Abstract
Background
This paper focuses on a longitudinal research program in Manitoba, Canada, by the Innovation Supporting Transformation in Community-Based Research Project (iPHIT) to learn from First Nations across the province that have developed effective community-based primary healthcare models. The research is relevant and timely as First Nations across the country, and Indigenous populations globally, work towards improvements in population health and health equity via critical analysis and restructuring of health services. The purpose of the paper is to deepen an understanding of decolonization as it is defined within the communities, as a central aspect of health restructuring.
Methods
The study is a qualitative, grounded theory analysis, which is a constructivist approach to social research that allows for generation of theory in praxis, through interactions and conversations between researchers and research participants. Findings are based on 183 in-depth interviews and eight focus group discussions with participants from 8 Manitoba First Nation communities. The study was designed to understand strengths, limitations and priorities of primary healthcare strategies and frameworks of the communities. The iPHIT team was an active collaborative partnership between the First Nation communities, First Nation Health and Social Secretariat of Manitoba, and the University of Manitoba. The First Nation partners led in all aspects of the research, from development to implementation, data collection, analyses, and dissemination. Respected Elders from the communities also guided in appropriate research and engagement protocols.
Results
Data was coded and then grouped into 4 interconnecting themes. These are: (1) First Nation control of healthcare, (2) traditional medicine and healing activities, (3) full community participation, and (4) moving out of colonization involves cleaning up and moving beyond the mess that colonization has inflicted.
Conclusion
Decolonizing health involves a taking back of Indigenous wisdom and traditional activities; connections to the land, resources; intra- and inter-community relationships. Participants emphasized the value of full community engagement with respect to inclusion of different interpretations of and experiences in the world, highlighting creation of a shared vision. The study focused on First Nation community experiences and interests in Manitoba specifically, though the data may be applicable to national and global decolonization efforts.
Decolonizing Health in Canada: A Manitoba First Nation Perspective