Module 4 Current Array of Aboriginal Health Services. Welcome to Current Array of Aboriginal Health Services. This course takes 45 minutes to complete. There is a quiz at the end of each chapter and a link to handouts and resources at the end of the learning module.
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This course takes 45 minutes to complete. There is a quiz at the end of each chapter and a link to handouts and resources at the end of the learning module.
You can either have the volume turned on or off to complete this learning module.
Select the arrow keys at the bottom of your screen to move forward and move back, or to stop and start the learning module.
By the time you complete this learning module, you will be able to identify:
Aboriginal self-determination in healthcare
Holistic health, and health status monitoring
Federal government programs
Provincial government programs
Current Array of Aboriginal Health Services
Holistic vs. Wholistic: We have used the more commonly seen spelling of Holistic (for non-Aboriginal Canadians) in this module vs. the Aboriginal spelling which refers to Aboriginal philosophy in which everything is related by virtue of shared origins.
This list can be printed if you want to refer to it throughout the module.
True or False
Q: The federal government is responsible for covering the health care needs of all Aboriginal people in Canada (First Nations, Inuit and Métis).
A: True False
Move forward to begin Chapter 1
The International Covenant on Civil and Political Rights, Article 1 states:
“All peoples “All peoples have the right of self-determination. By virtue of that right they freely determine their political status and freely pursue their economic, social and cultural development.”
Essentially this means that a group of people (usually a common ethnicity) living in a territory have the right to determine their own future.
What is Aboriginal Self-Determination in health? Being involved in the health services in response to needs the community has identified, including:
The federal government recognizes that Aboriginal governments and institutions require the authority to make decisions in a number of areas, including health, similar to self-government.
We will review a history of the change in Aboriginal government structure that led to the removal of self-government.
Traditional governments were characterized by the collective ownership of all lands, waterways, forests and wildlife, full participation and consensus in decision-making and non-coercive leadership.
Government policy was usually framed in the context of doing what was best for First Nations, Inuit and Métis people in the long term, but operated in the national interest.
An Overview of the Traditional Aboriginal Government Structure
In Aboriginal culture- all people were considered equal – men, women and youth, and contributed equally to the success of the community.
All Leaders had to agree for a decision to pass that affected the whole community.
At the micro level, decisions were based on need, survival and family structure.
Developments evolved inside of the nation, band, community and the clan structure.
All members were expected to contribute to the benefit of the larger group.
HealthTraditional medicine and Aboriginal health and wellness are rooted in a holistic approach. The steps to the Aboriginal Path of Well-being include:
1. Health in balance: giving equal importance to all aspects of health
6. Joint and personal responsibility: health and well-being is the responsibility of the individual, family and community
2. Wellness: both emotional and spiritual
3. Active choice: one’s ownership for health decisions
4. Holistic approach: balance the mind, body, and spirit with community and environment
5. Understand root causes: past and present aspects that impact health
Post-European contact, a colonial-style government structure was implemented with significant changes to Aboriginal social and government structures.
In this new situation, the economies and belief systems of the two groups were increasingly incompatible.
During the 1800s and mid-1900s, the government exercised extreme measures to assimilate FNIM people into new society. Traditional ceremonies were made illegal:
Spiritual leaders and healers were arrested when trying to perform traditional medicines and healing.
The displacement of the traditional system contributed greatly to the impoverishment of Aboriginal societies.
Poverty was non-existent during these times.
Removed was collective ownership and decision-making.
Impoverishment of Aboriginal Societies
These needs included health, work, and food.
The traditional government system ensured that the needs of the people were met.
One main reason was that they were not consulted during the creation of the paper, and it had major impacts to their lives.
In addition, special rights deriving from their unique and historical relationship with the government.
FNIM Response: Citizens Plus. More commonly known as the Red Paper.
Leaders maintained that their people were entitled to all the benefits of Canadian citizenship.
Leaders based their response on early legislation from 1763 and the intent of their treaties.
Some Key Developments Transfer of Control over Community Health Programs
The Government’s Re-evaluation of Aboriginal Self-Determination in Canada
Over the last few decades, governments recognized that the losses as a result of the policies and practices governments have placed on Aboriginal communities (i.e. assimilation, move to reserves, and removal of self-determination) had a detrimental impact to their well-being. This recognition has resulted in a concerted effort to increase the transfer of health accountability in some form back to Aboriginal communities.
