications including heart, kidney, liver, eye and limb diseases. Through the proposed study, we will discover the differences in maternal and infant pregnancy outcomes, prenatal services, education, food intake, physical activities, infant feeding between women and children living in urban, rural and remote communities. We will also assess the impact of COVID-19 on the mood and mental health of pregnant women and new mothers, which could affect the feeding and health children as well. The quality of care and education during prenatal, delivery and postnatal period in mothers living in remote communities will be compared to other areas in the province.

The information collected from the study will help us to identify the weakness of the health system and areas, which will be potentially improved to prevent the harmfulness in future pandemic or other unpredicted situation on pregnant women and children. The improvement of prenatal and postnatal program in the communities based on the results of the study will help to convalesce the long-term health of women, children and the next generation of most residents in the communities. The evidence based data and feedback from mothers in remote communities will be reported to national and provincial health authorities to make policy changes in prenatal and postnatal health, particularly in remote communities such as Island Lake communities. The studies and future improvement of community prenatal and postnatal work are unable to be achieved without the supports from community health authorities and community health workers. The data collected from community participants and the results of the studies will be transferred to FARHA and participating communities as detailed in this Data Transfer Agreement, which will help the capacity building in prenatal and postnatal health in the communities.

Supporting Breastfeeding around Labor meeting (Moms in Motion website news)

Breastfeeding has declined in Manitoba over the past several years. On October 20, 2023, a meeting entitled “To support breastfeeding around labor” was held in University of Manitoba in Winnipeg. The meeting was co-organized by the Moms in Motion Research Team (MIM), the Department of Obstetrics, Gynecology and Reproductive Science (OGRS) at the University of Manitoba, and the First Nation Health and Social Secretariat of Manitoba (FNHSSM).

The purpose of the meeting was to share recent findings, progresses and initiatives on breastfeeding in Manitoba.

Dr. Garry Shen and his colleagues in MIM team and the Department of Internal Medicine at the University of Manitoba recently conducted an administrative database study on breastfeeding initiation in Manitoba from 2014-2021 to assess the impact of the Lactation Consultant Program on mothers’ decision to initiate breastfeeding for their babies.

The Lactation Consultant (LC) Program has been discontinued in major hospitals in Manitoba since January 1, 2018 due to funding cuts. This withdrawal of the LC program was associated with a significant decline in breastfeeding initiation among First Nations (FN) and non-FN mothers living in urban, rural, or remote communities during the period of 2018-2021, compared to that during 2014-2017.

The reduction in breastfeeding initiation in FN and remote-living babies was 3-fold of that in non-FN or urban-living babies.

During the meeting, Dr. Vanessa Poliquin, the Department Head of OGRS and Provincial Medical Specialty Lead for Women’s Health, Ms. Kira Friesen, co-lead of the Baby Friendly Initiative and a clinical nurse specialist, and Ms. Angela Matwick, Provincial Clinical Service Lead for Women’s Health in Shared Health, introduced a provincial breastfeeding initiative in the province. Ms. Elizabeth Decaire, the Nurse Program Advisor in FNHSSM, provided an update on the current status of supporting breastfeeding in First Nations communities.

All attendees of the meeting, including healthcare workers in rural and remote FN communities, agreed on an urgent need to improve breastfeeding status in Manitoba, and expressed interests to further discuss a strategic plan for how to enhance breastfeeding to babies in all ethnic groups living in all regions in the province.

Brief Biography: Garry Shen MD PhD

Dr. Garry Shen is a Professor in the Section of Endocrinology and Metabolism, Departments of Internal Medicine and Physiology in University of Manitoba. He received his medical degrees in Shanghai Jiaotong University School of Medicine and received research training in University of Iowa, Cleveland Clinic Research Institute, University of Alberta and Harvard Medical School.

He became a faculty member in Department of Internal Medicine, University of Manitoba since 1991 and currently serves as the Associate Director of Diabetes Research Group, Co-Chair of Endocrine Research Group, and the group leaders of Moms-in-Motion study.

His research program has been supported by multiple national grant agencies. He has published more than 150 full sizes papers or book chapters. He has received a numbers of career awards including Alberta Heritage Foundation Postdoctoral Fellowship Award and New Investigator Award from Canadian Lipoprotein Conference and Iacocca Visiting Professor Award from Joslin Diabetes Center.

He and his group have collaborated with First Nations Health and Social Secretariat of Manitoba, Fours Arrows Regional Health Authorities (FARHA) on the prevention of diabetes in pregnant women for near 2 decades. He worked with community health workers to promote prenatal education, healthy eating, physical activity and breastfeeding, and co-chaired Moms in Motion Conference in 2023 with FARHA.

For more information visit: www.momsinmotion.ca