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National Aboriginal Health Organization NAHO


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Title: National Aboriginal Health Organization NAHO

National Aboriginal Health Organization (NAHO)
  • Information and Communication Technology in the
    ArcticIcelandic Chairmanship of the Arctic
    CouncilOctober 20-21, 2003

  • Canadas Aboriginal Peoples
  • Aboriginal Health Research
  • Knowledge as a Community Resource and
    Knowledge-Based Strategies
  • National Aboriginal Health Organization (NAHO)
  • Origins and History
  • Interests and Initiatives
  • Aboriginal Health Infostructure
  • Opportunities for Innovation/Success Factors
  • Thanks to assistance of NAHO Policy Research, Dr.
    Valerie Gideon, Director of the First Nations
    Centre, and Ajunnginiq Centre _at_ NAHO

Canadas Aboriginal Peoples
  • Three distinct groups Approximately 1 million
    people or 3.3 of Canadas population
  • Inuit 5
  • First Nations 62
  • - Over fifty distinct cultural groups
  • Métis 30
  • Living in many types of communities
  • Reserve, Urban or Rural/isolated northern
  • (Statistics Canada 2003)

Inuit Regions Communities
  • Four Land Claims Regions
  • Nunavut
  • Nunavik
  • Inuvialuit
  • Labrador
  • 53 Inuit Communities, ranging from 120 to 6,000
  • Approximately 50,000 Inuit
  • 5 of Aboriginal population

Métis Identity Population in Canada
  • 31 Metis Identity
  • 68 live in urban areas
  • 40 urban Aboriginal Population

Responsibility for Health Services
  • Federal government accepts responsibility for
    public and environmental health services for
    First Nations living on reserves and for Inuit
  • First Nation, Métis and Inuit also use provincial
    and territorial government health services
  • Although Métis are recognized as an Aboriginal
    People in the Constitution, the federal
    government has not accepted jurisdiction for
    Métis and very few Métis-specific health
    initiatives exist at the provincial/territorial

Canadas Aboriginal Peoples
  • Compared to the population as a whole, Canadas
    Aboriginal population is
  • Young with 50 less than 25 years of age
  • Mobile
  • Growing rapidly in size
  • Increasingly concentrated in large urban and
    inner city areas
  • Poverty and marginalization remain major concerns
  • Education, income and economic development
    opportunities are improving
  • Health status is lower than general population on
    virtually every measure

Aboriginal Health Research in Canada
  • Key findings (Young K. 2003)
  • Over 60 of papers referred to First Nations
  • Only 2 dealt with those living off-reserve, and
    2 provided data on Métis
  • Only 3 of articles dealt with smoking, although
    the prevalence of smoking in the population is
  • Injuries account for over a third of all deaths,
    yet occupy 3 of publications

Aboriginal Controlled or Directed Research
  • Institute of Aboriginal Peoples Health
  • ACADRE program (Aboriginal Capacity and
    Development Research Environments)
  • National Aboriginal Health Organization (NAHO)
  • First Nations Regional Longitudinal Health Survey
  • Aboriginal Healing Foundation

Federal Government Support of Aboriginal Research
  • 1998 Government of Canada response to 1996 Royal
    Commission on Aboriginal Peoples, called
    Gathering Strength Canadas Aboriginal Action
    Plan, includes
  • Northern Contaminants Program (NCP)
  • Aboriginal Diabetes Initiative
  • Aboriginal HIV/AIDS Research Capacity Building
  • Research by Federal departments
  • Additional Health Research Initiatives affecting
    Aboriginal Peoples

Keynote Factors in Aboriginal Health
  • Inequitable health services
  • Poor health status than general Canadian
  • Difficulty accessing certain health care
    providers (pediatricians, mental health
    professionals, obstetricians/ gynecologists,
    midwives), in particular, in remote communities
  • Quality of health care in isolated/remote
  • Residential school experience and loss of land
    and culture have contributed to health and
    wellness status of Aboriginal peoples
  • Use of traditional healer/ medicines reported
    more likely to use traditional care if accessible
    at local health centre and covered by health care

Sources Regional Health Survey 1997, NAHO
Opinion Poll 2002
Overview of Canadian Indigenous Research Capacity
  • Strengths
  • Aboriginal controlled or directed organizations
  • Increased funding and involvement
  • Indigenous Research capacity is high priority
  • Emerging opportunities for national surveillance
  • Challenges
  • Sustaining the (funding) gains e.g. RHS, AHF
  • Ensuring meaningful involvement in research
  • Community Capacity to direct/use research
  • Improving access to health data
  • Systemic issues research funding mechanisms
    access to academic positions

National Aboriginal Health Organization (NAHO)
  • Vision Statement
  • The National Aboriginal Health Organization, an
    Aboriginal designed and controlled body, will
    influence and advance the health and well-being
    of Aboriginal Peoples by carrying out
    knowledge-based strategies.

