April 2015
Health services in Canada are primarily delivered by the provinces and territories. To promote better access to healthcare in First Nations communities and to improve the overall level of health of First Nations and Inuit, the federal government through Health Canada works with First Nations and Inuit partners to provide or fund effective, sustainable, and culturally-appropriate health programs and services.
The delivery and type of health services provided varies from community-to-community. Some First Nations communities receive funding to independently design and deliver the health services that meet their needs. Others work with Health Canada officials to develop community health plans to shape the health programs and services that either they deliver themselves or in partnership with Health Canada. In still others, particularly remote communities, Health Canada employs primary care nurses to work in community-owned nursing stations and deliver clinical care services. Health Canada also provides funding to support the construction and maintenance of the community health facilities in which health programming are delivered.
In the territories, health services are delivered to all residents by the territorial governments. Health Canada funding in the territories focusses on health promotion and disease prevention.
Health services offered in First Nations communities can include a combination of:
- primary care nursing services accessible 24/7;
- public health protection activities such as immunization and activities to help prevent the spread of HIV and tuberculosis;
- health promotion and disease prevention programs to support healthy child development, mental health and addictions, and healthy living; and
- environmental public health activities such as the testing of drinking water.
Where medically required health services are not available in a community, Health Canada provides coverage for medical transportation for community members to access these services.
There are five key elements funded through Health Canada’s First Nations and Inuit health Branch to support First Nations and Inuit health:
- Health promotion and disease prevention programming ($408 M annually) which includes programs that support healthy child development, including prenatal nutrition, maternal child health, early childhood development and mental wellness programming such as addictions support and suicide prevention. Healthy living programs include programs to address diabetes and nutrition education activities.
- Public health protection activities ($98 M annually) include communicable disease control and management such as immunization efforts and activities to address tuberculosis and HIV/AIDS. It also includes environmental health activities related to indoor air quality, mould, drinking water and wastewater management and environmental contaminants.
- Primary care services ($305 M annually) include home and community care (in-home supports) in First Nations communities, plus, nursing services in 80 remote and isolated First Nations communities, serving some 91,000 First Nations. Health Canada directly delivers clinical care services in 53 remote and isolated communities in Alberta, Manitoba, Ontario and Quebec. In an additional 27 remote and isolated communities (including 12 in Saskatchewan), Health Canada provides funding through contribution agreements to enable First Nations Authorities to deliver primary care services. Additionally, Economic Action Plan 2015 committed $12 million over three years to Indspire, to provide post-secondary scholarships and bursaries for First Nations and Inuit students pursuing post-secondary education, including health-related careers.
- Supplemental health benefits ($1.1 B annually) for eligible First Nations and Inuit, regardless of residence in Canada, with coverage for medically necessary health-related goods and services that are not provided through provincial or territorial health programs or private insurance plans. The Non-Insured Health Benefits (NIHB) program includes coverage for:
- certain prescription drugs
- medical transportation
- dental care
- vision care
- medical supplies and equipment and
- short-term crisis intervention mental health counselling
- Health infrastructure support ($636 M annually) that includes support for:
- community health planning,
- accreditation processes,
- health human resources,
- eHealth,
- tele-health,
- health system integration with provinces, including the BC Tripartite Initiative, and
- health facilities and maintenance for 734 health facilities including
- nursing stations,
- residences for health service providers,
- offices and health centres, and
- National Native Alcohol and Drug Abuse Program (NNADAP) treatment centres.
In total, Health Canada invests more than $2.5 billion every year to support the health of First Nations living on-reserve. Economic Action Plan 2015 included an additional $2 million annually on an ongoing basis, to enhance mental wellness team supports in First Nations communities.
Health Canada remains committed to supporting better alignment between federal and provincial and territorial health systems and increased First Nation’s control over health services to create a health system that is responsive to community needs. Various health service integration processes are underway across the country at the regional and community level, such as the First Nations Health Authority in British Columbia. BC First Nations now have greater responsibility for their own health services and are incorporating their cultural knowledge, beliefs and values into the design and planning of their health programs and services.
