The FNHC Mandate
In May 2011, BC First Nations provided the First Nations Health Council (FNHC) an ambitious mandate. In addition to providing dedicated political leadership for the implementation of the health plans and agreements, and supporting health systems transformation, leaders called upon the FNHC to build partnerships to make progress on the social determinants of health.
At that time, the FNHC mandate was captured in the Consensus Paper 2011: British Columbia Perspectives on a New Health Governance Arrangement – approved and adopted by BC First Nations Chiefs at Gathering Wisdom for a Shared Journey in May 2011.
In working to fulfil these commitments the FNHC has been building new partnerships with Canada and BC and engaging First Nations on ways to improve the health and wellbeing of children, families and communities.
During these discussions and deliberations, the FNHC has been challenged on whether we are reaching beyond the third pillar of our mandate. As a result the FNHC requested a legal opinion to clarify whether it is acting appropriately in pursuing agreements with BC and Canada to create a platform for collaboration with First Nations on broader issues that influence health and wellbeing.
The legal opinion has determined that the FNHC is acting within the mandate set out by BC First Nations in the Consensus Papers. It can be viewed on our website here.
Progress Report on Regional Caucuses
The Regional Caucus sessions are well underway with the Vancouver Coastal, Interior and Fraser Salish sessions now completed. At each session, Chiefs, Leaders, and Health Leads have engaged senior decision-makers from the Department of Indigenous and Northern Affairs Canada (INAC) and Employment and Social Development Canada (ESDC) on a wide range of topics, including children and family wellbeing, early learning and childcare, and poverty.
A highlight for many participants has been a presentation delivered by Terry Cross – the founder of the National Indian Child Welfare Association in the United States. At each session, Terry led a discussion on decolonizing First Nations child welfare and the linkage between the social determinants of health and the ability to improve outcomes for children, youth and families.
Feedback from Regional Caucuses:
“I loved Terry Cross! I learned a lot from him – his wisdom and his wonderful energy. The discussion was very focused and we covered a lot of ground – at the same time the social determinants links to Health & Wellness outcomes was and is obvious. Holistic models = transformation!”
“[The session can be improved by] a form sent to bands in advance – For our Health director/Manager to fill in if they are unable to attend. So we can include their comments.”
“Discussion and dialogue with INAC reps was very informative and opportunity to voice concerns and ideas.”
“The information & discussions that took place gave lots of different insight into the issues & how we can work to change them.”
“Terry Cross presentation was inspiring. It puts the community in a position to solve its own problems and issues.”
“I would love to be invited/included in the future.”
Common Themes and Considerations:
The discussions at each session have highlighted common themes and considerations for improving health and social services, including:
- Nations need flexible, needs-based funding
- Funding must flow directly to communities for prevention programming
- Nation-to-Nation relationship is key to federal reforms
- New resources are required to support health and wellness planning at the Nation level
- Break down siloes to support a more coordinated and integrated approach to health and social service planning and delivery
- Focus on outcomes – less on rules and reporting when it comes to community funding
- Relationships with Canada and BC must be based on reciprocal accountability – all accountable for outcomes
- Poverty will be eliminated when First Nations have full access and control over their lands, waters and resources
At the end of the spring Regional Caucuses, the FNHC will revise the Regional Summary Reports shared with First Nations in November of last year. These Regional Summary Reports will build upon the body of knowledge developed throughout this process and will be tabled for review during the Regional Caucuses in the fall of this year.
The Regional Caucuses are part of an ongoing process of engagement with First Nations with respect to the social determinants of health. The FNHC is guided in its engagement work by the engagement and approvals pathway as outlined in the Consensus Paper 2012: Navigating the Currents of Change: Transitioning to a New First Nations Health Governance Structure.
The engagement and approvals pathway is the process by which input is shared and consensus is built for key decisions within the health governance structure. Through dialogue at Sub-Regional Caucuses and Regional Caucuses, the FNHC aims to support a process of priority setting and consensus building.
BC First Nations are set to come together at Gathering Wisdom for a Shared Journey IX in May 2018. At this Gathering Wisdom forum, BC First Nations will be asked to make a decision on a long-term strategy aimed at addressing the social determinants of health. There is a full year to work together through Sub-Regional Caucuses and Regional Caucuses to build a blueprint that sets priorities for investment, partnership and policy change.
Read the Social Determinants of Health Discussion Guide
This discussion guide was prepared by the FNHC to support discussions on the social determinants of health at Sub-Regional and Regional Caucuses. This is a tool to show the link between specific sectors and health outcomes. This discussion guide includes specific information on children and family wellbeing, early childhood experiences and poverty to reflect the three main themes of the Regional Caucus.
This is a key tool to talk about the social determinants of health and to learn more about the work of the FNHC.