We call upon those who can effect change within the Canadian health-care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients.

Indigenous Watchdog Status Update

Current StatusOct. 4, 2021IN PROGRESS
Previous StatusSept. 5, 2021IN PROGRESS

Why “In Progress?”

The federal government response focuses on specific programs and services as opposed to the broader strategy and policy recommendations adopted by national health advocacy organizations: HealthCareCAN, Canadian Medical Association, Royal College of Physicians and Surgeons, Indigenous Health Alliance, Canadian Partners Against Cancer, Dalla Lana School of Public Health Waakebiness-Bryce Institute for Indigenous Health.

United Nations Declaration on the Rights of Indigenous Peoples. (2007) 

Article 31. 

1. Indigenous Peoples have the right to maintain, control, protect and develop their cultural heritage, traditional knowledge and traditional cultural expressions, as well as the manifestations of their sciences, technologies and cultures, including human and genetic resources, seeds, medicines, knowledge of the properties of fauna and flora, oral traditions, literatures, designs, sports and traditional games and visual and performing arts. They also have the right to maintain, control, protect and develop their intellectual property over such cultural heritage, traditional knowledge, and traditional cultural expressions. 

2. In conjunction with Indigenous Peoples, States shall take effective measures to recognize and protect the exercise of these rights. 

Institute of Indigenous Peoples Heath

The Institute of Indigenous Peoples’ Health (IIPH) fosters the advancement of a national health research agenda to improve and promote the health of First Nations, Inuit and Métis peoples in Canada, through research, knowledge translation and capacity building. The Institute’s pursuit of research excellence is enhanced by respect for community research priorities and Indigenous knowledge, values and cultures. IPHC is part of the Canadian Institute for Health Research (CIHR).

IIPH Research Centre Action Plans and Progress Reports

Action Plan: Building a healthier future for First Nations, Inuit, and Métis peoples, Nov, 2016

In its latest strategic plan, Roadmap II, the Canadian Institutes of Health Research (CIHR) established the health and wellness of Indigenous populations as one of the agency’s four priority areas of research. Consistent with a number of the calls to action of the Truth and Reconciliation Commission, CIHR recognizes the importance of stepping up its efforts to build the research evidence that is critical for improving the health status of First Nations, Inuit, and Métis peoples.

As part of this commitment, CIHR has enhanced its relationship with First Nations, Inuit, and Métis communities.  Based on their advice, it has committed to immediately implement a series of concrete actions to further strengthen Indigenous health research in Canada. Specifically, CIHR will:

