scholarly journals Towards attainment of Indigenous health through empowerment: resetting health systems, services and provider approaches

2021 ◽  
Vol 6 (2) ◽  
pp. e004052
Author(s):  
Cheryl Barnabe
Keyword(s):  
Health Systems ◽  
Indigenous Health ◽  
Indigenous Rights ◽  
Indigenous Communities ◽  
Models Of Care ◽  
Indigenous Populations ◽  
Health And Wellness ◽  
Financial Investments ◽  
Dominant Society ◽  
Significant Health

Colonial policies and practices have introduced significant health challenges for Indigenous populations in commonwealth countries. Health systems and models of care were shaped for dominant society, and were not contextualised for Indigenous communities nor with provision of Indigenous cultural approaches to maintain health and wellness. Shifts to support Indigenous health outcomes have been challenged by debate on identifying which system and service components are to be included, implementation approaches, the lack of contextualised evaluation of implemented models to justify financial investments, but most importantly lack of effort in ensuring equity and participation by affected communities to uphold Indigenous rights to health. Prioritising the involvement, collaboration and empowerment of Indigenous communities and leadership are critical to successful transformation of healthcare in Indigenous communities. Locally determined priorities and solutions can be enacted to meet community and individual needs, and advance health attainment. In this paper, existing successful and sustainable models that demonstrate the empowerment of Indigenous peoples and communities in advocating for, designing, delivering and leading health and wellness supports are shared.

scholarly journals Approaches to incorporating indigenous health into the Canadian medical school curriculum

2017 ◽  
Vol 86 (2) ◽  
pp. 57-59
Author(s):  
Danielle Robinson ◽  
Chowdhury Anika Saiva ◽  
Purathani Shanmuganathan
Keyword(s):  
Medical School ◽  
Cultural Competency ◽  
Indigenous Health ◽  
Health Status Disparities ◽  
School Curriculum ◽  
Indigenous Populations ◽  
Canadian Medical School ◽  
Health Curriculum ◽  
School Programs ◽  
Significant Health

In Canada, there are significant health status disparities that exist between Indigenous and non-Indigenous populations. Cultural competency among physicians is a probable way to address this large gap. The purpose of this article is to discuss the current challenges that exist in designing and delivering an Indigenous health curriculum in Canadian undergraduate medical school programs. This article will highlight the importance of cultural competency for improving the health outcomes of Indigenous populations. Additionally, it will explore potential approaches for better integration of Indigenous health into medical curricula.

‘Best Intentions’ Lives on: Untoward Health Outcomes of Some Contemporary Initiatives in Indigenous Affairs

2002 ◽  
Vol 36 (5) ◽  
pp. 575-584 ◽  
Author(s):  
Ernest Hunter
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Health Services ◽  
Health Outcomes ◽  
Social Issues ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Indigenous Populations ◽  
Royal Commission ◽  
Indigenous Mental Health

Objective: A shortened version of a presentation to the Australian Institute of Aboriginal and Torres Strait Islander Studies, this paper raises questions regarding policy and program directions in Indigenous affairs with consequences for Indigenous health. Method: The author notes the inadequate Indigenous mental health database, and describes contemporary conflicts in the arena of Indigenous mental health, drawing on personal experience in clinical service delivery, policy and programme development. Results: Medicalized responses to the Stolen Generations report and constructions of suicide that accompanied the Royal Commission into Aboriginal Deaths in Custody are presented to demonstrate unforeseen health outcomes. Examples are also given of wellintentioned social interventions that, in the context of contemporary Indigenous society appear to be contributing to, rather than alleviating, harm. Problems of setting priorities that confront mental health service planners are considered in the light of past and continuing social disadvantage that informs the burden of mental disorder in Indigenous communities. Conclusions: The importance of acknowledging untoward outcomes of initiatives, even when motivated by concerns for social justice, is emphasized. The tension within mental health services of responding to the underpinning social issues versus providing equity in access to proven mental health services for Indigenous populations is considered.

