Principles for Engaging with First Nations, Inuit and Métis: Chief Public Health Officer Health Professional Forum

On this page

• Preface
• About the CPHO Health Professional Forum and Indigenous Health Sub-Group
• Introduction: What is reconciliation
• Truth and Reconciliation Commission principles for reconciliation
• Principles for engagement
• Acknowledgements

Preface

Meaningful engagement with Indigenous Peoples and their communities is essential to redressing inequities in health system policies and structures in Canada that have been anchored in systemic racism.

Recent efforts to address inequality includes the National Inquiry into Missing and Murdered Indigenous Women and Girls, which looked into and reported on the systemic causes of all forms of violence against Indigenous women and girls, as well as work with First Nations, Inuit and the Métis Nation to develop an action plan for the United Nations Declaration on the Rights of Indigenous Peoples that upholds human rights and advances reconciliation.

Inequities between Indigenous Peoples and non-Indigenous Canadians have only been exacerbated by the COVID-19 pandemic. Non-Indigenous health professionals will play an important role in transforming health and healthcare to better meet the needs of Indigenous Peoples. To accomplish this, health professionals must work in the spirit of reconciliation and partnership with Indigenous Peoples. However, many health professionals struggle in determining how or where to begin.

With this in mind, the Chief Public Health Officer (CPHO) Health Professional Forum's (the Forum) Indigenous Health Sub-Group has developed a set of principles for engaging with First Nations, Inuit and Métis. These principles, described below, are intended to provide a foundation from which to support organizational efforts in working collaboratively with Indigenous Peoples and communities to improve health equity and cultural safety in Canada's health system.

Meaningful engagement with First Nations, Inuit, and Métis must follow a distinctions-based approach and reflect the unique interests, priorities and circumstances of each People. As such, the Forum's Indigenous Health Sub-Group has engaged, and will continue to engage with First Nations, Inuit and Métis on this resource to ensure that it reflects the diverse perspectives of Indigenous Peoples and communities across Canada.

About the CPHO Health Professional Forum and Indigenous Health Sub-Group

Formed in 2018 and comprised of 19 national health organizations, the Chief Public Health Officer (CPHO) Health Professional Forum (the Forum) brings together national health organizations to collaborate and take action on public health issues of national importance. Indigenous health, including cultural competency and safety, was recognized by the Forum as a key priority area for collaboration. The Indigenous Health Sub-Group of the Forum was formed to share and build upon the work of member organizations to advance Indigenous cultural competence, awareness, safety and humility among health professionals.

CPHO Health Professional Forum members

• Association of Medical Microbiology and Infectious Diseases Canada
• Canadian Association of Social Workers
• Canadian Dental Association
• Canadian Indigenous Nurses Association
• Canadian Medical Association
• Canadian Nurses Association
• Canadian Paediatric Society
• Canadian Pharmacists Association
• Canadian Psychological Association
• Canadian Public Health Association
• College of Family Physicians of Canada
• Community Health Nurses of Canada
• HealthCareCAN
• Indigenous Physicians Association of Canada
• Infection Prevention and Control Canada
• Public Health Agency of Canada
• Public Health Physicians of Canada
• Royal College of Physicians and Surgeons of Canada
• Society of Obstetricians and Gynecologists of Canada

Indigenous Health Sub-Group members

• Assembly of First Nations
• Association of Medical Microbiology and Infectious Diseases Canada
• Canadian Indigenous Nurses Association (co-lead)
• Canadian Paediatric Society
• Canadian Public Health Association
• College of Family Physicians of Canada
• Community Health Nurses of Canada
• Health Canada
• HealthCareCAN
• Indigenous Physicians Association of Canada
• Indigenous Services Canada
• Infection Prevention and Control Canada
• Métis National Council
• National Collaborating Centre for Indigenous Health
• Pauktuutit Inuit Women of Canada
• Public Health Agency of Canada
• Royal College of Physicians and Surgeons of Canada (co-lead)

Introduction: What is reconciliation

According to the Truth and Reconciliation Commission of Canada (TRC), "reconciliation is a process of healing of relationships that requires public truth sharing, apology, and commemoration that acknowledge and redress past harms. Reconciliation requires constructive action on addressing the ongoing legacies of colonialism that have had destructive impacts on Aboriginal Peoples' education, cultures and languages, health, child welfare, the administration of justice, and economic opportunities and prosperity".

Recognizing that reconciliation is a process and not a product, the TRC provides a set of principles for reconciliation to assist Canadians in identifying which attitudes, traits and behaviours support a broader process of reconciliation.

Source: What We Have Learned: Principles of Truth and Reconciliation (2015)