  1. Increase its capacity to interact with Indigenous communities in a culturally appropriate manner, through the creation of a dedicated team assigned to work directly with Indigenous peoples, researchers, and communities;
    • Progress Reports : 2017
      • CIHR has established a dedicated Indigenous Health Research Support Office. This team is responsible for supporting initiatives such as Pathways to Health Equity for Aboriginal Peoples, a major program of research focused on suicide prevention, diabetes/obesity, tuberculosis and oral health; supporting the iterative peer review process, which is designed to ensure higher success rates for applications with an Indigenous health focus; and supporting the development of policies and resources to strengthen Indigenous health research generally across CIHR.
      • We know that delivering on these 10 commitments will require a concerted effort on the part of the whole organization, and to that end, we have made cultural competency and cultural humility classes available to staff, with more training opportunities to follow in the future. To build on what is being taught in these classes, last week’s employee recognition event, held during National Public Service Week, had an Indigenous theme, including Elders, a smudging ceremony, and traditional dancing and food.
    • Progress Report: 2018
      • To reflect current respectful terminology and alignment with other federal departments, CIHR renamed the CIHR Institute of Aboriginal Peoples’ Health to the CIHR Institute of Indigenous Peoples’ Health (IIPH).
    • Progress Report: 2019
      • To prioritize Indigenous Peoples leading their own research and to ensure appropriate engagements, we also developed a definition of culturally safe involvement. It defines research environments as socially, spiritually, emotionally and physically safe, which requires understanding the root causes of health inequities among Indigenous Peoples, including the impact of colonization.
  2. Ensure that the Federal Government is made aware that the membership of CIHR’s Governing Council should reflect the diversity of Canada’s Indigenous peoples;
    • Progress Report: 2017
      • We recognize that Indigenous voices must be heard around the management table, and that is why we are working with our government partners to encourage the inclusion of representatives of the Indigenous community on Governing Council and other committees. As a first step, we have ensured that at least half of the membership of the Institutes Advisory Board for Indigenous Peoples’ Health is made up of representatives from the First Nations, Inuit and Métis communities, with three seats reserved for representatives of the national Indigenous organizations.
    • Progress Report 2018
      • To respond to the need for improved Indigenous leadership in governance at CIHR, we are pleased that Dr. Mark S. Dockstator, President of the First Nations University of Canada, has been appointed to CIHR’s Governing Council. We also look forward to working with the newly reconstituted IIPH Institute Advisory Board which will help guide IIPH in the development of its emerging strategic plan, and validate the criteria by which CIHR is counting its investments in Indigenous health research. The advisory board is a valuable resource for IIPH, the institutes and CIHR as a whole. Complementing the work of the advisory board, which has seats reserved for delegates from the Assembly of First Nations, Inuit Tapiriit Kanatami and the Métis National Council, CIHR upholds its commitment to meet with senior leadership from Indigenous organizations and has had initial discussions with the National Association of Friendship Centres, and more recently, the Native Women’s Association of Canada. We believe this ongoing dialogue will help ensure our investments align with Indigenous priorities
    • Progress Report 2019
      • In 2018, the IIPH Indigenous Advisory Board (IAB) was reconstituted and now counts among its members two Elders, Elder Mary Wilson and Mabel Horton who will provide guidance, cultural and spiritual support to IIPH in the development of its activities. Other CIHR IABs also increased Indigenous representation, including the Institute of Gender and Health and the Institute of Population and Public Health. The CIHR Indigenous Health Research Support Unit is now fully staffed at CIHR and it increases CIHR’s capacity to support and interact meaningfully with Indigenous Peoples, researchers and communities.
  3. Accept the definition of “Indigenous health research” as drafted by the Institute of Aboriginal Peoples’ Health in consultation with Indigenous stakeholders;
    • Progress Report 2017
      • The words we use matter, and, as a sign of respect, it is important that, when discussing Indigenous health research, we use the vocabulary favoured by First Nations, Inuit and Métis communities. We wish to thank the Indigenous stakeholders who helped our Institute of Aboriginal Peoples’ Health draft a new, more encompassing and culturally sensitive definition of “Indigenous health research.”
    • Progress Report 2019
      • Adopted in 2017, CIHR’s definition of Indigenous Health Research (IHR) emphasizes research by and with Indigenous Peoples.
  4. Develop, in collaboration with the newly appointed Institute Advisory Board on Indigenous Peoples’ Health, performance indicators to validate CIHR investments in Indigenous health research;
    • Progress Report: 2017
      • With a new definition of Indigenous health research now in place, CIHR is working closely with its Institutes Advisory Board on Indigenous Peoples’ Health to refine its performance indicators. This will support our goal of being open and transparent when reporting on our progress on investing in Indigenous health research.  CIHR has also been collaborating with the Social Sciences and Humanities Research Council (SSHRC) and Natural Sciences and Engineering Research Council (NSERC) in order to standardize the practice for collecting data on applicants’ and other stakeholders’ identities (including Indigenous identity), with the goal of gaining a better sense of participation rates across applicant and stakeholder groups.
  5. Increase its investments in Indigenous health research to a minimum of 4.6% (proportional to Canada’s Indigenous population) of CIHR’s annual budget;
    • Progress Report: 2017
      • CIHR continues to take steps to ensure its investment in Indigenous health research totals 4.6% of its annual budget. For our recent Project Grant competition, all 38 applications for Indigenous health research projects went through our iterative peer review process where at least two of the reviewers had expertise in Indigenous health and wellness and who provided their written reviews through a mentorship lens. This resulted in 22 of the 38 Indigenous health research projects being awarded funding, with an additional 12 projects receiving one-year bridge grants, for a total investment of $16.5M.  This topic will be discussed in detail at the next meeting of the Institutes Advisory Board on Indigenous Peoples’ Health.
    • Progress Report 2018
      • As part of its Action Plan, CIHR adopted a new definition of IHR that put emphasis on research by and with Indigenous Peoples. As a result of the new definition, CIHR revalidated its estimates in funding for IHR and calculated a new baseline estimate (based on the previous three years) of ~2%. In 2017/18, CIHR increased its investment in Indigenous health research to 3% of its total budget. We are confident that this will continue to grow towards our commitment of 4.6% investment in IHR through some key actions.
    • Progress Report: 2019
      • In 2016/17, CIHR revalidated its investments for IHR to develop a baseline of 2.1% of the total annual budget (based on fiscal years 2014/15 to 2016/17). In 2017/18, CIHR increased its investment in IHR to 3% of its total annual budget. For the 2018/19 fiscal year, investment in IHR increased again to 3.3%. The 0.3% increase represents an additional $5M invested in IHR in 2018/19, for a total of over $36M. CIHR will continue to implement key actions to ensure its investment in IHR increases to a minimum of 4.6% of its annual budget. Creating impactful strategic initiatives developed by and with Indigenous Peoples is a priority across the organization and all 13 institutes.
  6. Seek to grow these investments as research capacity and additional financial resources allow;
    • Progress Report 2017
      • CIHR launched the refresh of the Indigenous Mentorship Network Program on December 13, 2016, with an $8M investment over five years, enough to fund eight teams, including seven regional nodes (in British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec and Atlantic Canada) plus an international/coordinating node. The goal of this program is to break down the barriers hindering participation of First Nations, Inuit and Métis trainees and new investigators in health research. CIHR has also begun discussions with partners around collaborative and innovative strategies to support capacity for Indigenous health research across the spectrum, from entry level (high school) to post-doctoral, including building capacity for communities to engage in research. In May, CIHR’s Institute of Aboriginal Peoples’ Health hosted a national gathering of graduate students in Indigenous health attended by 20 students and a new investigators meeting. At these two events, the interest in supporting scholarship using an Indigenous research paradigm was evident. In September 2017, CIHR will be supporting Indigenous new investigators, as well as Elder/youth pairs, to attend the third annual Pathways Annual Gathering, an event that brings together community members, researchers, national Indigenous organizations and CIHR staff to encourage respect for and inclusion of Indigenous Ways of Knowing in CIHR’s Indigenous health research projects, and support networking and community building.
    • Progress Report 2018
      • The first is launching the Network Environments for Indigenous Health Research (NEIHR) – an $89M, 15-year capacity building investment – which is being supported financially by all 13 institutes. Second is a careful and ongoing review of potential administrative barriers that currently disadvantage true community-led research, including institutional eligibility. Third, we are continuing our commitment to iterative peer review for IHR which allows for promising applications to receive feedback from the peer review panel and resubmit in order to strengthen their applications. Iterative review has been implemented in the last three rounds of the Project Grant competition (including current competition in progress) and some of our priority-driven initiatives. We are now formalizing the terms of reference and selection process for the Reference Group on Appropriate Review Practices for Indigenous Health Research, which will include Elders.
    • Progress Report 2019
      • In December 2018, CIHR launched the second component of the Network Environments for Indigenous Health Research (NEIHR) – a $100.8M, 16-year capacity building investment – which is supported financially by all 13 CIHR Institutes. The purpose of the NEIHR Program is to establish a national network of centres focused on capacity development, research and knowledge translation (KT) centered on First Nations, Inuit and Métis. The network of centres is intended to provide supportive research environments for Indigenous health research driven by and grounded in, Indigenous communities in Canada. It will also ensure continued growth, broad regional development and national collaborations.  In addition to the NEIHRs, CIHR continues to invest in initiatives that address Indigenous specific health needs. For example, CIHR has recently launched the Pathways Implementation Research Teams Component 3 request for applications which focus on equitable reach, access and sustainability of interventions in four priority areas: mental wellness, diabetes/obesity, tuberculosis, and oral health. CIHR also launched the Team Grants for the Indigenous Healthy Life Trajectories Initiative. These grants will support four (4) teams to build infrastructure and capacity along the continuum of care and prevention from pre-conception to pregnancy, infancy and early childhood with a life trajectory perspective relevant to the following research areas: a Developmental Origins of Health and Disease (DOHaD) life trajectory approach, a focus on the prevention of Non-Communicable diseases (NCD) and an intervention cohort design. The funded research teams will collaborate to develop the partnerships, and leverage the necessary expertise and resources to establish an Indigenous-driven I-HeLTI Intervention Cohort. In March 2019, IIPH launched the Indigenous Research Chairs in Nursing. This initiative will support nurses of both Indigenous and non-indigenous ancestry to conduct research in Indigenous Health Nursing, thus furthering the development of knowledge and best and wise practices in the area of nursing practice, education, research and administration. The Chairs will undertake research to understand social, economic and cultural determinants of health and Indigenous holistic health practices to improve the health of Indigenous Peoples. CIHR’s Science Council recently endorsed the SPOR Capacity Development Initiative. The first component of this initiative is the Patient-Oriented Research Awards – Transition to Leadership Stream. This funding opportunity will include an Indigenous Peoples’ Health Pool to supports trainees transitioning into independent patient-oriented research careers. Other initiatives launched during the last year include Indigenous components in their funding opportunities. The Food security and Climate Change in the Canadian North under the scientific leadership of the Institute of Nutrition, Metabolism and Diabetes, will support research that will provide a deeper understanding of food security and climate change in the Canadian North, with a particular focus on Indigenous populations. There is an Indigenous component in the Transitions in Care – Best and Wise Practices Grants, to support groups of researchers and knowledge users to identify best and wise practices in the areas of transitions in care, led by the Institute of Circulatory and Respiratory Health. The Institute of Gender and Health launched the Indigenous Gender and Wellness Travel Awards to bring interested First Nations, Inuit and Métis Peoples, researchers, organizations, Indigenous community members, and other allies of Indigenous Peoples to attend an Idea Fair and Learning Circle on “Indigenous Gender and Wellness”. The event, held on June 18-20, 2019 in Montreal, on the traditional unceded territory of the Kanien’keha:ka (Mohawk) people, provided an opportunity for Indigenous Peoples and allies to meet each other and share their ideas and goals. The Cannabis Research in Priority Areas funding opportunity was launched in March 2019 by the Institute of Neurosciences, Mental Health and Addiction (INMHA). Its purpose is to explore in more detail the potential therapeutic benefits and harms associated with cannabis use on Indigenous Peoples’ health. Additional funding opportunities are planned under CIHR’s Integrated Cannabis Research Strategy, including research to evaluate policies related to the legalization and regulation of cannabis that may impact the health of Indigenous Peoples. 
  7. Continue working with the Reference Group on Indigenous Health Research ‎ to implement iterative peer review processes for applications relevant to Indigenous health, so as to ensure better success rates for Indigenous-focused investigator-initiated grant applications;
  8. Create, with the advice of the Institute Advisory Board on Indigenous Peoples’ Health, impactful strategic initiatives aimed at improving the health of Indigenous peoples;
    • Progress Report: 2017
      • CIHR continues to look for ways to integrate Indigenous health research into its funding opportunities, and has recently earmarked funds for Indigenous components in funding opportunities for the microbiome, HIV/AIDS, maternal, reproductive and child and youth health, and improved immunization coverage, among others. The CIHR Institute of Aboriginal Peoples’ Health will be working with its community to identify other opportunities for investment.
    • Progress Report: 2019
      • Consistent with the CIHR Health Research Roadmap II and the CIHR Action Plan: Building a healthier future for First Nations, Inuit and Métis Peoples, IIPH committed to support more community-based participatory research and to build capacity within Indigenous communities in a culturally safe way. In order to achieve that, and with guidance from its Institute Advisory Board (IAB), Indigenous communities, Elders and Knowledge Holders, IIPH has developed a new strategic plan, released on June 27th, that maps out four strategic directions for the next 5 years:
        • To support First Nations, Inuit and Métis Peoples and communities to drive Indigenous health research and knowledge translation.
        • To contribute to the process of improving First Nations, Inuit and Métis health using multiple Indigenous and non-Indigenous research paradigms simultaneously to support research and innovation.  
        • To advance research beyond acknowledged notions of health equity and give primacy to wellness, strength and resilience of First Nations, Inuit and Métis Peoples at the individual, group and structural levels.
        • To encourage and champion Indigenous community-based health research networks across Canada to develop capacity for First Nations, Inuit and Métis health research and knowledge translation. 
        • IIPH and its partners will strive to improve the health of Indigenous Peoples by recognizing Indigenous knowledges and being respectful of Indigenous values, cultures and ways of knowing.
  9. Hold annual meetings between the President of CIHR and leaders of the Assembly of First Nations, Inuit Tapiriit Kanatami, and the Métis National Council to discuss Indigenous health research priorities
    • Progress Report 2017
      • We are committed to strengthening our relationship with the Indigenous community, including the national Indigenous organizations, and have made significant strides in building positive and collaborative relationships. For example, we have been working closely with Inuit Tapiriit Kanatami (ITK) on one of their biggest health priorities – suicide prevention. In Iqaluit in March 2017, CIHR and ITK cohosted an important international symposium on suicide prevention. CIHR is also pleased to have become a member of a Health Portfolio Table which will strengthen our ability to engage with the Métis National Council. And to make certain that we listen and hear from the community about its needs, the national Indigenous organizations will once again be participating in our third annual Pathways Gathering in September.
    • Progress Report 2019
      • In January 2019, consistent with the Action Plan commitment to meet with senior leadership from Indigenous organizations, CIHR’s President, Dr. Michael J. Strong, met with Inuit Tapiriit Kanatami’s (ITK) President, Natan Obed. This meeting was held to discuss how CIHR could support ITK in the implementation of their National Inuit Strategy on Research (NISR), which was released in March 2018. The presidents agreed to meet on a regular basis to assess progress towards the commitments made. CIHR’s President subsequently participated in the ITK Executive Training Program, an experiential learning opportunity on the realities and priorities of Inuit, on the land in Inuit Nunangat. CIHR was also invited to participate in the NISR Roundtable in February 2019. The relationship built with the Indigenous communities in recent years will continue to be an invaluable source of strength to address gaps in Indigenous health research together. Efforts to build and maintain engagement with the leadership of other Indigenous organizations with a national mandate will continue.
  10. Work with other federal research councils to develop strategies to strengthen Indigenous research capacity development through training and mentoring along the entire career continuum from undergraduate to postdoctoral levels.;
    • Progress Report: 2017
      • CIHR staff have joined a Tri-Agency working group convened by SSHRC to identify areas of collaboration for Indigenous research between SSHRC, CIHR and NSERC. This group will focus on strategies for capacity building, investments for improved management of Indigenous data, and administrative efficiencies to support Indigenous community-based research. CIHR is also exploring opportunities to leverage investment funds with the other Tri-Agencies to achieve the greatest impact when it comes to supporting Indigenous research.