NAHO Mandate
  • How can knowledge-based strategies be used to
    improve Aboriginal health?

Knowledge as a Community Resource
  • Knowledge is a community resource. It defines
    and drives the community. Its
    interconnectedness, its multifaceted and
    multidimensional, its revered, its language,
    communication and history.
  • Its collective memory. Its captured and
    maintained for future generations. Its a
    reflection of life experience. Its acquired
    through listening and being empathetic. Its
    wisdom, strength and leadership. Its a
    strategic resource. Its the power of a good
    mind. Its imperfect.
  • Its a gift bestowed by the Creator.
  • Quote from Tom Maracle

Knowledge Catalyst for Change
  • The key to Aboriginal Health Partnerships is
    that theyreflect the needs and circumstances of
    the communities and people they serve.
  • Romanow Commission
  • Creating change starts with creating a vision
    for change and then empowering individuals to act
    as change agents to attain that vision.
  • Lorenzi Riley

policy initiatives are adopted precisely because
of their power to convince decision makers that
they are the most appropriate course of action
Thus, any attempt to re-frame or replace an
existing policy is only likely to be successful
if extremely compelling evidence to justify a
change of course can be gathered. -Dion Stout
and Kipling
Model for Change
Policy Makers
Health Professions
Health Administrators
Health System Based on Peoples Needs
Academic Institutions
Borrowed from Towards Unity for Health
Using Knowledge-Based Strategies to Achieve the
Leadership Strategy
Best Practices
Knowledge Based Strategies
Knowledge-Sharing Culture
Tools Technologies
Communities of Practice
Incentives Partnerships
How to Create and Support Knowledge
  • Royal Commission on Aboriginal Peoples (RCAP)
    consultations identify need for national health
    institute in 1996
  • Aboriginal Health Institute recommended by
    National Forum on Health in 1997
  • Speech from the Throne commits Canadian
    Government to establish the Institute 1998
  • Consultations with five of Canadas National
    Aboriginal Organizations (1998)

Brief History
  • Cabinet approved design framework allowing for
    implementation (June 1999)
  • Organization for the Advancement of Aboriginal
    Peoples Health incorporated (March 10, 2000)
  • 10 Board members appointed/5 elected Staff
    recruitment Board orientation to mandate and
    establishing initial structures New corporate
    logo selected Change name to National Aboriginal
    Health Organization (NAHO) (2000)
  • Establishment of 3 Centres - Inuit, First Nations
    and Métis (2001)

Member Organizations
  • Five National Aboriginal Organizations
  • Assembly of First Nations (AFN)
  • Congress of Aboriginal Peoples (CAP)
  • Inuit Tapiriit Kanatami (ITK)
  • Collaboration with Pauktuutit Inuit Womens
    Association of Canada
  • Métis National Council (MNC)
  • Native Womens Association of Canada (NWAC)

Principles of Uniqueness
  • Commit to unity and respect diversity
  • Consider knowledge of Aboriginal traditional and
    western contemporary healing and wellness
  • View community as primary focus, including
    community-based research
  • Reflect values and principles contained in
    traditional knowledge and practices

Main Interests
  • Knowledge transfer
  • Provide a support network for Aboriginal health
    workers and communities
  • Share information on best practices and health
  • Advocate health research in the area of
    evidence-based decision making to ensure the
    unique needs of Aboriginal Peoples are met

NAHOs Goals
  • To improve and promote the health of Aboriginal
    Peoples, through knowledge-based activities
  • To promote health issues pertaining to Aboriginal
    Peoples by means that include communications and
    public education activities
  • To facilitate and promote research and develop
    research partnerships
  • To foster the recruitment, retention, training
    and utilization of Aboriginal People in the
    delivery of health care
  • To affirm Aboriginal traditional healing
    practices and medicines and to ensure such
    practices receive recognition

Object 1 Specific Initiatives
  • Collecting data
  • The First Nations Regional Longitudinal Health
    Survey (RHS)
  • NAHO Opinion Poll on Health Care
  • Sharing information
  • NAHO Annual Conference (November 2004) and three
    regional gatherings
  • Five Inuit regional workshops
  • Métis Health Policy Forum
  • A series of workshops on Health and Community
    Control, Aboriginal health information, etc.
  • Information Clearinghouse on Aboriginal Health
  • Creating and supporting knowledge
  • Best Practices Program

Key Findings
  • First Nations Regional Longitudinal
  • Health Survey (RHS)
  • Over 28,000 on-reserve First Nations (2nd
  • 250 trained community interviewers using laptops
    with daily remote uploads of data
  • NAHO Opinion Poll on Health Care
  • First national poll on Aboriginal health issues
    in 2002
  • 400 Métis individuals surveyed in three provinces
  • 1209 First Nations adults living on or near