Truth and Reconciliation Commission principles for reconciliation

1. The United Nations Declaration on the Rights of Indigenous Peoplesis the framework for reconciliation at all levels and across all sectors of Canadian society.
2. First Nations, Inuit, and Métis Peoples, as the original peoples of this country and as self-determining peoples, have Treaty, constitutional, and human rights that must be recognized and respected.
3. Reconciliation is a process of healing relationships that requires public truth sharing, apology, and commemoration that acknowledge and redress past harms.
4. Reconciliation requires constructive action on addressing the ongoing legacies of colonialism that have had destructive impacts on Aboriginal Peoples' education, cultures and languages, health, child welfare, administration of justice, and economic opportunities and prosperity.
5. Reconciliation must create a more equitable and inclusive society by closing the gaps in social, health, and economic outcomes that exist between Aboriginal and non-Aboriginal Canadians.
6. All Canadians, as Treaty peoples, share responsibility for establishing and maintaining mutually respectful relationships.
7. The perspectives and understandings of Aboriginal Elders and Traditional Knowledge Keepers of the ethics, concepts, and practices of reconciliation are vital to long-term reconciliation.
8. Supporting Aboriginal Peoples' cultural revitalization and integrating Indigenous knowledge systems, oral histories, laws, protocols, and connections to the land into the reconciliation process are essential.
9. Reconciliation requires political will, joint leadership, trust building, accountability, and transparency, as well as a substantial investment of resources.
10. Reconciliation requires sustained public education and dialogue, including youth engagement, about the history and legacy of residential schools, Treaties, and Aboriginal rights, as well as the historical and contemporary contributions of Aboriginal Peoples to Canadian society.

Principles for engagement

Principle 1: Advancing reconciliation

• Respect and seek to implement the Truth and Reconciliation Commission of Canada's Calls to Action (PDF).
• Acknowledge that reconciliation is an ongoing process, and that every interaction between Indigenous and non-Indigenous Peoples is an opportunity to advance reconciliation.
• Reconciliation should promote positive health outcomes through building capacity for Indigenous Peoples and organizations' self-determination, ensuring equal access to health services, and building positive, mutually respectful relationships between Indigenous and non-Indigenous people.

Principle 2: Respecting Indigenous cultures, knowledge and history

• Recognize that Canada is a Treaty nation based on a nation-to-nation relationship with Indigenous Peoples whose Aboriginal and Treaty rights are entrenched in Section 35 of the Constitution of Canada, which includes the right to health and self-determination from their unique cultural perspectives.
• Put the United Nations Declaration on the Rights of Indigenous Peoples into action in order to address injustices, combat prejudice, and end systemic racism and discrimination.
• Recognize the distinctions among and within First Nations, Inuit, and Métis.
• Recognize that cultural practices and traditions are essential to the health and well-being of First Nations, Inuit and Métis.
• Commit to incorporating Indigenous knowledge and experiences into a range of practices, such as clinical and public health practice, as guided by Indigenous Peoples.
• Acknowledge and respect the importance of Elders and Knowledge Keepers in the cultures and societies of First Nations, Inuit, and Métis Peoples and leverage their experience and knowledge wherever possible.
• Recognize the relevance of intergenerational trauma to the lives and health outcomes of Indigenous Peoples today, acknowledging that such trauma is experienced and expressed differently at different stages of life.
• Commit to practicing trauma-informed care and enabling cultural safety, including bringing a trauma-informed perspective to any engagement or partnership with an Indigenous person or group.
• Promote holistic perspectives that help protect and promote the health, safety and well-being of First Nations, Inuit and Métis.

Principle 3: Building relationships and demonstrating humility and openness

• Seek advice, and be open to receiving advice.
• Work in a manner that is inclusive of partners and stakeholders, and engage partners and stakeholders at the earliest point possible.
• Use appropriate, and clear, and plain language in a respectful manner, communicate transparently and involve First Nations, Inuit and Métis wherever possible.
• Recognize the importance of reciprocity and trust, and commit to work with partners in a circle of shared responsibility, accountability and stewardship.
• Recognize the importance of culturally safe engagement with Indigenous partners.
• Incorporate Indigenous knowledge and experiences over the course of the engagement.
• Commit to work in a way that produces timely results, while respecting Indigenous partners' internal governance structure and timelines.
• Recognize and respond to the particular needs of individuals across the lifespan, families, and communities, by taking into account the social determinants of health.
• Recognize the power relationship between health service providers and those seeking to access health services.
• Empower people to speak up when there is a perceived risk to safety.

Principle 4: Improving health equity and social justice

• Acknowledge the role that colonization, history, and systemic racism in society play in health disparities today, and make health equity a key objective of engagement.
• Promote social justice for First Nations, Inuit and Métis and work towards eliminating health inequity.
• Recognize that improving health equity and social justice is an ongoing process with future mechanisms in place to improve the overall health experience for everyone.

Acknowledgements

This document was developed in collaboration with members of the CPHO Health Professional Forum:

• Association of Medical Microbiology and Infectious Diseases Canada
• Canadian Association of Social Workers
• Canadian Dental Association
• Canadian Geriatrics Society
• Canadian Indigenous Nurses Association
• Canadian Medical Association
• Canadian Nurses Association
• Canadian Paediatric Society
• Canadian Pharmacists Association
• Canadian Psychological Association
• Canadian Public Health Association
• College of Family Physicians of Canada
• Community Health Nurses of Canada
• HealthCareCAN
• Indigenous Physicians Association of Canada
• Infection Prevention and Control Canada
• Public Health Agency of Canada
• Public Health Physicians of Canada
• Royal College of Physicians and Surgeons of Canada
• Society of Obstetricians and Gynecologists of Canada

In addition, we gratefully acknowledge the leadership and contributions of the Indigenous Health Sub-Group of the CPHO Health Professional Forum, which, in addition to Forum members, includes the following organizations:

• Assembly of First Nations
• Indigenous Services Canada
• Métis National Council
• National Collaborating Centre for Indigenous Health
• Pauktuutit Inuit Women of Canada