Institute of Indigenous Peoples’ Health: Initiatives
Network Environments for Indigenous Health Research

July 16, 2019 – The Network Environments for Indigenous Health Research (NEIHR) Program, an $100.8M investment over 16 years, has been developed to address those needs in capacity development, research and knowledge translation. The NEIHR Program is led by the Institute of Indigenous Peoples’ Health (IIPH) and co-led by the Institute of Circulatory and Respiratory Health (ICRH). This Program is supported financially by all 13 Institutes of CIHR.

The purpose of the Network Environments for Indigenous Health Research (NEIHR) Program is to establish a national network of nine centres focused on capacity development, research and knowledge translation centred on Indigenous Peoples (i.e., First Nations, Inuit and Métis). The network of centres is intended to provide supportive research environments for Indigenous health research driven by and grounded in Indigenous communities in Canada. The funded NEIHR centres will take a comprehensive approach to capacity building in Indigenous health research by concentrating on Indigenous communities and structural factors (e.g., educational systems, institutions, research infrastructures, policy apparatus) while keeping a focus on individual agency (e.g., supporting trainees and researchers). NEIHR is the largest one-time investment in Indigenous health research in the history of CIHR and of Canada. It involves all of the 13 CIHR Institutes and represents a 16-year commitment valued in excess of $100 million. The 13 CIHR Institutes are comprise of: IIPH; Institute of Aging (IA); Institute of Cancer Research (ICR); Institute of Circulatory and Respiratory Health (ICRH); Institute of Gender and Health (IGH); Institute of Genetics; Institute of Health Services and Policy Research (IHSPR); Institute of Human Development, Child and Youth Health (IHDCYH); Institute of Infection and Immunity; Institute of Musculoskeletal Health and Arthritis (IMHA); Institute of Neuroscience, Mental Health and Addiction; Institute of Nutrition, Metabolism and Diabetes; and Institute of Population and Public Health (IPPH).

NEIHR Program Objectives:

  • Support Indigenous community-based health research that reflects the priorities and values of Indigenous Peoples;
  • Develop an Indigenous community-based health research network environment that will support Indigenous leadership and research-related organizations with existing and new research infrastructures and platforms;
  • Augment awareness, capacity and relevance of Indigenous health research that improves the health of First Nations, Inuit and Métis Peoples across all health research domains;
  • Improve understanding of Indigenous health research and Indigenous research paradigms through ethical and impactful partnerships between Indigenous communities and health researchers, scholars, professors and instructors, research administrators, policy and decision makers, and other parties with an interest in Indigenous health research;
  • Engage Indigenous Peoples in Canada in leading and conducting health research and knowledge translation;
  • Engage with researchers, Indigenous Peoples and other relevant parties from different countries as appropriate, in order to advance the objectives of the NEIHR centres; and
  • Develop enduring NEIHR centres with sustainable mandates to build research capacity, conduct research, advance Indigenous research paradigms, and carry out knowledge translation activities.

Through a funding competition centres will be established in British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec, Atlantic Canada, Nunavut, and either Yukon or the Northwest Territories. A coordinating centre will also be established to harmonize the work of the centres.

Indigenous Healthy Life Trajectories Initiative

Under the leadership of IIPH, and in collaboration with IA, ICRH, IGH and IPPH, CIHR has developed the Healthy Life Trajectories Initiative (HeLTI). HeLTI follows a Developmental Origins of Health and Disease (DOHaD) approach, which explores how the interaction of environmental factors with genes prior to and during conception, pregnancy, infancy and early childhood impacts an individual’s health later in life. HeLTI combines a unique set of coordinated and linked international intervention cohorts to focus the DOHaD approach specifically on non-communicable diseases (NCDs) both in Canada and in countries where there is a high incidence of NCDs.

NCDs, including diabetes, cardiovascular diseases, and respiratory diseases are also a priority issue for Indigenous Peoples in Canada. Therefore, with input from Indigenous communities, and in collaboration with other CIHR Institutes, IIPH decided to lead the development of an Indigenous component of HeLTI (I-HeLTI) to address similar issues faced by and specific to Indigenous Peoples in Canada. In 2018, CIHR awarded 11 development grants and held a strengthening workshop for the I-HeLTI program. The development grants targeted Indigenous communities. This decision represented a paradigm shift that ensured Indigenous Peoples were at the forefront of research. Moving forward, IIPH and other CIHR Institutes will support I-HeLTI team grants.