1979: Federal Indian Health Policy recognizes that FNIM people may assume responsibility for administering any or all aspects of their community health programs.
1988: Final Transfer Agreement transfers responsibility for Universal Health Programs to the Government of the Northwest Territories (NWT). NWT would continue to have access to any new federal programs for FNIM people
1988-1989: Cabinet and Treasury Board approves the health Transfer south of the Territories: policy framework, financial authorities and resources for transferring control of community-based health programs to FNIM communities.
1995: Inherent Right to Self-Government Policy recognizes that the inherent right to self-government is an existing Aboriginal right under section 35 of the Constitution substantive information with respect to FNIM control of health services.
April 1999: Nunavut Territory is created with the conditions of the 1988 Northwest Territories Final Transfer Agreement applying to the Government of Nunavut.
Oct. 2013: The Government of Canada hands over full health care services control to the newly formed First Nations Health Authority (100% First Nations community-run) in British Columbia, a first for a province in Canada.
2013: Health Canada\'s Health Services Integration Fund is a five-year, $80 million initiative supporting collaborative planning and multi-year projects aimed at better meeting the health care needs of FNIM Canadians.
2014: Canada Health Transfer (CHT) is the largest major transfer to provinces and territories. It provides long-term predictable funding for health care.
The Federal Indian Health Policy is based on four pillars of public health from which the federal government and FNIM communities can build upon to increase the level of health in FNIM communities:
The removal of Aboriginal self-determination had detrimental effects to the health and well-being of FNIM people.
Are much more likely to have poor health and die prematurely.
Have a higher burden of chronic conditions and infectious disease.
Are more likely to live in poverty affecting aspects of their lives.
Children are more likely to die in the first year of life.
For example: go hungry, or suffer from poor nutrition and obesity.
Lessons from Aboriginal Self-DeterminationIt is well documented that when initiatives are developed, led, and managed by First Nations and Inuit, there is the greatest potential for success in improving health care for their people.
Pictured: MnaamodzawinHealth Services in Little Current, Ontario
1. Community Crisis Teams in Northern Ontario
In response to a rising suicide rate amongst First Nations youth in Northern Ontario, the NishnawbeAski Nation (NAN) reached out and received funding to create crisis teams in the communities.
First Nations communities have considerable flexibility on crisis team spending decisions.
The program is administered by a First Nations organization (the NAN), which is accountable to Aboriginal Healing and Wellness Strategy.
This is an almost pure example of Aboriginal self-determination.
Oct.1, 2013, the federal government transferred its role in the
First Nations health programming in British Columbia to the new First Nations Health Authority.
Under the system, First Nations work closely with government and health agencies for better coordination of health programs and services.
The government funds the program and acts as a governance partner, but do not deliver or define services.
There is one question for this chapter.
Q: Name two reasons that self-determination is important to Aboriginal health as defined in the chapter.
Emerging ModelsFNIM leaders and federal and provincial governments collaborate to improve relationships to develop new models in Aboriginal health programming and service delivery.
What are protocol agreements?Protocol agreements establish and formalize relationships with FNIM people. They provide a framework for collaboration and outline processes for engagement with the FNIM nations regarding a contemplated project or activity that may have adverse effects on established rights.
While protecting and promoting the distinct culture, identity and heritage of FNIM people.
Fosters partnership opportunities that respect FNIM traditions.
Recognizes the unique history and ways of life of FNIM communities in Ontario.
Is intended to improve the well-being of FNIM people and communities.
Sets a collaborative relationship with the government and FNIM people.
Protocol agreements establish and formalize relationships with FNIM people. They provide a framework for collaboration and outline processes for consultation with an FNIMgroup regarding a contemplated project or activity that may have adverse effects on established rights.
Federal and Provincial DirectivesIn 2005, the Blueprint to Aboriginal Health was created as the result of collaborative efforts by federal, provincial and territorial governments and representatives of FNIM people.
Federal consultation directives are specific to First Nations people and Inuit. There are no federal level provisions for Métis people.
Consultation Directive #2Departments and agencies must assess their activities, policies and programs that may adversely impact potential or established Aboriginal or Treaty rights and related interests.
Based on this review, federal officials will ensure that appropriate consultation activities with FNIM groups are carried out.