A brief history of indigenous health in Brazil

2010 ◽  
Vol 4 (4) ◽  
pp. 1951
Author(s):  
Maria Neyrian Fátima Fernandes ◽  
Arieli Rodrigues Nóbrega ◽  
Rosinaldo Santos Marques ◽  
Ana Michele De Farias Cabral ◽  
Clélia Albino Simpson
Keyword(s):  
Indigenous People ◽  
Health Systems ◽  
Health Inequalities ◽  
Indigenous Health ◽  
Indigenous Rights ◽  
Social Diversity ◽  
Brazilian Legislation ◽  
History Of ◽  
The Right

ABSTRACTObjective: to provide a brief history context on the indigenous struggle for rights. It was at its peak in the 1970s, until the Indigenous Health Subsystem implementation in 1999. Method: it is a bibliographic review research made through BIREME and Scielo databases, including documents and publications of FUNASA, FUNAI, and the Brazilian legislation on indigenous, from 1970s to 2000s using the term: indigenous health. Results: after a myriad of movements that fought for indigenous rights recognition, the Indian Statute was sanctioned in 1973 regulating the indigenous issues in Brazil. Thereafter the Brazilian Constitution of 1988 it took a new direction, recognizing the right for cultural and social diversity, among others. Conclusion: the indigenous people integration to the health systems happened, and is still happening, according to the SUS purpose of reduce health inequalities among the whole population. Descriptors: nursing; indigenous health; Brazil.RESUMOObjetivo: traçar um breve histórico das lutas pelos direitos indígenas, cujo ápice foi nos anos 1970, até o estabelecimento do Subsistema de Atenção aos Povos Indígenas em 1999. Método: revisão a partir de levantamento bibliográfico nos bancos de dados, BIREME e Scielo, em documentos e publicações da FUNASA e da FUNAI, e na legislação brasileira indigenista, dos anos 1970 até 2000 com a utilização do descritor: saúde indígena. Resultados: após uma série de movimentos que lutavam pelo reconhecimento dos direitos indígenas, foi sancionado o Estatuto do Índio em 1973 que regulamentava a questão indígena no Brasil. Após Constituição do Brasil de 1988 houve um novo redirecionamento, reconhecendo o direito à diversidade cultural e social, entre outros. Conclusão: a integração dos povos indígenas aos sistemas de saúde aconteceu e está acontecendo conforme o propósito do SUS de redução das desigualdades em saúde na população como um todo. Descritores: enfermagem; saúde indígena; Brasil. RESUMENObjetivo: hacer un breve histórico de la lucha por los derechos indígenas que alcanzó su máximo en la década de 1970, hasta la creación de lo Subsistema de Atención a los Pueblos Indígenas en 1999. Método: revisión desde las búsquedas bibliográficas en bases de datos, BIREME y SciELO, en los documentos y publicaciones de la FUNASA, FUNAI y en la legislación indígena brasileña, desde los años 1970 hasta 2000 usando el descriptor: salud indígena. Resultados: después de una serie de movimientos que luchaban por el reconocimiento de los derechos indígenas, se promulgó el Estatuto de lo Indio en 1973, que regulaba la cuestión indígena en Brasil. Posteriormente a la Constitución brasileña de 1988 ocurrió una nueva dirección, reconociendo el derecho a la diversidad cultural y social, entre otros. Conclusión: la integración de los sistemas de salud indígenas ocurrió y está ocurriendo según el propósito del SUS de reducir las desigualdades en salud en toda la población. Descriptores: enfermería; salud indígena; Brasil. 

scholarly journals Indigenous Trauma Intervention Research in Canada: A Narrative Literature Review

2021 ◽  
Vol 12 (2) ◽  
pp. 1-24
Author(s):  
Sarah Panofsky ◽  
Marla J. Buchanan ◽  
Roger John ◽  
Alanaise Goodwill
Keyword(s):  
Mental Health ◽  
Indigenous Health ◽  
Historical Trauma ◽  
Indigenous Communities ◽  
Psychological Trauma ◽  
Mental Health Research ◽  
Indigenous Populations ◽  
History Of ◽  
Narrative Literature Review ◽  
Indigenous Mental Health