Transition In Care Initiative

IIPH supports the CIHR Transitions in Care (TiC) Initiative (CIHR, 2019b), which is co-led by ICRH, IHDCYH, IHSPR, IIPH in collaboration with IA, ICR, IGH and IMHA. Transitions in care are when transfer of responsibility and accountability for some or all aspects of patient care occurs among providers, institutions, and/or sectors (e.g., federal and provincial jurisdictions, or education, judicial and other environments). Our Canadian health systems are organized in a way that requires individuals to receive health services from a number of care providers, in a number of locations, leading to multiple transitions in care over time. This is especially true for individuals experiencing changes to their health status, as they grow older, experience a change in care need and/or have a change in their location of care. This initiative is a multi-Institute, multi-pillar and trans-disciplinary initiative that integrates CIHR’s commitment to the health and wellness of Indigenous Peoples, Sex- and Gender-Based Analysis, Training and Early Career Development, and Data Use and Management across three primary focus areas: across life’s trajectories; changing health status or care; and key populations to optimize transition outcomes.

TiC Initiative Objectives:

  • To inform actionable health system changes within the TiC focus areas through systematically identifying transition in care knowledge gaps and/or identifying effective evidence-based interventions and/or policies;
  • To address transition in care gaps and/or determine effectiveness of implemented activities through evaluation of existing evidence, policy and/or best and wise practices;
  • To address identified transition in care gaps at a local, regional and/or national level through identification, adoption, spread and scale, and iterative evaluation of evidence-based practices and/or solutions;
  • To improve quality of life, and support efficiencies and sustainability of health care delivery with a potential to stimulate economic growth and competitiveness through development, adoption, scaling and iterative evaluation of innovative policies and/or best and wise practices for transitions in care; and,

To achieve measurable and sustainable impacts in the health system, and for patients, through effective partnerships among researchers, health providers, patients, family, care-givers, agencies, government, industry and other relevant stakeholders.

Indigenous Gender and Wellness Initiative

Along with other CIHR Institutes (i.e., IGH and IPPH), IIPH is supporting the development of the CIHR Indigenous Gender and Wellness Initiative. This community-led initiative will aim to explore how Indigenous perspectives on gender can improve social, physical and economic wellness of First Nations, Inuit and Métis Peoples. Gender refers to the socially constructed roles, behaviours, expressions and identities of girls, women, boys, men, and gender diverse people (CIHR, 2015b). Gender can affect identities, choice of occupation, and participation in ceremony. More is yet to be done to support Indigenous perspectives on gender and how they affect wellness of First Nations, Inuit and Métis Peoples. Some potential research topics include: (1) the role of First Nation clan mothers in community health; (2) Indigenous masculinity and the importance of men in family caregiving; and (3) Two-Spirit People and resiliency.

Collaborations in Canada and Abroad

Early Career Investigator Meetings, Community-Based Research Capacity-Building Workshops, and National Gathering of Graduate Students in Indigenous Health

The IIPH Early Career Investigator Meeting (ECIM), and the Community-Based Research and Capacity-Building Workshop (CBRCBW) bring together Indigenous health researchers who are early in their careers with community members, established researchers, and partners from across IIPH mandate areas. Through these events, participants have an opportunity to make connections with other early career investigators, community members, established researchers, and representatives from partner organizations.

Recognizing the importance of building capacity in Indigenous health research, the 2018 combined ECIM and CBRCBW event was hosted by IIPH in collaboration with the Métis National Council (MNC). In future years, IIPH will strive to partner with the Assembly of First Nations, Inuit Tapiriit Kanatami, and other Indigenous organizations and Indigenous health research groups in planning these events in order to provide unique learnings each year such as Inuit Knowledge and First Nations teachings. Similar to the ECIM and CBRCBW, the National Gathering of Graduate Students in Indigenous Health (NGGS) is a mentorship event that is directed at graduate students. The NGGS attracts graduate students conducting research in Indigenous health and wellbeing with the goal of providing support and guidance in their research journey. This event is another investment that IIPH will support over the years in collaboration with graduate students and other groups such as NEIHR centres.

Research Chair in Indigenous Health Nursing

IIPH, IGH and the Canadian Nurses Foundation, in partnership with First Nations Health Authority, Fonds de recherche du Québec – Santé (FRQS), Research Manitoba, New Brunswick Health Research Foundation, Nova Scotia Health Research Foundation and Saskatchewan Health Research Foundation, plan to support Research Chairs in Indigenous Health Nursing. This initiative is expected to:

  • Support research and development of knowledge and best and wise practices in the area of Indigenous health nursing;
  • Investigate structural factors, including gender, that support and impede Indigenous health nursing and Indigenous health;
  • Explore, describe and/or explain Indigenous research paradigms and their theoretical and methodological implications for Indigenous health nursing standards;
  • Advance the understanding and conceptualization of Indigenous health nursing and its role in the nursing profession;
  • Examine the recruitment and retention of people into the nursing discipline (i.e., practice, education, research and administration) and nurses into the specialty of Indigenous health nursing
  • Create opportunities and the will for nurses and trainees to engage in Indigenous health nursing; leadership; and

Provide mentorship and training for students.

Canadian Consortium on Neurodegeneration in Aging

Indigenous Peoples are unduly affected by neurodegenerative diseases causing dementia. In order to address this issue, and in collaboration with other CIHR Institutes and external partners, IIPH plans to invest in the Canadian Consortium on Neurodegeneration in Aging (CCNA). The external partners who plan to support this investment in CCNA are: Alberta Innovates, Alzheimer Society of Canada, Brain Canada Foundation, Centre for Aging and Brain Health Innovation, CARP, Canadian Nurses Foundation, FRQS, Hypertension Canada, New Brunswick Health Research Foundation, Ontario Brain Institute, and Saskatchewan Health Research Foundation. This planned investment in CCNA is to advance scientific knowledge in the area of neurodegenerative diseases in order to contribute to the improvement of health, wellbeing and services for people affected. The CCNA is the flagship initiative of the CIHR Dementia Research Strategy. This strategy also has an international component that may, in the future, provide opportunities to advance knowledge with respect to dementia and Indigenous Peoples.

Trilateral Cooperation Among CIHR, the Health Research Council of New Zealand and the National Health and Medical Research Council of Australia

In addition to the various partnerships and collaborations already mentioned in this strategic plan, IIPH will work with international partners, both Indigenous and non-Indigenous, to contribute to improving the health and wellbeing of Indigenous Peoples around the globe.

In December 2017, CIHR, the Health Research Council of New Zealand and the National Health and Medical Research Council of Australia renewed their commitment to collaborate on health research priorities of Indigenous Peoples. In developing and undertaking future joint initiatives, the three agencies will continue to facilitate the sharing of the expertise, cultures and values of the populations they represent—the Aboriginal and Torres Strait Islander Peoples, Māori people and the First Nations, Inuit and Métis Peoples—to support Indigenous methodological approaches to health and wellbeing research. This will prove especially valuable throughout the partnership as agencies develop a joint action plan and reassess priorities each year. Based on its success in working with Australia and New Zealand, IIPH will explore collaborations with other countries.

Institute of Indigenous Peoples’ Health Strategic Plan 2019 – 2024

Indigenous Peoples in Canada (First Nations, Inuit and Métis) continue to experience serious health inequities in comparison to the general Canadian population. Changing the status quo requires introducing new knowledge. Research paradigms that are based on Indigenous cultures, values and beliefs and that are respectful of traditional Indigenous knowledges underpin the work ahead and the ‘reason for being’ of IIPH.