Key Findings
  • Inuit Regional Workshops
  • Inuvik Regional Workshop, Feb. 25-28
  • Nunavik, Mar. 25-29
  • Nain in Labrador, April 8-11
  • Iqaluit, May 8-12
  • Rankin Inlet, Nov. 25-29
  • Loss of language
  • Water quality
  • Active living
  • Teenage pregnancy
  • Tobacco use
  • Land activities
  • Improving primary caregiving
  • Inuit family values
  • Resources for community health representatives
  • Culture shock
  • Nutrition
  • Strong language and cultural festivities
  • Active youth
  • Eager to learn about traditional healing
  • Cancer
  • Addictions and suicide rates
  • Elders traveling for care

Our Collected Works to Date Highlights
  • Analysis of Aboriginal Health Careers
  • Aboriginal Health A Constitutional Rights
  • Effective Governance Strategic Consideration for
  • Ethics of Aboriginal Research
  • Midwifery and Aboriginal Midwifery in Canada
  • Traditional Medicine in Contemporary Contexts
  • Winds of Change A Strategy for Health Policy
    Research and Analysis
  • Capacity Building for the Health of Aboriginal
  • Aboriginal Integrated Health Organizations

Our Collected Works to Date Highlights
  • NGOs and a Management Strategy Framework for NAHO
  • A Framework for Aboriginal Health Systems
  • Improving Population Health, Health Promotion,
    Disease Prevention and Health Protection Services
    and Programs for Aboriginal People
  • Establishing a Leading Knowledge-Based
  • A Path to a Better Future-A Preliminary Framework
    for a Best Practices Program for Aboriginal
    Health and Health Care
  • Strategic Directions for an Evidence-Based
    Decision Making Framework Framework at NAHO
  • Submission to the Commission on the Future of
    Health Care in Canada

Information Clearinghouse on Aboriginal Health
  • Features
  • News and Current Events
  • Research Register
  • Conference Register
  • Professional Exchange
  • Keep Me Posted
  • Community Profiles and Geography
  • Funding and Budgets
  • Legislation
  • Feedback and Surveys
  • The Library
  • Reading Room
  • Featured Papers
  • Highlight Capsules
  • References
  • The Store
  • Select and order
  • Facilities and Programs
  • People and Organizations
  • Career and Education Centre

Object 2 Promoting Health Issues
  • Aboriginal evidence-based framework for decision
  • Based on community-identified priorities
  • Integrates qualitative and quantitative data
  • Builds on Aboriginal languages, cultures and
    indigenous knowledge, practices and values
  • Continually assesses/reassesses information from
    the community, interpretations of the evidence,
    and evaluation of outcomes
  • Integrates an Aboriginal peer-review process
  • Takes into account patients rights

Object 3 Facilitate Aboriginal Health Research
Search for discovery (basic curiosity)
NAHO focus
1) Basic Biomedical Research
3) Research into culture, pop. health
Individual (even cellular) level
Communities, social systems, populations
4) Health services systems investigations
2)Applied Clinical Research
Directed translation/synthesis of knowledge gained
Working Through Partnerships
  • Launch of the NAHO Journal
  • Framework Agreement with the Institute of
    Aboriginal Peoples Health
  • Development of models for Aboriginal Health
    Research Ethics
  • NAHO Research Associates
  • Participation in the Canadian Population Health
  • ACADRE Centers
  • Facilitate identification of Inuit-specific
    mental health research priorities

Object 4 Advance and support Aboriginal health
  • Initiate and engage partnership arrangements
  • Member Affiliations
  • Object Specific Agreements
  • Friends of NAHO agreements
  • Contractual Agreements
  • Letter of Intent with Canadian Medical
    Association, Canadian Public Health Association
  • Draft Framework Agreement with IAPH
  • Memorandum of Understanding with AFN

Object 4
  • Workshops
  • How to Effectively Use Health Information and
    Youth Workshops on How to Conduct Research -
    First Nations Centre
  • Proposal Writing Workshops - Metis Centre
  • Building capacity of Aboriginal health
    researchers through ACADRE centers
  • Work to address broader capacity-building
    requirements to enhance recruitment and retention
    of Inuit students and health care workers
  • Develop resource books for health interpreters
  • Creation of new health professions, e.g.
    traditional midwives