As such, early discussions with the FNIM groups who may be adversely impacted by a federal activity are crucial.
Consultation Directive #4The Government of Canada and its officials are required to carry out a fair and reasonable process for consultations.
A meaningful consultation process is characterized by good faith and an attempt by parties to understand each other’s concerns, and move to address them.
Consultation Directive #5To manage FNIM consultation and accommodation, the Government of Canada will facilitate efficient and effective cooperation among and within federal departments and agencies via senior federal official governance structures which will assign a lead in a consultation process where the lead is not clear.
Consultation Directive #6The Government of Canada, in carrying out consultation processes, must act in accordance with its existing commitments and processes (e.g. Treaties, Treaty land entitlement agreements, settlements and consultation agreements).
Consultation Directive #7The Government of Canada and its officials can rely on FNIM groups, industry and provinces and territories, to carry out procedural aspects of a consultation process (e.g. information sessions or consultations with FNIM groups). The information collected during can be used by the Government of Canada and its officials in meeting its consultation obligations.
Consultation Directive #8A whole of government approach for FNIM consultation will be used in the regulatory review process for major natural resource projects. Consultation will be integrated into environmental assessment and regulatory approval processes.
True or False
Consultation directives were developed to identify potentially adverse impacts of federal activities on Aboriginal or Treaty rights and interests and find ways to avoid or minimize them.
Provincial DirectivesIn 2004, the provincial government collaborated with FNIM leaders and communities to determine a new approach for FNIM health care.
The collaborative approach to FNIM health care was to realize progress towards goals.
The strategy that was developed was called Ontario’s New Approach to Aboriginal Affairs.
FNIM leaders stressed the need for more control over a range of matters that affect their communities.
FNIM leaders also stressed the importance of improved relationships with Ontario
One of the key goals that emerged was to improve the coordination of provincial and federal programs.
These were considered important elements of Ontario\'s New Approach to Aboriginal Affairs.
The federal government’s duty to consult applies to provincial and territorial governments.
Ontario, has a legal obligation to consult with FNIM people when it contemplates decisions or actions that may adversely impact asserted or established Aboriginal or treaty rights.
Giving timely and accessible information to FNIM communities on initiatives.
Obtaining information on any potentially affected rights.
Listening to any concerns raised by the community, and determining how to address them.
Attempting to avoid, minimize and/or mitigate adverse impacts on Aboriginal or treaty rights.
For initiatives involving federal, provincial and territorial governments, opportunities to coordinate efforts between jurisdictions should be pursued to the maximum extent possible.
The Need for Improved Health Services and AccessWhile First Nations, Inuit and Métis are all recognized as Aboriginal under the Canadian Constitution Act of 1982, policies are not applied consistently across the groups and therefore, each group faces its own unique set of challenges in navigating the Canadian health care system.
The system is based on public policies that have created jurisdictional gaps that are underscored by a continued debate between federal, provincial and FNIM governments as to who is responsible for the delivery of health care to FNIM people. Higher morbidity and mortality rates among FNIM people have partially been attributed to the uncoordinated health care service delivery system.
Source: British Columbia Provincial Health Officer, 2009
Jordan River Anderson, a young child from Manitoba’s Norway House Cree Nation, was born in 1999 with a rare neuromuscular disorder.
The reason was not medical but because of a jurisdictional dispute between federal and provincial governments over who should pay for his home care.
Source: The Aboriginal Health Legislation and Policy Framework in Canada, 2011 National Collaborating Centre for Aboriginal Health
Jurisdictional Responsibilities for FNIM Healthcare Service DeliveryFNIM health policy in Canada is made up of a complicated mix of policies, legislation and agreements that delegate responsibility between federal, provincial, municipal and Aboriginal governments in different ways in different parts of the country.
Source: National Collaborating Centre for Aboriginal Health (NCCAH), 2011
They additionally fund public health programs focused on prevention of communicable disease, safe drinking water, and other public health issues; and non-insured health benefits, which covers expenses not typically covered by provincial health care plans, including dental and vision care, prescription drugs, medical supplies and equipment, transportation and other services.
Source: FNIHB, 2008
The tendency is to delegate responsibility to local levels.
In the absence of a clear national FNIM health policy:
jurisdictional gaps and inconsistent levels of funding continue to create barriers for many FNIM communities
Sources: NCCAH, 2011; Lavoie, Forget, & O’Neil, 2007
Stating the minister may enter into an agreement with Canada and/or First Nations for the delivery of health services.