Ask Indigenous people how they view health and wellbeing and they will describe a holistic approach, a striving for balance in the spiritual, physical, emotional and mental spheres of their self and their environment. If there is an imbalance in one or more areas, the individual strives to restore the balance by focusing attention on the required sphere(s), thereby returning to a state of wellness. This worldview is qualitatively different from Western approaches to health and research, which focus more on illness as something foreign to the body and requiring treatment.

Indigenous holistic concepts of health will be the focus of IIPH’s strategic priorities and the way IIPH intends to advance the health of Indigenous Peoples, while remaining inclusive of other scientific research approaches. Increasingly, Indigenous worldviews, theories, ways of knowing (i.e., epistemologies) and methodologies are better received and more productive than Western approaches alone when carrying out research with Indigenous Peoples in Canada.

The four strategic priorities of IIPH for the next five years are as follows:

  1. To support First Nations, Inuit and Métis Peoples and communities to drive Indigenous health research and knowledge translation.
  2. To contribute to the process of improving First Nations, Inuit and Métis health using multiple Indigenous and non-Indigenous research paradigms simultaneously to support research and innovation.
  3. To advance research beyond acknowledged notions of health equity and give primacy to wellness, strength and resilience of First Nations, Inuit and Métis Peoples at the individual, group and structural levels.
  4. To encourage and champion Indigenous community-based health research networks across Canada to develop capacity for First Nations, Inuit and Métis health research and knowledge translation.

Strategic Priority # 1

To support First Nations, Inuit and Métis Peoples and communities to drive Indigenous health research and knowledge translation.

StrategiesindicatorsOutcomes
Review and implement policies pertaining to institutional eligibility of Indigenous community organizations to administer CIHR research fundsIncreased number and diversity of Indigenous community organizations eligible to receive CIHR fundsIndigenous health research capacity is strengthened
Enable the flow of CIHR funding directly to Indigenous communities to enable communities to control research and knowledge translationIncreased Indigenous health research investments to Indigenous communitiesStrengthened Indigenous health research capacity among Indigenous communities to drive the research agenda
Support the review of Indigenous health research in both CIHR investigator-initiated research and research in priority areas by reviewers who are qualified in the area of Indigenous health research.Increased percentage of applications received and funded in the area of Indigenous health researchHigh quality and diverse research is supported across all areas of Indigenous health research and knowledge translation

Strategic Priority # 2

To contribute to the process of improving First Nations, Inuit and Métis health using multiple Indigenous and non-Indigenous research paradigms simultaneously to support research and innovation.

StrategiesIndictorsOutcomes
Design research funding opportunities that ensure First Nations, Inuit and Métis Peoples are an integral part of the entire research process while promoting Indigenous research ethics aligned with, at a minimum, the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS 2)Increased percentage of funding opportunities relevant to Indigenous health research incorporating an integrated knowledge translation approach and that speak to TCPS 2Effective and efficient design, planning, operations and oversight of Indigenous health research and knowledge translation
Collaborate with CIHR and its Institutes to ensure that research funding opportunities support Indigenous ways of knowing along with other epistemological approaches in Indigenous health researchIncreased funding opportunities that support Indigenous ways of knowing and other epistemologies that are relevant to Indigenous health researchEffective and efficient design, planning, operations and oversight of CIHR and its Institutes supporting Indigenous health research involving Indigenous ways of knowing along with other epistemological approaches
Provide Indigenous health research and knowledge translation opportunitiesIncreased percentage of research investments addressing all funded Indigenous health researchHigh quality and diverse research is supported across all areas of Indigenous health research and knowledge translation

Strategic Priority # 3

To advance research beyond acknowledged notions of health equity and give primacy to wellness, strength and resilience of First Nations, Inuit and Métis Peoples at the individual, group and structural levels.

StrategiesIndicatorOutcomes
Contribute to improved health, wellbeing, strength and resilience of Indigenous Peoples at the individual, group and structural levelsIncreased research contributing to improving health of Indigenous Peoples in Canada, and to strengthening the Canadian healthcare system for Indigenous PeoplesResearch results contribute to the achievement of improved health outcomes, more effective health services and products, and a strengthened healthcare system that focuses on the health, wellbeing and strength of Indigenous Peoples at the individual, group and structural levels
Increase the evidence for the transformative nature of research at the structural level to benefit Indigenous PeoplesIncreased percentage of Indigenous health research publications and activities that inform decision making and policy settingCIHR-supported research results are translated in order to implement Indigenous knowledge systems and Indigenous health research governance led by Indigenous Peoples, to decolonize academic institutions and other organizations, and to support culturally competent and culturally safe research organizations
Collaborate with international bodies, both Indigenous and non-Indigenous, to foster the integration of a wellness, strength and resilience approach to Indigenous health research and knowledge translationIncreased Indigenous research and knowledge translation involving international collaborationsIndigenous health research capacity is strengthened in Canada with international Indigenous and non-Indigenous organizations researching Indigenous Peoples’ concepts of wellness, strength and resilience

Strategic Priority # 4

To encourage and champion Indigenous community-based health research networks across Canada to develop capacity for First Nations, Inuit and Métis health research and knowledge translation.

StrategiesIndicatorOutcome
In collaboration with CIHR and its Institutes, support mentorship and training of the next generation of researchers, knowledge users and communities of practice in the area of Indigenous health research and knowledge translationIncrease in new researchers, knowledge users and communities of practice that go on to work in the area Indigenous health researchStrengthened research capacity among the next generation of Indigenous health researchers, knowledge users and communities of practice
Create Indigenous health research awards that enable Indigenous trainees to be guided by mentors, including Indigenous Elders and Knowledge HoldersIncreased number of trainees supported in the area of Indigenous health researchTraining and career awards for both academics and non-academics that contribute to and build on ongoing progress in Indigenous health research
Foster the establishment of long-term partnerships and collaborations among Indigenous communities, researchers and other interested partiesIncreased percentage of grants reporting stakeholder involvement related to Indigenous health in the research processLeveraged partnerships and collaborations in Indigenous health research

http://www.cihr-irsc.gc.ca/e/51559.html

Institute of Indigenous Peoples’ Health:

Indigenous Health Primer, 2019

Royal College of Physicians and Surgeons

In 2019, the Indigenous Health Committee (IHC) at the Royal College, an independent body that comprises Indigenous physicians, scholars and other health care professionals, created a vision for Indigenous health and care:

Create health care that is free of racism where every Indigenous person is treated with respect, recognized as an individual rather than a stereotype and experiences the highest level of health, and that all stakeholders understand how colonial structures and systems link to current health inequities.

Working together, the IHC and the Royal College are taking steps to focus on Indigenous health education across all residency training programs and throughout professional practice by providing educational tools and resources.

The following resources have been developed by the IHC and are eligible for continuing professional development credits under the Royal College Maintenance of Certification (MOC) Program.

Indigenous Health Primer

Key messages

  • Legislation and policies related to Indigenous people in Canada were created with the intention to assimilate Indigenous people.
  • The policies and laws, based entirely on race alone, resulted in cultural, social and economic disruption.
  • Jurisdiction regarding health care delivery for Indigenous people is complex and often misunderstood.
  • Current inequities in health and well-being experienced by Indigenous people are the result of these dismissive and oppressive policies and laws, which continue in some forms in our present day.

Understanding legislation and policies can be overwhelming but, put simply, there are two fundamental areas of legislation and policies that affect the lives of all Indigenous Peoples in Canada:

1. the set of laws and policies that were originally designed to assimilate Indigenous people, and

2. a second set of laws that dictate the level of government that is responsible for health care delivery to Indigenous people.

Indigenous Science

Indigenous science is a form of Indigenous knowledge. It refers to the science of Indigenous cultures. It is a way of seeing and knowing that is dynamic, holistic, intergenerational and time-tested. Indigenous science has existed for thousands of years, thus developing sophisticated modes of knowledge-transfer that have enabled its survivance (more than mere survival — it is a way of life that nourishes Indigenous ways of knowing).

