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Provincial Aboriginal Health Services Strategy
Summary Overview of Aboriginal Health Division Activities
February 2001

The Provincial Health Officer identified six health goals for British Columbia in 1997 that spoke to improvements in living and working conditions, opportunities for individual capacity development, a sustainable physical environment, efficient and effective health services, improved health for Aboriginal people and reduction of preventable illness and injuries.

Aboriginal people continue to be challenged by both the poorest health status among identified populations, and serious inequities in health when compared to other British Columbians. This situation is the result of a number of social and economic indicators; a lack of historical relationships; and legislation and policy barriers.

According to the PHO, Aboriginal health indicators show:

  • Life expectancy that is 12 years less than the provincial average
  • Infant mortality rates more than twice the provincial average
  • Low educational attainment rates 1.5 times the provincial average
  • Unemployment rates nearly three and a half times the provincial average
  • Lone parent families occurring nearly five times more often than the provincial average
Among the barriers to improving health, Aboriginal British Columbians consistently have identified a lack of access to services, the lack of meaningful participation or control in how services are delivered, and the absence of working relationships with health service providers.

While identifying a number of objectives and examples of indicators for five of the goals, the PHO noted that none were developed for Goal 5: improved health for Aboriginal peoples because any "... process to finalize specific objectives and indicators must include the extensive involvement of Aboriginal peoples, and must complement the other processes and negotiations that are underway concerning Aboriginal health".

A meeting of Aboriginal health stakeholders determined that a Provincial Aboriginal Health Services Strategy in British Columbia must be developed to improve the health of Aboriginal people and decrease health status disparities with other British Columbians. To achieve those goals, the stakeholders established a steering committee to develop recommendations that would:

  • Improve access to health care
  • Increase Aboriginal involvement in decision-making and planning for health services
  • Promote working relationships between Aboriginal communities, governments, health authorities and other health stakeholders
The PAHSS steering committee draws members from Aboriginal political organizations, provincial health organisations and population specific agencies:
  • First Nations Chiefs Health Committee (FNCHC)
  • Union of BC Indian Chiefs (UBCIC)
  • Métis Provincial Council (MPC)
  • Aboriginal Health Association of British Columbia (AHABC)
  • Community Health Associates of British Columbia (CHABC)
  • BC Aboriginal Network on Disabilities (BCANDS)
  • Council of Aboriginal Women (CAW)
The steering committee has developed a three year workplan to guide their PAHSS-related activities:

2000 - 2001: Information gathering

  • Capacity building and consultation with First Nations and Aboriginal communities in support of MOH initiatives.
  • Develop and pilot test a Provincial Health Services document.
  • Consultation and communication with Aboriginal communities in support of PAHSS activities
2001 - 2002: Develop resources materials and information sharing
  • Health needs assessment and recommendations, as determined by feedback received from pilot testing of Provincial Health Services document
  • Consultation with Aboriginal communities through identified consultation mechanisms to develop the PAHSS
  • PAHSS Steering Committee consultation and recommendations
2002 - 2003: Implementation
  • Final consultation regarding PAHSS recommendations
  • Presentation and revision of strategy, including recommendations by MOH Executive
  • Strategy implementation: involving Aboriginal communities, health authorities and MOH
All recommendations will be reviewed and approved by the health policy tables between MOH and the Aboriginal political organizations.

The PAHSS Steering Committee meets four times a year, or as deemed necessary by the committee. Meetings are held in Vancouver at the request of the members.

AHD and aboriginal health organization activities to achieve PAHSS goals

Access Initiatives - Year One

The PAHSS Steering Committee has recommended that the first year (2000-2001) in the development of the strategy focus education and information sharing with First Nations and Aboriginal communities. In the first year of the strategy, information sessions are being hosted by the various members of the PAHSS to share information about how provincial health services are delivered and accessed. Further, community members are being encouraged to share their experiences and recommendations for improving access to health information and services. Each organization developed sessions based on the needs of their membership.

Year Two

The information collected will be used to develop resource materials; to identify gaps and service; and to make policy recommendations. This information will be reviewed again with the community to ensure appropriate involvement.

Year Three

Will focus on implementation.

Increased involvement in decision-making and planning; and greater control

  • AHD, in conjunction with the AHABC, has hosted two Provincial Forums (1999 and 2000) for Aboriginal Governors to identify issues and make recommendations. An Aboriginal Governors Working Group was struck to make recommendations. 50 recommendations were approved at the 2000 Aboriginal Governors Forum, and accepted by MOH. Achieving a Balance of Wellness for All British Columbians: Aboriginal People and Regionalization was published and distributed to health authorities and health stakeholders.
  • In response to the AGWG recommendations, MOH is requiring health authorities to have a minimum of two Aboriginal governors, as well as requiring health authorities to develop collaborative Aboriginal Health plans in 200/02. MOH is also considering mechanisms for Aboriginal participation in Community Health Service Societies governance.
  • Three Aboriginal political organizations have established policy tables with the MOH. The FNCHC is a party to the Senior Officials Group with regular meetings; a tripartite Memorandum of Understanding (FNCHC, MOH, and Health Canada) has been developed to support joint policy development and discuss gaps in services; and is acting on an active workplan. The MPCBC and the UBCIC have both signed framework agreements to further work through their policy tables.
  • MOH, through AHD, provides advice to provincial negotiators in health related treaty discussions.
  • AHD participated in the development of tri-partite treaty interim measures and other negotiated agreements - one example being the agreement for the A'QAM Community Care Home (St. Mary's Indian Band and Canada).

Improved Relationships Between Stakeholders

  • The AHD funded the development of a Health Authorities Handbook on Aboriginal Health (AHABC), and an Aboriginal Health Resource Directory (CHABC) to assist health authorities and Aboriginal communities work together.
  • AHD staff meet regularly with all their contractors, community organizations and groups at their request, as well as health authorities, to better improve relationships between stakeholders.