Legislation and Policy in Ontario
FNIM health Provisions in Ontario:
First Nations and Inuit communities have taken on various levels of responsibility to direct, manage, and deliver a range of federally funded health services.
Over the past three decades, First Nations and Inuit communities have assumed an increasingly prominent role in the design and delivery of a wide range of community health services.
This was done through a series of transfer arrangements and contribution agreements with the federal government.
Delivery of services is administered from direct delivery of services by the First Nations and Inuit Health Branch, transferred health services, or where communities have full control and responsibility for all aspects of providing services, such as the First Nations Health Authority in British Columbia.
Aboriginal Affairs and Northern Development Canada (AANDC)The AANDC funds an Assisted Living Program that provides non-medical social support services and an Income Assistance Program for First Nation seniors’ on-reserve in all provinces and the Yukon Territory.
Shared responsibilities between federal and provincial/ territorial levels of government.
Cancer Research in FNIM People
Funded through the usual sources: governments, universities, hospitals, health charities and private foundations and corporations.
Gaps Due to Jurisdictional Divides The two main issues with the jurisdictional divides are funding and barriers to coordination of services.
Funding levels often depend on the participation of provincial governments in the support of:
FNIM services, and
the availability of FNIM health experts to lobby for support.
This leads to discrepancies, e.g. some off-reserve FNIM community services have to rely solely on fundraising.
There are inter-governmental barriers and cross-jurisdictional barriers that affect the coordination of health services. We have discussed some of them earlier in this chapter.
Legislated definitions have created divisions among FNIM people, e.g.:
Since 1985 First Nations people have been defined pursuant to the Indian Act as status, non-status, and reinstated Indians.
Jurisdictional distinctions divide the FNIM community against itself:
Reserve governments are separate from organizations representing off-reserve people.
Métis organizations compete for the recognition of Métis people.
Inuit organizations seek action on problems in the North.
FNIM stakeholders, health care providers and government agencies across regions develop core health strategies for coordination processes with the hope of bridging gaps.
Recently, cross-jurisdictional mechanisms have emerged in a few provinces.
The Saskatchewan Northern Health Strategy (ended in 2010) that brought together First Nations, Métis, northern municipalities, Regional Health Authorities (RHAs), and federal and provincial authorities.
These methods are steps in the right direction; however their effectiveness in addressing cross-jurisdictional issues is constrained by existing legislation, policies and budgets that are decided at the national and provincial levels.
There are several FNIM specific health policy-frameworks that provide for cross-jurisdictional coordination mechanisms to try to bridge jurisdictional gaps in health service delivery.
The frameworks usually consist of a collaborative committee comprised of stakeholders from FNIM organizations and federal and provincial governments.
They try to reduce the roadblocks to appropriate access to services and/or funding.
Ontario’s Aboriginal Health and Wellness Strategy (AHWS), developed in 1994 is considered to be one of the most comprehensive in the country.
In 2010, the Ontario government worked with its Aboriginal partners to develop a renewed Aboriginal Healing and Wellness Strategy. Five Ontario government ministries fund the strategy.
Source: www.mcss.gov.on.ca/en/mcss/programs/community/ahws/goal_strategy.aspx, Mar 2014
These are formal organizations created either through federal-provincial partnerships or self-government agreements. An example is the Sioux Lookout First Nations Health Authority (SLFNHA) created in 1993 and serving 31 First Nations communities in northern Ontario.
The SLFNHA is partnership between Sioux Lookout Zone First Nations, the Town of Sioux Lookout and the governments of Canada and Ontario.
It has a funding agreement with the provincial and federal governments to provide health services for First Nations people and the residents of Sioux Lookout.
In 2013: Health Canada\'s Health Services Integration Fund (HSIF) is a five-year, $80 million initiative supporting collaborative planning and multi-year projects aimed at better meeting the health care needs of FNIM people. HSIF builds on the lessons learned and partnerships developed under the Aboriginal Health Transition Fund.