Despite this survivance, Indigenous Science has been devalued in the past by a Eurocentric worldview and institutions that have deemed it to be simplistic or primitive. Indigenous Science is place-based and therefore dependent on a deep connection and relationship to traditional lands and the natural world.

Anishinaabe Historian Brenda Child states “In Ojibwemowin, our language, the term for medicine is mashkiki or ‘strength of the earth.’ Medicine people approached the plant and medicinal knowledge in a meticulously systematic way, according to Frances Densmore, always emphasizing experiment and study. Like artists in their work, they were masterful observers of the natural world. They knew the exact time to harvest a multiplicity of plants, many of which had the most ephemeral season…Their work sustained the Ojibwe goal of mino bimaddizi [”the philosophy of a good life]” (Densmore, 2005).

Although Indigenous Nations in what is now referred to as Canada are incredibly diverse, they all share a common, earth-centred worldview. They also share a sense of deep interconnection and relationship with the land that differs from the dominant Eurocentric understanding.

“To the settler mind, land was property, real estate, or natural resources. But to our people, it was everything: identity, our connections to our ancestors, the home of non-human kinfolk, our pharmacy, our grocery store, our library, the source of everything that sustained us. Our lands were where our responsibility to the word was enacted, sacred ground. It belonged to itself; it was a gift, not a commodity, so it could never be bought or sold” (Kimmerer, 2013

https://www.royalcollege.ca/rcsite/health-policy/indigenous-health-e

Medical Organization Commitments to Indigenous Health and Healing

Canadian Public Health Association

The Canadian Public Health Association is the independent national voice and trusted advocate for public health, speaking up for people and populations to all levels of government.

Policy Statement: Indigenous Relations and Reconciliation, October, 2019

CPHA acknowledges that health is a basic human right and the Association takes a public health approach to achieve health for all. A public health approach aligns with the need to adopt culturally appropriate practices for meaningful relationship- building with Indigenous Peoples…When building relationships with Indigenous partners, CPHA recognizes and respects the diverse knowledge systems of Indigenous Peoples. Indigenous ways will be equally valued and interwoven with public health approaches.

The 2015 final report of the Truth and Reconciliation Commission (TRC) put forward 94 Calls to Action that frame the national processes of reconciliation.1 These Calls to Action directly impact many pathways for improved health of Indigenous Peoples in Canada, including land, economy, culture, health, education, law, and governance.

POLICY GOAL

CPHA envisions a future when reconciliation is meaningfully embedded in all aspects of its work and the Association establishes and maintains relationships with Indigenous Peoples based on mutual respect, trust, and dialogue.

PRINCIPLES

In support of its policy goal, CPHA upholds the following principles:

  • Public health is based on respect for the well-
  • being of all people and their intricate links to the natural environment.
  • The realization of TRC Calls to Action and the implementation of the articles of UNDRIP are essential to the health and well-being of Indigenous Peoples.
  • The jurisdictional and legal context of treaties and the rights of Indigenous Peoples are relevant to the implementation of effective public health services.
  • Indigenous law and governance systems are recognized and upheld.
  • The rights, knowledge, protocols, and traditions of Indigenous Peoples are respected.
  • Indigenous Peoples are encouraged and supported to train for and work in public health, and celebrate the strengths, skills, and knowledge they bring to the profession.
  • The diversity of Indigenous Peoples and their right to self-determination are inviolable.
Indigenous Health Alliance

The Indigenous Health Alliance was a 3-year project that arose in response to the Truth and Reconciliation Commission calls to action for health. It has a mission to eliminate the differences in quality of care between indigenous and non-indigenous patients. Most important, it is through a process led by indigenous peoples. In addition to many other first nations and territorial organizations, our members and supporters include:

  • The Royal College of Physicians and Surgeons of Canada
  • The College of Family Physicians Canada
  • The Canadian Medical Association
  • The Assembly of First Nations, and the
  • The National Indian Residential School Survivor Society
Canadian Medical Association

Feb. 27, 2021: Toronto Star – Dr. Alika Fontaine from Treaty 4 territory in southern Saskatchewan is the new President of the Canadian Medical Association. The CMA unites the medical profession in Canada to improve the health of Canadians and strengthen the health care system. Lafontaine co-led the Indigenous Health Alliance from 2013 to 2017, a “health transformation project” involving 150 First Nations and several national health organizations.  Once Lafontaine’s nomination is ratified at the August meeting, he will officially become president-elect. His presidency is set to begin in August 2022.

CMA Sir Charles Tupper Award for Political Advocacy — 2019 Recipient

Dr. Alika Lafontaine is receiving the Sir Charles Tupper Award for Political Advocacy for demonstrating recent leadership, commitment and dedication in advancing CMA goals and policies through grassroots advocacy.

The Indigenous Health Alliance is one example of Dr. Lafontaine’s advocacy work. In 2013, he was helping Saskatchewan First Nations figure out why its residents were so sick and uncovered a gap in the quality improvement approach between Indigenous and non-Indigenous patients. Committed to eliminating these differences across Canada, Dr. Lafontaine drafted and co-led a national strategy with territorial organizations representing 150 First Nations and several national health organizations. That proposal was then submitted to the federal government on behalf of those First Nations — the Indigenous Health Alliance — to advance health transformation.

HealthcareCAN

HealthCareCAN, the national voice of action for health organizations and hospitals across Canada – was formed from the merger of the Canadian Healthcare Association and the Association of Canadian Academic Healthcare Organizations in January 2014.

Bringing Reconciliation to Healthcare in Canada: Wise Practices for Healthcare leaders”. April 2018

The 10 identified Wise Practices includes the following within Indigenous Client Care and Outcomes:

  • Enhance the journey of Indigenous clients through the practice of trauma-informed care and programs such as Indigenous navigators, access to traditional foods and healing practices, support from Elders, and land- based healing; the specific initiatives should emerge from the recommendations made by local Indigenous communities, advisors, and clients.

HealthcareCAN Issues Brief, 2016 Suggested Recommendations:

  • Advocating for parallel support of Indigenous traditional medicine approaches to healing;
  • Working with traditional healers to develop respectful ways to teach learners as well as practicing health care providers on how to work with traditional healers or people who are using traditional healing methods – this may include accreditation
  • Developing community partnerships between First Nations communities and health organizations to ensure inclusion of traditional healing in the primary care models in ways that are respectful, responsive, and directed by First Nations communities and traditional healers.
The Canadian Partnership Against Cancer 

June 21, 2018 – Committed $24 million in funding until 2022 to support improved cancer outcomes by supporting action on self-determined priorities of First Nations, Inuit and Métis leaders, organizations and communities. The investment of the Partnership will result in large-scale changes that deliver high-quality, culturally respectful cancer services and programs in all provinces and territories. the Partnership and our partners are focused on the following areas:

  • Increasing access to, and use of, screening services especially in rural and remote areas of Canada;
  • Promoting wellness and preventing cancer (e.g., smoking cessation);
  • Improving cultural supports through Indigenous patient navigation; and
  • Led by Indigenous partners, exploring opportunities to better gather and analyze Indigenous-specific cancer data through data linkage.

The Partnership has invested $15 million to date in building respectful, impactful and collaborative relations with Indigenous communities across Canada.

June 4, 2019 – The Canadian Partnership Against Cancer’s “Canadian Strategy for Cancer Control 2019-2029 identifies three priorities for First Nations, Inuit and Métis. For each of these priorities, Peoples-specific actions were identified that help drive needed changes in outcomes and experience for all First Nations, Inuit and Métis.

