Summary of the Evaluation of the First Nations and Inuit Health Branch's Health Planning and Quality Management Activities 2010-2011 to 2014-2015

Introduction

• The HPQM program supports capacity development for First Nations and Inuit communities to design, manage, evaluate, and deliver health programs and services
• The evaluation assessed the relevance and performance of HPQM activities from April 2010 to March 2015

Background

• The HPQM program includes four components:
  • Health planning (governance) - supports on-reserve First Nations communities in the planning and development of health services and program delivery models
  • Accreditation - promotes and supports the accreditation of on-reserve health services for ongoing health system improvement
  • Health consultation/liaison - increases partnerships of national First Nations and Inuit organizations and governments to improve health outcomes
  • Health research - enhances knowledge about First Nations health through funding research projects
• HPQM expenditures between April 2010 and March 2015 were approximately $642 million

What the evaluation found

• HPQM activities align with federal policy and program objectives to increase the responsibility and control First Nations and Inuit communities have over health programs and services.
• There is a continued need for effective capacity building to reduce health inequalities in First Nations and Inuit communities
• HPQM activities have positively impacted First Nation community capacity, which in turn has enhanced the quality of health programs and services
• Strengthened processes and tools in communities with lower initial levels of capacity are needed - in particular remote and isolated communities, smaller communities, as well as communities in crisis
• Efficiencies could be gained by further enhancing collaboration within the Branch and with other federal government departments
• A refined performance data collection approach may enhance how FNIHB is able to measure increased capacity and control and the quality of service being delivered

Recommendations and responses

1. Strengthen processes and tools to improve opportunities for all First Nations communities to develop the capacity to exercise ownership and control, particularly with those First Nations communities with lower initial levels of capacity

   Response: FNIHB will work with First Nation partners to review and update the current Health Planning Guide. FNIHB headquarters will work with regions to identify 15-20 health services organizations and nursing stations that would benefit most by increasing capacity and entering the accreditation process, and provide them with the Health Services Accreditation Toolkit

2. Enhance information exchange and collaboration on health planning and quality management activities across FNIHB programs and regional offices

   Response: Engage First Nations, Inuit and Regional partners to revise the Health Planning Guide

3. Update HPQM performance measurement strategy to establish methods to measure increased capacity and control and the quality of service being delivered

   Response: FNIHB in partnership with HPQM representatives will work in collaboration with Health Canada's Head of Performance Measurement and the Office of Audit and Evaluation to complete a performance information profile

About the evaluation

This evaluation was completed in November 2016 by the Office of Audit and Evaluation for Health Canada and the Public Health Agency of Canada. The evaluation included key informant interviews, surveys, case studies, document and literature reviews, and financial data and performance data reviews. The Assembly of First Nations (AFN) and Inuit Tapiriit Kanatami (ITK) were consulted during the scoping and development phases of the evaluation, as well as on preliminary findings and the draft final report.