Health systems and community planning actions arising from the Tripartite First Nations Health Plan revolve primarily around three objectives:
- Improving access and availability of services/programs for BC First Nations on reserve and off reserve (whether delivered by FNIH or health authorities or private providers;
- Ensuring services and programs are culturally appropriate and responsive; and,
- Ensuring services are holistic and integrated.
First Nations feedback on Health Systems and Community Planning
Some of the key themes that emerged from the Gathering Wisdom, Regional Caucus sessions (2008-2010), Health Directors Forum (Sept 30-Oct 1, 2008) and the BC First Nations Submission on Blueprint for Aboriginal Health (AFN) are as follows:
- First Nations must participate in meaningful ways at all levels of the health sector, in the governance, decision-making, planning, delivery and evaluation of health services to First Nations people.
- While there are some successful initiatives, i.e. FNIHB Transfer Policy, many of the initiatives that have been created for First Nations provide limited opportunity for real and meaningful First Nations decision making and planning – opportunities to improve upon initiatives such as these should be explored and implemented with full First Nations participation; transfer of FNIHB must be undertaken with the full involvement of First Nations leadership.
- The provincial Medical Officer of Health should be expanded to include surveillance of progress by all jurisdictions to address the determinants of health in First Nations communities.
- First Nations want a health system that is designed and delivered within their own communities by their own people, in keeping with their own unique cultural ways and traditions.
- More must be done to ensure the long term sustainability of the Tripartite First Nations Health Plan and various strategies, initiatives and programs (for First Nations).
- Financial resources are urgently required for developing comprehensive health plans supported by proper cost analysis and projections and resources.
- There must be increased efforts and supports for building cross cultural understanding between First Nations and non-Aboriginal counterparts and colleagues.
- Programs and services must build on strengths that already exist in the community.
The Tripartite Management Team (inlcuding representation from BC, Canada and First Nations Health Council) has taken a number of steps to address the issues put forward by communities, particularly with respect to feedback regarding the need for First Nations participation in decision making. One of the most important steps taken was the establishment of community engagement hubs, which allows for community involvement in health planning. In 2008, FNHC commissioned an environmental scan of Chronic Disease management services and programs for First Nations, and in 2008 the tripartite partners commissioned a cultural competency and cultural responsiveness concept paper.
Though many First Nations have existing health plans, much work on health systems and planning remains to be done to ensure that First Nations have greater control over the design and implementation of their own health systems. The FNHC will continue to work with the tripartite partners to ensure that First Nations continue to participate in decision making processes and that First Nations have the capacity to take on their own health systems.