  • Priority 1 – Culturally appropriate care closer to home
  • Priority 2 – People’s specific, self-determined cancer care
  • Priority 3. – First Nations-, Inuit -, or Métis-governed research and data systems

https://www.partnershipagainstcancer.ca/cancer-strategy/

Dalla Lana School of Public Health’s Waakebiness-Bryce Institute for Indigenous Health

Aug. 2, 2019 – Dalla Lana School of Public Health’s Waakebiness-Bryce Institute for Indigenous Health offers five days learning about Indigenous health in one of Canada’s first land-based learning courses. The move to land-based learning is an attempt to truly Indigenize the educational experience so that public health workers can begin to gain the kind of understanding they’ve been missing, said Suzanne Stewart, director of the Waakebiness-Bryce Institute. She hopes this shift in thinking will address the root reasons for many of the failures of public health institution programs to improve Indigenous health.

“The Western paradigm has privileged the mind. In Indigenous culture, it’s the spirit and the heart that makes decisions and guides our lifestyle and behaviours,” she said. “Everything to do with Indigenous health is tied to spirituality, and spirituality is based in the land and in the relationship between land and people.”

https://www.utoronto.ca/news/healing-begins-land-how-u-t-s-dalla-lana-school-public-health-indigenizing-teaching-public

Royal College of Physicians and Surgeons of Canada 2019

The Royal College is the national professional association that oversees the medical education of specialists in Canada, accredits the residency programs at 17 universities across Canada and also accredits the learning activities that physicians pursue in their continuing professional development programs.

Indigenous Health Primer:

Key messages

  • Legislation and policies related to Indigenous people in Canada were created with the intention to assimilate Indigenous people.
  • The policies and laws, based entirely on race alone, resulted in cultural, social and economic disruption.
  • Jurisdiction regarding health care delivery for Indigenous people is complex and often misunderstood.
  • Current inequities in health and well-being experienced by Indigenous people are the result of these dismissive and oppressive policies and laws, which continue in some forms in our present day.

Understanding legislation and policies can be overwhelming but, put simply, there are two fundamental areas of legislation and policies that affect the lives of all Indigenous Peoples in Canada:

1. the set of laws and policies that were originally designed to assimilate Indigenous people, and

2. a second set of laws that dictate the level of government that is responsible for health care delivery to Indigenous people.

Indigenous Science

Indigenous science is a form of Indigenous knowledge. It refers to the science of Indigenous cultures. It is a way of seeing and knowing that is dynamic, holistic, intergenerational and time-tested. Indigenous science has existed for thousands of years, thus developing sophisticated modes of knowledge-transfer that have enabled its survivance (more than mere survival — it is a way of life that nourishes Indigenous ways of knowing).

Despite this survivance, Indigenous Science has been devalued in the past by a Eurocentric worldview and institutions that have deemed it to be simplistic or primitive. Indigenous Science is place-based and therefore dependent on a deep connection and relationship to traditional lands and the natural world.

Anishinaabe Historian Brenda Child states “In Ojibwemowin, our language, the term for medicine is mashkiki or ‘strength of the earth.’ Medicine people approached the plant and medicinal knowledge in a meticulously systematic way, according to Frances Densmore, always emphasizing experiment and study. Like artists in their work, they were masterful observers of the natural world. They knew the exact time to harvest a multiplicity of plants, many of which had the most ephemeral season…Their work sustained the Ojibwe goal of mino bimaddizi [”the philosophy of a good life]” (Densmore, 2005).

Although Indigenous Nations in what is now referred to as Canada are incredibly diverse, they all share a common, earth-centred worldview. They also share a sense of deep interconnection and relationship with the land that differs from the dominant Eurocentric understanding.

“To the settler mind, land was property, real estate, or natural resources. But to our people, it was everything: identity, our connections to our ancestors, the home of non-human kinfolk, our pharmacy, our grocery store, our library, the source of everything that sustained us. Our lands were where our responsibility to the word was enacted, sacred ground. It belonged to itself; it was a gift, not a commodity, so it could never be bought or sold” (Kimmerer, 2013

Indigenous Health Values and Principles Statement: June 21, 2019

As in the first edition, the second edition examines the values pertaining to Indigenous health and bridges these values to the CanMEDS framework with actionable principles to guide the delivery of culturally safe health care. The culturally safe physician is a complete health care practitioner who:

  • embraces Indigenous knowledge/science….
  • practicing with cultural humility, fostering an environment of cultural safety and proactively pursuing anti-racism interventions.
  • Understands that Indigenous health is an integral component of medical research, education, training and practice, and that this research is based on evidence from empirical sources, critical appraisal of relevant material beneficial to patients, leading Indigenous and non-Indigenous practices and lifelong learning that can be adapted to serve Indigenous patients.

The culturally safe physician also embraces the following Indigenous values:

Openness: traditional Indigenous medicine reinforces the holistic approach to health and wellness embraced in Indigenous cultures. Indigenous healing practices, spiritual well-being and natural therapies are recognized by the patient, and he or she decides whether western medical practices are comprehensive, complimentary, beneficial, holistic or integrative.
Evidence: health care decisions and healthy life choices are based on qualitative and quantitative information that is readily available, focused and whose limitations are clear. This includes Indigenous knowledge in traditional Indigenous medicine and its value in the education of medical students, residents and practicing physicians.

http://www.royalcollege.ca/rcsite/health-policy/initiatives/indigenous-health-e

Integration of Indigenous Healing Practices in Provinces and Territories

Federal Government

Budget 2017 and 2018 provided $86 million over 5 years and $490 million over 2 years respectively, to preserve access to medically necessary health benefits and services through the Non-Insured Health Benefits. Non-Insured Health Benefits medical transportation benefit provides coverage to enable clients to access medically necessary health services, including services provided by traditional healers. 

The Indian Residential Schools Resolution Health Support Program secured a 2 year renewal for fiscal year 2016 to 2017 and 2017 to 2018 ($116 million total) that provides access to mental health, emotional and cultural support services for eligible former residential school students and their families. The services provided are based on the specific needs of individuals, families and communities, and may be provided by Elders, traditional healers, Indigenous community health workers, psychologists and social workers.

Indigenous Services Canada (ISC) is working with the National Aboriginal Council of Midwives to implement the Budget 2017 midwifery investment of $6 million over five years. ISC also continues to support the development of Indigenous Service Delivery Models for crisis planning, prevention, response and recovery and land-based programming, which incorporate Indigenous healing practices.

Budget 2018announced $248.6 million over 3 years, starting in fiscal year 2018 to 2019, for services, including mental health and emotional supports to survivors and their families for the duration of the Indian Residential School Settlement.

British Columbia

Mar. 1, 2017 – The BC Health Regulators (BCHR) representing 23 regulatory colleges governed by the Health Professions Act and the Social Workers Act declared their commitment to making the health system more culturally safe for First Nations and Aboriginal People through actions and processes which will ultimately embed culturally safe practices within all levels of health professional regulation.

Follow-up: Annual reports outlining strategic activities which demonstrate how each organization is meeting their commitment to cultural safety.

Alberta

Oct. 2, 2018 – Release of “Indigenous Health Transformation Roadmap: 2018-2020” through the Population, Public and Indigenous Health Strategic Clinical Network of Alberta Health Services. Specific projects identified are:

  • Recognize the value of Indigenous healing practices, establish policies to guide the implementation and administration of practices within AHS
  • Expand access to Indigenous healing practices in the treatment protocols with Indigenous peoples within AHS
  • Work with other SCNs to ensure Indigenous priorities, perspectives and healing practices are considered in their care pathways and system innovations
Saskatchewan

March 28, 2018 – Dr. JoLee Sasakamoose has assumed leadership of the Indigenous Peoples’ Health Research Centre (IPHRC) as the new director. Sasakamoose’s research explores the intergenerational effects of historical trauma with Indigenous Peoples and the use of traditional healing methods in the promotion of health and wellbeing. In partnership with the First Nations communities of Saskatchewan, she co-authored the Indigenous Cultural Responsiveness Theory, a theoretical framework to improve wellbeing of Indigenous Peoples.