Jeannie Simon, NW Navigator
Leah Bergstrome, NSM Navigator
Audrey Logan, ESC Navigator
Chantel Antone, SW Navigator
Deena Klodt, HNHB Navigator
Recruitment Underway, TC Navigator
Verna Stevens, Champlain Navigator
Sherri Baker, NE Navigator
Lynn Brant, SE Navigator
Kathy MacLeod-Beaver, CE Navigator
“Hospitals are an entirely alien environment for the average FNIM person—and even for me. However, my experience at the Windsor Regional Hospital has been nothing but positive. The hospital is fully vested and open to our communities”
Audrey Logan, ESC Aboriginal Patient Navigator
Hamilton Niagara Haldimand Brant
Erie St. Clair
The role of the Regional Aboriginal Cancer Leads is to provide leadership on FNIM cancer care in the region and champion the Aboriginal Cancer Strategy.
The Regional Aboriginal Cancer Leads are located in the 10 Regional Cancer Programs with higher FNIM population to provide support to FNIM patients with cancer and their families
Dr. Shannon Wesley, NW Lead
Dr. Andrea East, HNHB Lead
Dana Strength, NSM Lead
Bernice Downey, TC Lead
Recruitment Underway, Champlain Lead
Dr. Jason Pennington, CE Lead
Dr. Hugh Langley, SE Lead
Dr.Mike Vreugdenhil, SW Lead
Dr. Mark Tomen, ESC Lead
Dr. AnnelindWakegijig, NE Lead
Engage and collaborate with primary care providers
Champion the strategic vision with Regional Cancer Program staff
Lead strategic planning and program design
Conduct peer education and training
“It’s all about building trust. I have always done my best in this regard with my patients and it’s time for the healthcare system to do the same. Respect certainly goes a long way in healing.”
Dr. Mark Tomen, Regional Aboriginal Cancer Lead, Erie-St. Clair Region
Move forward to begin the quiz for this chapter
The quiz for this chapter is comprised of one multiple choice question. Select all responses that you think are accurate for the statement.
Health legislation and policy applicable to Ontario include:
Source: British Columbia Provincial Health Officer, 2009.
The Canada Health Act (CHA), which established national standards for health care service delivery.
Persons insured under the CHA are defined as residents of the province, other than:
The coverage of Status and/or Treaty Indians is not stated.
Source: Department of Justice, 2010
The Federal government agreed that culturally relevant heath care programs and traditional healing traditions that address the whole person are key to reducing FNIM health disparities.
This led to the development of a variety of programming throughout the last few decades.
Understanding offerings at the federal level can help support your decisions when making recommendations to FNIM patients.
Source: Health Canada, 2003
Federal government offered the IHTP to transfer control of health program resources over to the community.
Giving communities flexibility to allocate funds according to community priorities.
One main reason was the lack of improvement in FNIM health status after years of federal spending.
The transfer required specific mandatory public health programs to be provided.
Indian Health Transfer Policy (IHTP)
First Nations and Inuit Home and Community Care programs for over 600 communities.
Instead of increasing funding, they determined that increased input by FNIM people would be more effective.
This freezes inequities between communities, e.g. to keep competent health care professionals in isolated communities, it is often necessary to offer better wages and bonuses than elsewhere, but it is not financially possible.
Meet identified needs: It claims to support the revitalization of indigenous healing practices, with no funds available for this. It does not provide for population growth.
Cover the environment, housing, infrastructure because they do not fall under the umbrella of health care, even though they very much do affect health.
There is a no enrichment clause resulting in major differences between First Nations in the number and quality of services available.
Negative Aspects FNIM have reported that funding does not:
Take into account off-reserve and non-status users. The funding formula has created issues of funding gaps in jurisdictional responsibility.
At its completion date, the AHT Fund funded 311 Aboriginal health-related projects across the country. The projects piloted different approaches to better coordinate and adapt health services including e- and tele-health, substance abuse, child and youth care, mental health, chronic disease, public health, home care and governance.
Families play an important role in encouraging and maintaining healthy lifestyles in Aboriginal communities. Health Canada established programs to support the health of First Nations and Inuit families, including:
Several initiatives under Health Canada’s First Nations and Inuit Health Division are aimed to support and promote better health for status First Nations people and Inuit living on reserve or in the territories.
Aboriginal Diabetes InitiativeEstablished in 1999, the Aboriginal Diabetes Initiative (ADI) was developed to reduce type 2 diabetes among FNIM people (a key health risk factor). It supports health promotion and primary prevention activities and services delivered by trained community diabetes workers and health service providers. The ADI is comprised of four main components.
