Gender-informed and place-based harm reduction: exploring service offerings in Atlantic Canada.

Abstract

This research investigates the implementation and challenges of harm reduction strategies, emphasizing gender-informed approaches and geographical disparities across Atlantic Canada. Despite compassionate principles aimed at minimizing the adverse effects of substance use, harm reduction strategies face significant opposition from policymakers and the public. This study uniquely contributes to the field by examining the intersection of gender-informed approaches, regional disparities, and policy challenges in harm reduction services within Atlantic Canada, an area that has received limited attention in previous research. Gender-informed harm reduction services address unique risks faced by different genders in substance use, including the differential impacts of gender roles and expectations. Tailored programs addressing mental health and experiences of violence and trauma benefit women and gender-diverse individuals. However, such services are often limited and concentrated in urban centers, leaving gaps in smaller provinces/territories and rural settings in Canada. Health and social spending reductions have exacerbated the inaccessibility of holistic harm reduction services. Time-limited programs pose a significant barrier, often failing to meet the evolving needs of pregnant and parenting women and gender-expansive AFAB individuals. Strong collaborations and place-based approaches are essential for equitable access to services and well-being during pregnancy and postnatally. Flexible, long-term support systems for both parents and children are necessary, and reduce common fears and experiences of judgment, stigma, and child welfare involvement that deter people from seeking care. An environmental scan study of community-based harm reduction projects in Atlantic Canada was conducted. Environmental scans involve a systematic process of collecting, analyzing, and interpreting information about organizations' internal and external environments and are used to inform policy and programming. Data analysis using open and focused coding revealed critical gaps in service provision as well as notable improvements in the availability and quality of harm reduction services in the region. Findings indicate a need for gender-specific services, a comprehensive continuum of care, and equitable geographic distribution of services. Addressing these gaps through tailored, informed, and inclusive strategies can enhance the effectiveness of harm reduction, improving long-term health outcomes for individuals, families, and communities across Atlantic Canada.