Object 5 Affirm Traditional Healing Practices
  • Bulletins with the Native Law Centre
  • Traditional Medicine and Legal Issues
  • Intellectual Property Rights and their Impact on
    Indigenous Knowledge and Medicines
  • Support and gatherings for Aboriginal midwives
    from across Canada
  • Environmental Scan by Dr. Dawn Martin-Hill
  • Discussion Paper on International Models
  • Gatherings with Communities, Elders and Healers
  • Métis Elders Gatherings
  • Strategies to preserve and protect traditional
  • Awareness seminars and workshops aimed at health
    professionals and students
  • Work with cultural institutes

Managing Change for an Aboriginal Health
  • Creating an Aboriginal community in practice
    for health infostructure adoption
  • Draft Blueprint and Tactical Plan recommends
    flexible technology architecture to accommodate
    varying community needs
  • Aboriginal Health Infostructure - an autonomous
    and distinct commitment, strategically and
    appropriately interlinked with the pan-Canadian
    Health Infostructure

Notable Policy Developments
  • 1996 Royal Commission on Aboriginal peoples
  • 1997 F/P/T Advisory Committee on Population
  • 1999 Ministerial Advisory Council on Health
  • January 2001, the Speech From The Throne
    Government of Canada commitment to strengthen its
    relationship with Aboriginal people, improve
    conditions for Aboriginal people, develop modern
    information systems, improve health care and
    support health research.

Notable Policy Developments
  • 2001 National Broadband Task Force recommended
    that government take leadership to ensure that
    affordable access to broadband services is
    available to all Canadians by 2004 as a matter of
  • 2002 The Health Transition Funds Aboriginal
    Health Synthesis Report recommended additional
    resources be allocated to support Aboriginal
    communities collection, management, and use of
    local health data
  • 2002 the Romanow Commission proposed that
    Aboriginal Health Partnerships be created,
    supported by up-to-date information on
    performance indicators and the capacity to make
    decisions based on the best available evidence.

Aboriginal Health Infostructure
  • Drivers
  • Improved continuum and access to health
    information and health care
  • Professional support for better recruitment and
  • Aboriginal peoples governance over their health
    information and service delivery
  • Improved health planning of Aboriginal health
    systems and F/P/T governments
  • Barriers
  • Connectivity and Capacity
  • Relevant Content
  • Inclusion in Canadian, provincial and/or
    territorial initiatives
  • Sustained support for initiatives
  • Policy uncertainties

Draft Blueprintand Tactical Plan
  • Key Directions
  • Empower communities
  • Improve access to health services
  • Build human resources institutional capacity
  • Improve linkages with N/P/T health systems
  • Respect OCAP
  • The Process
  • Planning Committee created in 2001
  • Environmental Scan completed
  • Vision drafted
  • Stakeholder feedback sessions initiated
  • Draft Plan in January 2003

Blueprint/Tactical Plan
  • Common Priorities
  • All validate Vision Statement
  • All support one-stop web-based health information
  • Region-specific approach to health infostructure
    development may be preferred
  • Capacity building is fundamental to user
    ownership and participation
  • Improved infrastructure is required
  • First Nations
  • Specific applications that respond to breadth of
  • Inuit and Métis
  • Development of basic infrastructure for sharing
    and utilizing of services and information

Opportunities for Innovation
  • Aboriginal Health Surveillance
  • Major Gap recognized by Canadian Public Health
  • Invitations to participate in developing
    surveillance systems in food and nutrition,
    cancer care, maternal health from Health Canada
  • Need for integrated, comprehensive Aboriginal
    public health surveillance strategy to identify
    priorities, building blocks, and implementation

Opportunities for Innovation
  • Building Models for Integrated Aboriginal Health
  • Providing key information in support of the
    Partnership model presented in Romanow Commission
  • Case studies of Aboriginal community-controlled
    systems, study of funding models and
    international perspectives
  • Common strands
  • Paradigm shift from ill to population-based
  • Local governance and Aboriginal involvement
  • Interdisciplinary primary care
  • Traditional medicine linked with mainstream
  • system
  • A focus on children and youth
  • Holistic framework

Linkages with Health Canada other Federal
  • Develop effective and friendly information tools
    for Aboriginal communities
  • Clearinghouse
  • Tool Kits for Community Planning
  • Support research for identifying health needs,
    priorities and successful models
  • Develop integrated models for addressing broader
    determinants of health across/within federal

Critical Success Factors
  • Inclusion of all Aboriginal peoples
  • Aboriginal peoples ownership, control, access
    and possession over their information
  • Aboriginal collective and individual empowerment
    in health systems
  • Holistic approach to health
  • and wellness

  • To be accountable to the Aboriginal Peoples of
    Canada, through the First Nations, Metis and
    Inuit Centres, and with other organizations
  • To make a difference in the health of the
    Aboriginal Peoples of Canada

Sharing Information and Ideas
  • Contact Us!
  • 56 Sparks Street
  • Ottawa, ON Canada
  • K1P 5A9
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