Manitoba

Budget 2020 – 2020 ($800K) and 2021 ($1.5M) funding to enable Neecheewam Inc. to expand its Winnipeg facility and improve access to Indigenous-led healing, care and treatment services to sexually exploited youth. Neecheewam operates the Strong Hearted Buffalo Women Crisis Stabilization Unit, a four-bed crisis intervention program for female and transgender youth who are at high risk of sexual exploitation. With new provincial funding, Neecheewam will undergo renovations to pilot a new, longer-term four-bed addition to its treatment facility.

June 3, 2018 – Aboriginal elders currently visit Winnipeg emergency rooms to work with patients and help ER staff to provide culturally appropriate care (CBC).

Sept. 20, 2017 – First Nations Health and Social Secretariat of Manitoba (Nanaandawewigamig) and the First Nations Diabetes Leadership Council in Manitoba have developed the First Nation Basic Foot Care Program. This innovative foot care service will help clients in all 63 Manitoba First Nations communities to maintain their health and lower their risks from diabetes- related foot complications. Patients living with diabetes who have foot ulcers are at risk for hospitalizations, lower extremity infections, and amputations. First Nations populations experience diabetes at a rate more than four times higher than the general Canadian population.

Ontario

May 30, 2016 – With funding support from five ministries, Indigenous partners and service providers will continue to support the Aboriginal Healing and Wellness Strategy. The strategy supports culturally appropriate solutions to improve healing, health and wellness in communities across Ontario.

Oct. 25, 2019 – Tungasuvvingat Inuit with the support of the Government of Ontario announce the re-opening of Mamisarvik Healing Centre in Ottawa to serve and offer delivery of Inuit specific trauma informed healing and address substance abuse disorders. Mamisarvik will offer extensive counselling sessions, culturally-specific healing, time with Elders and a world class team of health experts.

Nov. 16, 2020: Toronto Star – Centre for Addiction and Mental Health (CAMH) in Toronto launches an Indigenous-led centre dedicated to improving health-care services for First Nation, Inuit and Métis communities. Shkaabe Makwa, Anishinaabe for “Spirit Bear helper”, “plans to meld Indigenous knowledge and traditions with medical research, training and healing models for caregivers serving Indigenous communities”. Dr. James Makokis, Shkaabe Makwa’s first medical director said, ”He’s excited about the chance to focus on Indigenous ceremony, medicine and thought, especially in developing new research that addresses Indigenous needs. Renee Linklater, PhD Senior Director said, ”Culture is central to healing and wellness for many Indigenous people and that’s too often ignored.

Quebec

June 18, 2020 – BMO Financial Group (BMO) and the Hewitt Foundation are partnering to maintain social pediatric services in Northern Quebec Indigenous communities. Their respective donations of $3 million and $2 million send a strong message to the business community about the importance of supporting the Montreal Children’s Hospital in changing the face of pediatrics in Quebec through innovative ways of healing. The Minnie’s Hope Social Pediatric Centre was established more than five years ago by and for members of the Cree community of Whapmagoostui and the Inuit community of Kuujjuaraapik, both located on the southern shore of Hudson’s Bay. In partnership with the Children’s and others, Minnie’s Hope provides pediatric care and evaluations as well as therapeutic, social and educational programs developed — with the involvement of community members including elders — to reflect the values and knowledge of both communities.

This unique partnership approach that focuses on combining their traditions, values and knowledge and dedicated experts has made Minnie’s Hope a Canadian leader in its field. The $5M in new funding will support the construction of a larger centre to accommodate the growing communities with more administrative, medical and paramedical staff and new services and programs—all offered in a way to ensure cultural safety. “This project was initiated, developed and managed by Indigenous communities. 

http://nationtalk.ca/story/donation-of-5-million-from-bmo-and-hewitt-foundation-to-support-innovative-pediatric-centre-project-initiated-by-indigenous-communities

Nova Scotia

Dec. 13, 2019 – Researchers at Nova Scotia’s Cape Breton University have received a $850,000 grant to develop a traditional Mi’kmaq medicine for potential future commercial production as a skin ointment. Maskwiomin is made from the oil of birch bark and is used to treat skin conditions such as rashes, eczema and psoriasis.

Yukon

Sept. 18, 2017 – Yukon’s priority is to work with Yukon First Nations to develop more culturally relevant programming and alternative correctional therapeutic environments for individuals with disabilities, mental health and addiction issues, and to collaborate in order to reduce delays and improve outcomes.

Northwest Territories

June 30, 2021 – Action Plan for Critical Incident Investigation Report 2021 Recommendations” including

  1. That the Government of Northwest Territories implements a process to respond to patient and family concerns related to the care that they receive within the health care system.
  2. in partnership with communities, recruit and train Indigenous first responders, nurses, and physicians from within the communities and surrounding areas to decrease turnover and transiency, ensuring continuity of care.
  3. develop and initiate policies for the implementation of mandatory and ongoing cultural safety training, with content designed and delivered in partnership with the Indigenous community, for all health care workers. Cultural safety training should be grounded in an anti-oppression framework and include concepts of unconscious and perception bias (racism), Indigenous view of family including next of kin.
  4. explores recruiting and retaining Indigenous Elders to work collaboratively on cultural safety training.
  5. That the Government of Northwest Territories affect change within their health-care system to recognize the value of Aboriginal healing practices and use them in the treatment of Aboriginal patients in collaboration with Aboriginal healers and Elders where requested by Aboriginal patients.

For complete details see:

July 20, 2017 – The Governments of Canada, the Northwest Territories and its partners signed an agreement with the Tlicho Government to provide $24.9 million in funding and in-kind contributions to establish a NWT Strategy for Patient-Oriented Research (SPOR) Support for People and Patient-Oriented Research and Trials (SUPPORT) Unit – Hotıì ts’eeda. This health research and training will be rooted in Dene, Inuvialuit and Métis knowledge and will encourage a better understanding of the importance of culture and community in the delivery of our health care

Nunavut

Aug. 20, 2019 – Improving mental wellness for Inuit in Nunavut means providing better access to care that is culturally appropriate, closer to home, effective, and sustainable. The Partnership Table on Health, the Government of Nunavut, Nunavut Tunngavik Incorporated and Government of Canada’s came together to sign a joint declaration of intent for the construction and operations of a Nunavut Recovery Centre which will provide treatment in Nunavut for addictions and trauma.

The Nunavut Recovery Centre will provide a range of treatment and healing interventions that will address both addictions and trauma, and will be founded on Inuit cultural practices and values. 

Official Federal Government Response: Sept, 5, 2019



Sept. 5, 2019 – The Government of Canada recognizes the value and importance of Indigenous healing practices. 

Through funding announced in Budget 2017 and 2018, it is providing $86 million over 5 years and $490 million over 2 years respectively, to preserve access to medically necessary health benefits and services through the Non-Insured Health Benefits. The Non-Insured Health Benefits program is working with partners to advance the implementation of these changes to benefit coverage. Non-Insured Health Benefits medical transportation benefit provides coverage to enable clients to access medically necessary health services, including services provided by traditional healers. 

The Indian Residential Schools Resolution Health Support Program secured a 2-year renewal for fiscal year 2016 to 2017 and 2017 to 2018 ($116 million total) that provides access to mental health, emotional and cultural support services for eligible former residential school students and their families. The services provided are based on the specific needs of individuals, families and communities and may be provided by Elders, traditional healers, Indigenous community health workers, psychologists and social workers.

Indigenous Services Canada (ISC) is working with the National Aboriginal Council of Midwives to implement the Budget 2017 midwifery investment of $6 million over 5 years. ISC also continues to support the development of Indigenous Service Delivery Models for crisis planning, prevention, response and recovery and land-based programming, which incorporate Indigenous healing practices.

Budget 2018 announced $248.6 million over 3 years, starting in fiscal year 2018 to 2019, for services, including mental health and emotional supports to survivors and their families for the duration of the Indian Residential School Settlement.