Primary Prevention and Health Promotion: Community-led and culturally relevant health promotion and prevention activities to promote:
Diabetes awareness, healthy eating and physical activity as part of healthy lifestyles.
The quality of diabetes healthcare, and for evaluation studies and program monitoring of programming at the local, provincial and national levels.
Screening and Treatment: For increased and regular screening for the early diagnosis of diabetes complications. It provides education and support for people living with diabetes and their family members.
Research, Surveillance, Evaluation, Monitoring: Establish partnerships with research agencies / organizations to jointly fund priority research, support to determine:
Four Main Components of the ADI
Capacity Building and Training:
Offers training and continued education for community diabetes workers.
Founded in the 1990s, there are two types of Aboriginal Head Start programs in Canada:
Source: Health Canada, 2003
Health Care ServicesHealth Canada hires over 800 nurses to work directly in First Nations and Inuit communities across the country, and home care workers to take care of the needs of community members in their homes. They provide electronic health services and provide electronic devices for nurses and doctors to see and talk to one another across Canada.
Visit new parents, facilitating new baby care
Encourage physical activity
Facilitate community education sessions
Provide primary care services
Attend to emergency needs
The program works to identify and prevent environmental public health risks that could adversely impact the health of community residents. Programming includes:
In the territories, responsibility for environmental public health programming has been devolved to territorial governments or First Nations and Inuit control as part of land-claims settlements.
In 2002, Health Canada launched the Early Childhood Development Strategy.
That are language appropriate, and support the family unit and community dynamic.
It’s goal was to improve and expand early childhood development programs for First Nations and Inuit children.
They combine traditional and modern healing practices, nutritional and education services.
The Canada Prenatal Nutrition Program (CPNP)
98 % of communities report that CPNP provides a unique service in their community.
Instead of increasing funding, they determined that increased input by FNIM people would be more effective.
Provinces and territories are responsible for delivering health care services, guided by the provisions of the Canada Health Act.
However, there are some health-related goods and services that are not insured by provinces and territories or other private insurance plans.
It is on the NIHB benefit list.
Prior approval or predetermination is obtained.
It is for use in the home, other ambulatory setting.
It is not available through any other
It is prescribed by a physician, dental care provider, or other licenced health professional.
It is provided by a recognized provider.
Specific range of drugs as outlined on the Drug Benefit List (DBL)
Exceptions Items not on the DBL, but which may be considered on a case-by-case basis with written medical justification and prior approval
Exclusions Items not on DBL which don’t apply to the exception process
Open Benefits Drugs listed on DBL which are covered without the need to meet established coverage criteria
Limited Use BenefitsDrugs listed on DBL with specific criteria that must be met
There is an appeals process if a benefit is denied.
An eligible client, their parent, legal guardian or representative may initiate the appeal process.
Condition for which benefit is being requested
Justification for proposed treatment
Diagnosis and prognosis (note alternatives tried)
Relevant diagnostic test results
We will review how the NIHB process works in Ontario
There are more details about the NIHB program in the handouts available at the end of this learning module.
The global political climate has influenced on the policy decisions of the Canadian federal government. For example, to gain credibility and avoid criticism from the United Nations (UN) factored into Canada’s extension of voting rights to Indians in 1960 and the 1969 White Paper’s proposal to abolish Indian Status (Cairns, 2000). In 2007, Canada voted against the UN Declaration on the Rights of Indigenous Peoples, stating that it was inconsistent with the Canadian Constitution Act of 1982 and the Canadian Charter of Rights and Freedoms (Indian and Northern Affairs Canada, 2009); however, in 2010, Canada officially endorsed the Declaration and reaffirmed the nation’s “commitment to promoting and protecting the rights of Indigenous peoples at home and abroad” (Indian and Northern Affairs Canada, 2010).
2013 First Nations Gain Support to Declare Canada’s Treatment of Aboriginal People Genocide
In 2013, former National Chief Phil Fontaine, elder Fred Kelly, businessman Dr. Michael Dan and human rights activist Bernie Farber sent a letter to a UN representative on the rights of indigenous peoples, detailing that specific crimes against aboriginal people in Canada qualify as genocide under the post-Second World War Convention on the Prevention and Punishment of the Crime of Genocide.