Contemporary Indigenous mental health research is beginning to address colonization, contextualizing Indigenous health within a history of colonial relationships and inadequate mental health responses. In practice, however, dominant counselling models for mental health in Canada have neglected Indigenous perspectives and there is a paucity of research regarding interventions that address psychological trauma with Indigenous populations. We identified 11 Canadian studies that employed culturally appropriate trauma interventions within Indigenous communities. We discuss the findings in relation to the study participants, outcomes reported, and research design. Recommendations are provided to address the need for evidence-based trauma interventions that have efficacy for Indigenous people in Canada to address Indigenous historical trauma.

scholarly journals Editorial

2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Sonia Isaac-Mann ◽  
Evan Adams ◽  
Ted Mala
Keyword(s):  
British Columbia ◽  
Service Delivery ◽  
Indigenous Knowledge ◽  
First Nations ◽  
Health Systems ◽  
Indigenous Peoples ◽  
Health Authority ◽  
Indigenous Health ◽  
Health And Wellness ◽  
Respectful Care

Welcome to this two-part guest edition of the International Journal of Indigenous Health (IJIH), produced by the First Nations Health Authority (FNHA) in the province of British Columbia (BC), Canada. As guest co-editors, we are pleased to present to you this collection of research, promising and wise practices, innovations, and Indigenous Knowledge on health and wellness. These papers constitute a substantive contribution to, as our call for submissions framed it, “Health Systems Innovation: Privileging Indigenous Knowledge, Ensuring Respectful Care, and Ending Racism toward Indigenous Peoples in Service Delivery.”

scholarly journals Editorial

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Sonia Isaac-Mann ◽  
Evan Adams ◽  
Ted Mala
Keyword(s):  
British Columbia ◽  
Service Delivery ◽  
Indigenous Knowledge ◽  
First Nations ◽  
Health Systems ◽  
Indigenous Peoples ◽  
Health Authority ◽  
Indigenous Health ◽  
Health And Wellness ◽  
Respectful Care

Welcome to this two-part guest edition of the International Journal of Indigenous Health (IJIH), produced by the First Nations Health Authority (FNHA) in the province of British Columbia (BC), Canada. As guest co-editors, we are pleased to present to you this collection of research, promising and wise practices, innovations, and Indigenous Knowledge on health and wellness. These papers constitute a substantive contribution to, as our call for submissions framed it, “Health Systems Innovation: Privileging Indigenous Knowledge, Ensuring Respectful Care, and Ending Racism toward Indigenous Peoples in Service Delivery.”

scholarly journals Health Systems Responsiveness in Addressing Indigenous Residents' Health and Mental Health Needs Following the 2016 Horse River Wildfire in Northern Alberta, Canada: Perspectives From Health Service Providers

2021 ◽  
Vol 9 ◽  
Author(s):  
Kayla M. Fitzpatrick ◽  
T. Cameron Wild ◽  
Caillie Pritchard ◽  
Tara Azimi ◽  
Tara McGee ◽  
...  
Keyword(s):  
Mental Health ◽  
Health Systems ◽  
Service Providers ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Health Concerns ◽  
Mental Health Concerns ◽  
Services And Supports ◽  
Document Review ◽  
Northern Alberta

