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Dispelling Myths: Challenges in Restoring Health in First Nations

Presented at the Indigenous Health Conference 27May2016, Andrea L.K. Johnston spoke about the need for a national sharing of Indigenous-informed outcomes. For example, at the conference Chief Littlechild said, “We need to hold each other up”.

Andrea L.K. Johnston

on 15 October 2018

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Transcript of Dispelling Myths: Challenges in Restoring Health in First Nations

Dispelling Myths:
Johnston Research Inc.
May 27, 2016
Myth #1: Personal Conditions as the Blame
Solutions speak to:
What we eat
How we live
The why behind our decisions
We, alone, must decide to make a change
We are to blame for our over-reliance on the medical system & drugs
Were we ever given a
Were we ever given a
Is the
currently realistic?
Do we
Myth #2: FAMILY is to Blame
Indigenous families don't provide the necessary supports to produce proud, strong, resilient, self-sufficient, independent children, free of addictions.
Who is Making up the Indicators that say Families are failing?
No one knows what Indigenous governance would REALLY define as family Outcomes.
Are families failing or, Is the system failing them?
Did we not go to your schools?
Should we be taking gov't money, under
Gov't Terms?
Challenges in Restoring Health in First Nations
We were
prevented from
Gaining sustenance from the land
Starting from a place entrenched in Indigenous values
Enacting our role as custodians of the land
Making our communities places our peoples would want to come back to and live
18 reports reviewed using Google search on:
AFN, First Nations Wholistic Policy and Planning Model, 2007
NAHO, JAH, Health Governance, Jan. 2004
NCCAH, 2011, Health Policy Framework
FNQLHSSC, 2015, Indigenous Governance
Institute On Governance (IOG), Indigenous Governance, website, 2016
TIIP journal 6(1): Health Governance in B.C., Jan. 2015
Out all of the sources we reviewed, one was exceptional in defining
outcomes that are the responsibility of the government
Health Canada, First Nations and Inuit Health Strategic Plan, 2012
FNs receive services & benefits responsive to needs
branch ensures access to quality health services
branch provides supports for approaches to comprehensive community planning and community development
recognizing that outcomes are dynamic and should not be attributed to a single entity
First Nations and Inuit Health Strategic Plan, 2012
INAC: Fact Sheet: Aboriginal Self-Government, 2015
Aboriginal Midwifery and Midwifery Fact Sheet, 2012
include First Nations-determined indicators of health and wellness
Another was exceptional in
defining terms for outcomes that are FNs-driven
British Columbia Tripartite Framework Agreement On First Nation Health Governance, 2011
improve, among other things, the quality of data being collected and the health indicators available for First Nations health and wellness
collect within the 1st 18-months of the agreement a handful of standard gov't indicators and any other additional indicators, including wellness indicators supported by the governance stakeholders
FNHA, British Columbia Tripartite Framework Agreement On First Nation Health Governance, 2011
Indigenous Health in Indigenous Hands: Building an Indigenous Health Strategy, Toronto, 2015
FNHA, Grounding a National Mechanism to Oversee Tripartite Health Agreements for Indigenous Health Governance, 2014
CIHR, Institute for Aboriginal People's Health, Pathways to Health Equity for Aboriginal Peoples, 2015
AFN, National First Nations Non-Insured Health Benefits Strategy Forum, 2014
AFNIGC, Alberta First Nations Information Governance Centre, 2014 and 2015
FNHA, Implementing the Vision: BC First Nations Health Governance, 2006
AFN, Meeting on Indigenous Peoples and Indicators of Well-Being, First Nations’ Wholistic Approach to Indicators, 2006
Summary of the 17 Indigenous Health Governance Reports
8 are Federal, 6 Regional, 3 Local
Time span: 12 year, 2004-2016
re: FNHA
City of
Funding is always given with strings attached.
Government dictates how Chief and Council operate
Arthur Manuel and Grand Chief Ronald M. Derrickson released
Unsettling Canada, A National Wake-up Call
in 2015 and write,
The band council and band manager structure is the creation of government. They largely replace the role of the Indian Agent – administering government funds according to government rules.
Andrea L.K. Johnston,
Johnston Research Inc.

Evaluated over 100 health-related projects (past 20-yrs)
Band Member
Canadian Evaluation Society approved, Credentialed Evaluator, since 2011
This is based on my self-directed, self-funded, research. It includes my perspective both as a band member & a professional evaluator.
Seeing with two eyes

Rebuilding of Indian governments, and ultimately reaching
. (Missens, 2008)
Establishing respectful relationships -- requiring the
revitalization of Indigenous law and legal traditions
. (Truth and Reconciliation, 2015)
Where healing means setting out on
un-walked paths to decolonization
. (McCaslin, et al., 2009
Indigenous peoples have the right to administer health, housing, economic and social entities through their

. (UN, 2008)
Challenges in Evaluation
Build Evaluation Practice with these Essentials:
Foremost -- Indigenous-driven outcomes and indicators.
Indigenous defined evaluation strategies
Evaluation Frameworks independent of funding requirements
Evaluation practice using an
Indigenous Evaluation Lens
Visited over 80 First Nations
This presentation will:
Identify key myths that block improved health in First Nations Communities
Examine the myths from the point of view of First Nations communities
Show how the myths are reflected in the design and evaluation of health programs
Explore the coming challenges for health programs and evaluation
3-Key Myths of Poor Health Conditions,
from a typical First Nations perspective
Personal conditions are to blame
The Family is to blame
The community is to blame
Did we really have a choice?
How much are personal conditions the result of government policies and programs?
Families are coping and surviving in spite of severe externally imposed conditions
Myth #3: The Community is to Blame
The Myths in Action: A Review of Indigenous Health Governance
Indigenous Health Governance, for
Indigenous Indicators and Outcomes
Challenges in Restoring Health in First Nations Communities
Challenges in Health Governance
The Telegraph, 1951, Calgary
Anglican Church Archives, Old Sun
Coleen Rajotte/CBC
Jorge Rivas/Fusion
Do we

have a CHOICE?
Todd Bumgarner
Kevin Bissett, The Canadian Press
ID: 25859339, Dreamstime
Full transcript