An examination of the social determinants of health as factors related to health, healing and prevention of foetal alcohol spectrum disorder in a northern context – the brightening our home fires project, Northwest Territories, Canada

OBJECTIVE: The Brightening Our Home Fires (BOHF) project was conceptualized as an exploratory project to examine the issue of the prevention of foetal alcohol spectrum disorder (FASD) from a women's health perspective in the Northwest Territories (NT). While dominant discourse suggests that FASD is preventable by abstention from alcohol during pregnancy, a broader perspective would indicate that alcohol and pregnancy is a far more complex issue, that is, bound in location, economics, social and cultural views of health. This project was prevention focused and a social determinant of health (SDH) perspective informed this research. METHODS: The BOHF project was a qualitative research project using a participatory action research framework to examine women's health and healing in the north. The methodology utilized was Photovoice. Women were provided training in digital photography and given cameras to use and keep. The primary research question utilized was: What does health and healing look like for you in your community? Women described their photos, individually or in groups around this central topic. This research was FASD informed, and women participants were aware this was an FASD prevention funded project whose approach focused on a broader context of health and lived experience. RESULTS: This project drew 30 participants from: Yellowknife, Lutsel ‘ke, Behchokö and Ulukhaktok. These four different communities across the NT represented Dene and Inuit culture. The qualitative data analysis offered themes of importance to women's health in the north including: land and tradition; housing; poverty; food; family; health, mental health and trauma, and travel. Photovoice provides a non-threatening way to engage in dialogue on complex health and social issues.