Following the 2016 Horse River Wildfire in northern Alberta, the provincial health authority, the ministry of health, non-profit and charitable organizations, and regional community-based service agencies mobilized to address the growing health and mental health concerns among Indigenous residents and communities through the provision of services and supports. Among the communities and residents that experienced significant devastation and loss were First Nation and Métis residents in the region. Provincial and local funding was allocated to new recovery positions and to support pre-existing health and social programs. The objective of this research was to qualitatively describe the health systems response to the health impacts following the wildfire from the perspective of service providers who were directly responsible for delivering or organizing health and mental wellness services and supports to Indigenous residents. Semi-structured qualitative interviews were conducted with 15 Indigenous and 10 non-Indigenous service providers from the Regional Municipality of Wood Buffalo (RMWB). Interviews were transcribed verbatim and a constant comparative analysis method was used to identify themes. Following service provider interviews, a supplemental document review was completed to provide background and context for the qualitative findings from interviews. The document review allowed for a better understanding of the health systems response at a systems level following the wildfire. Triangulation of semi-structured interviews and organization report documents confirmed our findings. The conceptual framework by Mirzoev and Kane for understanding health systems responsiveness guided our data interpretation. Our findings were divided into three themes (1) service provision in response to Indigenous mental health concerns (2) gaps in Indigenous health-related services post-wildfire and (3) adopting a health equity lens in post-disaster recovery. The knowledge gained from this research can help inform future emergency management and assist policy and decision makers with culturally safe and responsive recovery planning. Future recovery and response efforts should consider identifying and addressing underlying health, mental health, and emotional concerns in order to be more effective in assisting with healing for Indigenous communities following a public health emergency such as a wildfire disaster.

scholarly journals Lessons Learned From Canada in Working Together to Support Indigenous Health and Wellness

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 132s-132s
Author(s):  
C. Politis ◽  
D. Keen
Keyword(s):  
Cancer Prevention ◽  
First Nations ◽  
Culturally Relevant ◽  
Indigenous Health ◽  
Indigenous Communities ◽  
Lessons Learned ◽  
Health And Wellness ◽  
Truth And Reconciliation ◽  
Key Informant ◽  
Mental Wellness

Background and context: First Nations, Inuit and Métis bear a disproportionate burden of cancer in Canada. In the spirit of truth and reconciliation, and to have the greatest impact, it is important for nonindigenous and indigenous partners to work together, and reflect on lessons learned in collaborating, to support First Nations, Inuit and Métis health and wellness. Aim: In response to the national Truth and Reconciliation Commission Calls to Action, the Canadian Partnership Against Cancer committed to understanding how collaborative projects funded through the Coalitions Linking Action and Science for Prevention (CLASP) initiative were successful in bringing together diverse groups - both indigenous and nonindigenous - to create and apply culturally-relevant cancer prevention approaches. Strategy/Tactics: Seven projects funded through the CLASP initiative, from 2009 to 2016, brought together over 275 First Nations, Inuit, or Métis communities, schools, and organizations with government, nongovernment, and academic partners in collaborative coalitions. The projects addressed cancer prevention issues prioritized by First Nations, Inuit, and Métis (e.g., unhealthy eating and physical inactivity) through approaches that were holistic and culturally-relevant, such as utilizing intergenerational knowledge sharing, incorporating mental wellness, and supporting existing capacity within communities. Program/Policy process: Over 30 knowledge products developed by the projects were reviewed to identify preliminary lessons learned about partner collaboration. Preliminary lessons learned were verified and expanded upon through nine key informant interviews with CLASP partners. Key informant interviews were informed by four advisors representing indigenous and nonindigenous leaders and partners. The refined set of lessons learned were finalized through qualitative analysis and validated through a conference session and one-day workshop with CLASP partners and First Nations, Inuit, and Métis community leaders. Outcomes: Twenty-seven lessons learned that describe how nonindigenous and First Nations, Inuit and Métis CLASP partners worked together to develop and put into practice culturally-appropriate cancer prevention approaches were identified. The lessons learned were grouped into six themes: 1. respectful relationships; 2. engagement with indigenous communities; 3. addressing accountability requirements, decision-making, and governance; 4. community direction; 5. supports and resources; 6. communication and knowledge exchange. What was learned: The actionable lessons learned are intended to guide future relationship building and engagement between nonindigenous partners and First Nations, Inuit and Métis partners. It is intended that these lessons will be beneficial to collaborative cancer prevention efforts around the world and inform broader system change leading to a reduction in indigenous cancer burden disparities.

