Examining barriers to harm reduction and child welfare services for pregnant women and mothers who use substances using a stigma action framework

often had limited resources such as housing, food and employment Underlying a number of the barriers at the institutional level (Bessant, 2003; Carlson et al., 2008; Comfort & Kaltenbach, 2000; is the differing mandates and paradigms between the substance Henry et al., 2018; Lean et al., 2013; Lussier et al., 2010; Marcenko use and child welfare fields, and the resulting lack of coordination et al. [...] In this discussion, the barriers associated with the four levels of stigma identified in the Action Framework are summarised 4.2 | Training and education and linked to examples, identified through the larger project on stigma, pregnancy, parenting, child welfare and opioid use (Schmidt Service provider education and training can target stigma at the et al., 2019), of emergent strategies from the s. [...] These interventions are multilevel, allowing service providers and policymakers to identify and act on This scoping review was conducted to understand how stigma and how stigma and barriers at the institutional and population levels related factors impact access to, retention in and outcomes of harm permeate and influence barriers at the individual and interpersonal reduction programmes and child. [...] While the results capture principles for developing and advancing anti- stigma interventions stigma and related barriers at the individual, interpersonal, and to that promote harm reduction, recovery, and capacity to parent, in an extent, the institutional levels, literature that captured barriers order to reach and engage pregnant women and mothers who use at the population level was limited. [...] In the studies cited in this review, we presented evi- how discriminatory laws and policies shape women's experiences dence of successful interventions that were guided by the principles with accessing substance use treatment and child welfare services of being traumainformed, culturally safe and women- centred and and how these policies could be improved to support women and in that support mothe.