The Tripartite approach to implementing Health Actions from the TFNHP
The Transformative Change Accord: First Nations Health Plan and the Tripartite First Nations Health Plan identify 29 action items and a further number of action items to be addressed in the Tripartite relationship between the iFNHA, Provincial and Federal Governments. This identifies a total of 8 actions related to “governance” and 31 actions related to “health actions”. The 31 actions have been clustered by the Tripartite Management Team (TMT) into 7 health action areas to make them easier to work with from a strategic perspective:
- Primary Care & Public Health
- Maternal & Child Health
- Mental Health & Substance Use
- Health Planning & Capital Systems
- Health Knowledge & Information
- Health Human Resources
While the iFNHA, and the government partners have achieved some progress in terms of health promotion initiatives, best practice investments, and projects related to specific single action items, the tripartite partners collectively are working with the 7 “health actions” areas to define a strategic framework to operate within. In February 2010 the TMT agreed on a Health Actions approach to accomplish this which is underpinned by 3 principles:
Strategic Principles for Health Actions Approach
TMT has agreed on three fundamental principles that must underpin the approach to addressing health actions from the Transformative Change Accord: First Nations Health Plan and the Tripartite First Nations Health Plan:
- The Tripartite partners will be at the table together to discuss transformation of health services that will benefit the health of First Nations communities in a new collaborative way of working. This requires that the ‘decision-makers’ and those with responsibility and authority on all sides are at the table to inform, plan and make decisions about system change that is needed and to monitor the changes as they occur;
- First Nations will be at the table when making plans and decisions for all health actions- this reflects increased First Nation decision-making in health at all levels from strategy and planning to implementation and service delivery; and
- ‘System transformation’ is the goal of all health actions work – services need to continue to change, adapt and improve so that they are more appropriate, accessible and effective for First Nations.
TMT agreed in its implementation of the work that each of the 7 areas would have a strategic ‘table’ consisting of senior executives from the partner governments who were currently responsible and accountable for these service areas (decision-makers). It was also agreed that interim First Nations Health Authority senior personnel would sit with the partners to develop these initial strategic approaches to ensure that these approaches work to create the space for First Nations to engage directly on these action items at the planning and implementation levels. Some clusters are further ahead than others – depending on how ready the Government partners and ourselves have been to begin the engagement for the specific areas.
ENSURING THE FIRST NATIONS VOICE IS INCLUDED
In preparation for the strategic engagement, the iFNHA Policy Team has assembled 7 position papers which bring together all of the FNs feedback, input, ideas and issues raised over the past 3 years through Regional Caucuses; Hubs; Gathering Wisdom; research done by iFNHA and many other gatherings and other sources – on each of the 7 areas. These have included all of the concerns and issues raised by First Nations that present barriers to accessing services; problems with eligibility; inappropriateness of services; regional health authority and physician issues etc. These analyses have provided a focus for the specific areas that concern FNs in BC and changes needed to the respective Federal and Provincial systems to make services more responsive to First Nations needs.