scholarly journals Preventing the Tragedy of Suicide Among Indigenous People in Canada: Physician Advocacy Through the Training Pipeline and Beyond

2016 ◽  
Vol 6 (2) ◽  
pp. 17-20
Author(s):  
Max Deschner ◽  
Emilie Glanz
Keyword(s):  
Indigenous People ◽  
Medical Training ◽  
Indigenous Health ◽  
Healthcare Access ◽  
Indigenous Communities ◽  
Indigenous Populations ◽  
Health Determinants ◽  
Accès Aux Soins ◽  
Santé Autochtone ◽  
Déterminants De La Santé

ABSTRACTFor decades, Canada’s Indigenous populations have experienced high rates of suicide relative to the general population. This com­mentary suggests that suicide among Indigenous people cannot be explained solely through the causal effects of downstream de­terminants of health; upstream health determinants such as Canada’s colonial past and cultural continuity are equally, if not more, instructive in understanding the tragedy that is taking place in many Indigenous communities across Canada. Medical trainees and physicians can contribute to improvements in Indigenous health by advocating for culturally safe healthcare access and research, as well as Indigenous-oriented medical training. RÉSUMÉPendant des décennies, les populations autochtones au Canada ont connu des taux élevés de suicide comparativement à la popula­tion générale. Ce commentaire suggère que le suicide chez les personnes autochtones ne peut être expliqué uniquement par les effets causaux des déterminants de la santé « en aval » ; les déterminants de la santé « en amont », tels le passé colonial du Canada et la continuité culturelle, sont tout aussi, sinon plus importants pour comprendre la tragédie se déroulant dans plusieurs communautés autochtones à travers le Canada. Les médecins et étudiants en médecine peuvent contribuer à l’amélioration de la santé autochtone en plaidant pour de la recherche et un accès aux soins de santé qui sont culturellement sécuritaires, et pour des formations médicales axées sur la santé autochtone. 

scholarly journals Fisher’s Linear Discriminant Function Analysis and its Potential Utility as a Tool for the Assessment of Health-and-Wellness Programs in Indigenous Communities

2020 ◽  
Vol 17 (21) ◽  
pp. 7894
Author(s):  
Eric N. Liberda ◽  
Aleksandra M. Zuk ◽  
Ian D. Martin ◽  
Leonard J. S. Tsuji
Keyword(s):  
Diabetes Mellitus ◽  
Discriminant Function ◽  
Discriminant Function Analysis ◽  
Function Analysis ◽  
Fasting Blood Glucose ◽  
Public Health Problem ◽  
Indigenous Communities ◽  
Wellness Programs ◽  
Indigenous Populations ◽  
Health And Wellness

Diabetes mellitus is a growing public health problem affecting persons in both developed and developing nations. The prevalence of type 2 diabetes mellitus (T2DM) is reported to be several times higher among Indigenous populations compared to their non-Indigenous counterparts. Discriminant function analysis (DFA) is a potential tool that can be used to quantitatively evaluate the effectiveness of Indigenous health-and-wellness programs (e.g., on-the-land programs, T2DM interventions), by creating a type of pre-and-post-program scoring system. As the communities of the Eeyou Istchee territory, subarctic Quebec, Canada, have varying degrees of isolation, we derived a DFA tool for point-of-contact evaluations to aid in monitoring and assessment of health-and-wellness programs in rural and remote locations. We developed several DFA models to discriminate between those with and without T2DM status using age, fasting blood glucose, body mass index, waist girth, systolic and diastolic blood pressure, high-density lipoprotein, triglycerides, and total cholesterol in participants from the Eeyou Istchee. The models showed a ~97% specificity (i.e., true positives for non-T2DM) in classification. This study highlights how varying risk factor models can be used to discriminate those without T2DM with high specificity among James Bay Cree communities in Canada.

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