Article 2 of the Convention states that genocide means any of the following acts committed with intent to destroy, in whole or in part, a national, ethnical, racial or religious group, as such:
Causing serious bodily or mental harm to members of the group.
Forcibly transferring children of the group to another group.
Imposing measures intended to prevent births within the group.
Deliberately inflicting on the group conditions of life calculated to:
Killing members of the group.
Bring about its physical destruction in whole or in part.
In August, 2013, the campaign gained local and worldwide attention, and brought to light several unresolved issues that needed to be addressed.
Moving forward, global policies and pressures will likely continue to shape the federal government’s position on public policy and FNIM health.
The United Nations’ Human Development Index (HDI) ranks countries on the social and economic well-being of their people.
In 2010, the UN released a study that showed the ranking if countries were judged solely on the social and economic well-being of their FNIM people.
The substantial difference in Canada’s HDI Rank overall vs. FNIM truly demonstrates the disparity between FNIM people and non-Aboriginal people.
This chapter has one true or false question.
Q: The Aboriginal Head Start On Reserve Program is comprised of six components: education; health promotion; culture and language; nutrition; social support; and parental/family involvement.
A: True False
September 2004: the AHWS’ mandate to combine traditional and contemporary services was revised to include a four-pronged approach as seen above:
Improve FNIM health
Support family healing
Facilitate community development and integration
Encouraging physical activity
Visiting new parents, facilitating new baby care
Providing primary care services during scheduled clinics
Attending to emergency needs
Facilitating community education sessions
2006-2011: From the Aboriginal Health Transition Fund (AHTF), Ontario received funding for:
One of the key achievements of the AHTF initiatives in Ontario was the development of an Ontario First Nation Tripartite Public Health Relationship Framework.
The framework uses an integrated approach to on-reserve public health and facilitates collaborations among governments and First Nations people.
2011: Ontario established the Trilateral First Nations Health Senior Officials Committee in partnership with the federal government and the Chiefs of Ontario.
The committee focuses on four priority areas identified by the Chiefs of Ontario:
2013: diabetes was expanded to include chronic disease prevention with a focus on diabetes and cancer.
Cancer Care Ontario (CCO) developed the Aboriginal Cancer Strategy II in collaboration with:
The strategy aims to help FNIM people decrease cancer incidence and mortality rates and better navigate the cancer care system.
Aboriginal Patient Navigators and Regional Aboriginal Cancer Leads in four regions were appointed in December 2012.
2012, Métis Nation of Ontario released the findings from its study on chronic diseases in Ontario’s Métis population
Ontario Federation of Indian Friendship Centres (OFIFC)
Received a grant to analyze and use health data from Our Health Counts and administrative databases held by the Institute of Clinical and Evaluative Sciences.
More information about the programs discussed in this section of the chapter is available at the end of this learning module.
Pictured: M\'Chigeeng First Nation in West Bay Ontario
Located at Sunnybrook Health Sciences Centre and Princess Margaret Hospital
Toronto Central Regional Cancer Programs (Two programs)
Champlain Regional Cancer Program
Erie St. Clair Regional Cancer Program
Mississauga Halton Central West Regional Cancer Program
Central Regional Cancer Program
South West Regional Cancer Program
Waterloo Wellington Regional Cancer Program
Central East Regional Cancer Program
North Simcoe Muskoka Regional Cancer Program
Hamilton Niagara Haldimand Brant Regional Cancer Program
North West Regional Cancer Program
North East Regional Cancer Program
South East Regional Cancer Program
The Ontario government funds a network of 10 Aboriginal Health Access Centres and three Aboriginal Community Health Centres.
These are FNIM community-led, primary health care organizations that provide primary care, health promotion /prevention activities, and services offered by traditional healers and elders.
AHACs are community-led, primary health care organizations that provide a combination of services to FNIM people in all locations.
There are ten locations across Ontario.
In 1989, the federal government offered the Indian Health Transfer Policy to transfer control of health program resources over to the community.
One of the main reasons for this change stemmed from the lack of improvement in Aboriginal health status after years of federal spending.
So instead of increasing funding, they determined that increased input by FNIM peoples would be more effective.
The assumption was that the community could better respond to the local needs better than a centrally managed program could.
The transfer required specific mandatory public health programs to be provided, giving communities flexibility to allocate funds according to community priorities, and limits funding, by way of a non-enrichment clause, to health care delivery costs at the time of transfer.
