Decolonizing Health in Canada: A Manitoba First Nation Perspective

Abstract

Background This paper focuses on a longitudinal research program in Manitoba, Canada, by the Innovation Supporting Transformation in Community-Based Research Project (iPHIT) to learn from First Nations across the province that have developed effective community-based primary healthcare models. The research is relevant and timely as First Nations across the country, and Indigenous populations globally, work towards improvements in population health and health equity via critical analysis and restructuring of health services. The purpose of the paper is to deepen an understanding of decolonization as it is defined within the communities, as a central aspect of health restructuring. Methods The study is a qualitative, grounded theory analysis, which is a constructivist approach to social research that allows for generation of theory in praxis, through interactions and conversations between researchers and research participants. Findings are based on 183 in-depth interviews and eight focus group discussions with participants from 8 Manitoba First Nation communities. The study was designed to understand strengths, limitations and priorities of primary healthcare strategies and frameworks of the communities. The iPHIT team was an active collaborative partnership between the First Nation communities, First Nation Health and Social Secretariat of Manitoba, and the University of Manitoba. The First Nation partners led in all aspects of the research, from development to implementation, data collection, analyses, and dissemination. Respected Elders from the communities also guided in appropriate research and engagement protocols. Results Data was coded and then grouped into 4 interconnecting themes. These are: (1) First Nation control of healthcare, (2) traditional medicine and healing activities, (3) full community participation, and (4) moving out of colonization involves cleaning up and moving beyond the mess that colonization has inflicted. Conclusion Decolonizing health involves a taking back of Indigenous wisdom and traditional activities; connections to the land, resources; intra- and inter-community relationships. Participants emphasized the value of full community engagement with respect to inclusion of different interpretations of and experiences in the world, highlighting creation of a shared vision. The study focused on First Nation community experiences and interests in Manitoba specifically, though the data may be applicable to national and global decolonization efforts.

Still Thriving: A Case Illustrating How COVID-19 Affected Indigenous Health and Wellness

“…The COVID-19 pandemic further exposed many of these inequities (Heck et al, 2021). Improving the health and well-being of Indigenous students and staff in the education sector falls within a growing broad discussion on decolonized approaches to understanding health and wellness (Eni et al, 2021). Decolonizing employee assistance programs requires a reconsideration of the existing models that school districts have in place and necessitates that they are shifted away from a primary focus on illness and disability and instead be centred on what is necessary to promote health and wellness for Indigenous educators individually and collectively (Eni et al, 2021).…”

“…Improving the health and well-being of Indigenous students and staff in the education sector falls within a growing broad discussion on decolonized approaches to understanding health and wellness (Eni et al, 2021). Decolonizing employee assistance programs requires a reconsideration of the existing models that school districts have in place and necessitates that they are shifted away from a primary focus on illness and disability and instead be centred on what is necessary to promote health and wellness for Indigenous educators individually and collectively (Eni et al, 2021). Indigenous understandings of human development are founded on collective values such as humility and altruism, and individual development that is aimed at the good of the community or nation rather than being utilized only for individualistic gain (Richmond et al, 2007).…”

“…1. Using a decolonizing approach, one that is aimed at dismantling the colonial cognitive and structural architecture of employee health and wellness programs by recognizing how historical social, cultural, economic, political, and educational factors have influenced their development (Eni et al, 2021;Kovach, 2009): a. Critically analyze how more robust and holistic understandings of how individual and collective human development might be better supported through policy and thereby enacted differently by focusing on the relationality of individuals to their families, communities, nations, and lands.…”