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Background In Manitoba, low-income pregnant women are eligible for the Healthy Baby Prenatal Benefit (HBPB), which provides up to CAD $81.41/month during the second and third trimesters of pregnancy. In research conducted in partnership with the Manitoba Metis Federation, we examined the association of the HBPB with Metis birth and early childhood outcomes. Methods Using the whole-population administrative data repository at the Manitoba Centre for Health Policy, we identified all Metis women who gave birth in Manitoba 2003–2011 and limited the cohort to women who were low-income (receiving income assistance during pregnancy; n = 4891). We adjusted for differences between the treatment (received HBPB; n = 3702) and control (did not receive HBPB; n = 1189) groups with propensity score weighting, and then used propensity score weighted regressions to compare birth and early childhood outcomes between the groups. Results Receiving the HBPB was associated with a lower risk of low birth weight (adjusted Relative Risk [aRR] 0.74; 95% CI 0.59, 0.94) and preterm (aRR 0.78; 95% CI 0.65, 0.94) births, a higher risk of large-for-gestational-age births (aRR 1.21; 95% CI 1.06, 1.39) and neonatal readmission within 28 days (aRR 1.58; 95% CI 1.05, 2.37). HBPB receipt was also associated with increased childhood vaccinations at age 1 (aRR 1.08; 95% CI 1.00, 1.15) and 2 (aRR 1.12; 95% CI 1.06, 1.18). We observed no significant associations for Apgar scores, small-for-gestational-age births, breastfeeding initiation, birth hospitalization length of stay or child development scores. Conclusion A modest unconditional prenatal benefit provided to low-income Metis women was associated with improved birth outcomes and child vaccinations; however, an association with increased large-for-gestational-age births may warrant further exploration. Lack of significant associations between HBPB and child development measures suggests more sustained support may be necessary to improve longer-term outcomes.

Background The Families First Home Visiting (FFHV) program aims to enhance parenting skills and strengthen relationships between parents and their children. Previous research found FFHV to be effective at decreasing child maltreatment in the general population of Manitoba, but whether it is beneficial specifically for First Nation families has not yet been investigated. Methods De-identified home visiting program data from 4010 First Nation families with children born 2003–2009 were linked to population-based administrative data housed at the Manitoba Centre for Health Policy. We applied inverse probability of treatment weights to adjust for confounders related to enrollment in FFHV, and then compared rates of children taken into care of child welfare, maltreatment-related hospitalization, and children witnessing or being a victim of a crime in FFHV-enrolled families to rates in families eligible for but not enrolled in FFHV. Results FFHV enrollment was associated with lower rates of children being taken into care before the age of 1 (adjusted Risk Ratio [aRR] 0.687; 95% Confidence Interval [CI] 0.576–0.819) and age 2 (aRR 0.763; 95% CI 0.611–0.881), lower rates of hospitalization for maltreatment-related injuries by age 3 (aRR 0.429; 95% CI 0.187–0.983), and lower rates of children witnessing or being a victim of a crime (aRR 0.591; 95% CI 0.385–0.907). Conclusions Families enrolled in FFHV had lower rates of maltreatment-related indicators compared to families eligible for but not enrolled in the program. Strategies for increasing enrollment through partnerships with First Nation organizations are recommended.