MenoYaWin" in the Anishinaabe language means "health, wellness, well-being", and refers to holistic healing and wellness, the "whole self being in a state of complete wellness".
MenoYa Win Health Centre, Sioux Lookout
A 60-bed hospital and 20-bed Extended Care facility that services all residents within Sioux Lookout and the surrounding area, including the Nishnawbe-Aski communities north of Sioux Lookout, the Treaty #3 community of Lac Seul First Nation, Hudson, Pickle Lake and Savant Lake.
They also offer an Aging at Home Elder Care Continuum program to improve the health and well-being of seniors in remote and isolated communities.
Tungasuvvingat Inuit Family Health Team Medical Centre and Family Resource and Health Promotion Centre
The Centre incorporates features unique to the Inuit population to provide high quality, culturally appropriate, interdisciplinary primary care for the community across the entire life cycle spectrum with a focus on identified Inuit population health priorities.
WAHA is responsible for providing comprehensive health services and facilities serving six communities along Ontario’s James Bay and Hudson Bay coastal regions, Moose Factory, Fort Albany, Attawapiskat, Moosonee, Kashechewanand Peawanuck.
A charter aircraft provides services to Kingston for eligible First Nation patients requiring diagnostic tests such as CT scans and MRI’s and specialist care.
Akwesasne Health provides home and long-term care to First Nations seniors in Cornwall, enabling them to stay in their communities with access to culturally relevant care.
The Erie-St. Clair CCAC has strategies to have direct engagement with FNIM communities to help plan health programs including support with cancer resources, financial aid, breast screening, and education.
Community Care Access Centres (CCACs) focus on removing barriers to access to care options and services including in FNIM communities.
Alzheimer Society London & Middlesex and the Oneida Nation of the Thames provides culturally safe information and support to First Nations people with dementia.
Other Health Services
Additionally, they adapted a residential treatment program specific for FNIM men. It is being extended to include a women’s program.
Centre for Addictions and Mental Health provides counselling to FNIM people experiencing homelessness, substance abuse and mental health issues.
Canadian Cancer Society offers support and information for people with cancer. This includes supporting information about services such as First Nations Healing.
Mamaweswen, the North Shore Tribal Council Collaborates with First Nations and the Indian Friendship Centre to improve primary health care services.
Their Chronic Disease Surveillance Project gathers Métis specific health data. One example is the March 2012 Cancer in the Métis Nation of Ontario Clinical Significance Report.
Ottawa Health Services Network Inc.
Coordinates specialist and tertiary health care for residents of the Baffin region while respecting the Inuit vision of wellness.
Métis Nation of Ontario Community Centres serves as cultural and service hubs that link Métis people to services and supports in their local areas across the province.
Other Health Services
Oneida Nation of the Thames
Offer programs to reduce the isolation of seniors by promoting social interaction and activities in southwestern Ontario.
The room contains Aboriginal medicines including sweet grass, sage, cedar and traditional tobacco.
Ontario Renal Network (ORN) organizes and manages the delivery of renal services. The ORN has established an FNIM resource room in London, ON.
Enhances and supports FNIM community capacity to understand and solve complex health care issues, improve access and address barriers to care.
Some activities include research, education and knowledge exchange.
It also provides links between hospital and communities to support discharge planning.
Tyendiaga Home and Community Care Program and the Community Wellbeing Centre
Supports integrated care, a single point of access, and a continuum of home care.
Supportive Care Oncology Networks Network of professionals that plan for supportive care services and advocate for equitable access to and delivery of these services.
Other Health Services
KeewaytinookOkimakanak - Knet Chief’s Council supports resources at the community level for the effective delivery and management of health services in Northwestern Ontario.
KeewaytinookOkimakanak Telemedicine Ontario delivers clinical, educational and administrative services via videoconferencing and advanced information communication technologies.
They provide cultural respectful services, to meet the needs of the FNIM population who make up one of the higher percentages of people seen.
Clearly states that the use of tobacco for ceremonial purposes will not be regulated under the terms of this legislation.
Where Ontario Ranks Compared to Other Provinces:
The quiz for this chapter is comprised of one short answer question.
Q: What program is available that coordinates cancer care for FNIM patients across local and regional healthcare providers, including coordinating care with hospitals, physicians, nurses, and pharmacists?
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