Summary:
There are efforts in place to retain and increase the number of Indigenous health care providers, but most are still in the development stage. Furthermore, not all health care professionals are required to take cultural competency training.
The Call to Action:
We call upon all levels of government to:
i. Increase the number of Aboriginal professionals working in the health care field.
ii. Ensure the retention of Aboriginal health care providers in Aboriginal communities.
iii. Provide cultural competency training for all health care professionals.
Analysis:
There are efforts in place to retain and increase the number of Indigenous health care providers, but most are still in the development stage.
Furthermore, not all health care professionals are required to take cultural competency training.
In June 2021, the Canadian Nurses Association released a Declaration Against Anti-Indigenous Racism in Nursing and Health Care. The declaration states that they “will create and sustain cultures of understanding, belonging, and inclusivity in our workplaces, profession, and communities.”
The declaration also commits to adopting Joyce’s Principle, which “requires the recognition and respect of Indigenous Peoples’ traditional and living knowledge in all aspects of health” and “provide mandatory, system-wide anti-racism and anti oppression education for staff, volunteers and boards of directors in our organizations.”
The Declaration was created by leaders of the Canadian Nurses Association, the Canadian Federation of Nurses Unions, Canadian Nursing Students Association, and Nurse Practitioner Association of Canada, with input from the Canadian Indigenous Nurses Association.
The associations met in November 2021 for the first National Summit on Racism in Nursing and Health Care in Canada.
The second National Summit on Racism in Nursing and Health Care in Canada is scheduled for November 2022.
In February 2021, The Canadian Association of Schools of Nursing (CASN), in partnership with the Canadian Indigenous Nurses Association (CINA), announced the Creation and Launch of an Annual Indigenous Nursing Student and Faculty Survey. The goal is to “collect and disseminate high quality, longitudinal evidence that would allow the recruitment and retention of Indigenous nursing students and faculty to be assessed and monitored across the country.”
The project is funded by Indigenous Services Canada.
In January 2021, the federal government committed $4 million to a National Consortium for Indigenous Medical Education. The consortium was created by Indigenous physicians working with health care organizations. One of its goals is to support the recruitment and retention of Indigenous physicians and medical faculty.
In the 2021 federal budget, the government committed $107.1 million over three years, beginning in 2021-22, to “continue efforts to transform how health care services are designed and delivered by First Nations communities.”
It did not, however, specify how health care services would be delivered by First Nations communities.
Previously
In October 2020, The Canadian Indigenous Nurses Association (CINA) and Canadian Nurses Association emphasized the need for a mandatory cultural competency and humility training program for health-care professions after the dearth of Joyce Echaquan, a 37-year-old woman from the Atikamekw community of Manawan, Que.
Health Canada also cited the efforts of the Aboriginal Health Human Resources Initiative (AHHRI). In a statement to CBC News, a Health Canada spokesperson wrote the AHHRI “aims to increase the number of Indigenous people entering health careers. It also provides training to community-based workers and health managers delivering health services in First Nations and Inuit communities.”
Through the AHHRI, Health Canada states it also “provides $3 million annually to an Indigenous Human Resources Bursary Program through Indspire, to support Indigenous students with bursaries and scholarships.”
This funding is not new, however, and has not increased under the Liberal federal government. It is also only available to those who apply and qualify for it.
In May 2019, the Association of Faculties of Medicine of Canada adopted a Joint Commitment to Action on Indigenous Health to address Calls to Action #23 and #24. The plan features 10 targets, with its strongest focus on recruiting more Indigenous students into medical school.
In October 2017, in response to Call to Action #23, the Royal College of Physicians and Surgeons of Canada approved a recommendation from the Royal College Indigenous Health Advisory Committee (IHAC) that “Indigenous Health become a mandatory component of residency education, meaning curriculum, assessment and accreditation throughout medical training would address the health inequities and racism faced by Indigenous Peoples,” according to a Summary Table of Royal College Projects and their contributions to TRC Calls to Action.
It also revised its Indigenous Health Values and Principles Statement (first released in July 2013).
The Royal College’s Indigenous Health Committee, an independent body that comprises Indigenous physicians, scholars and other health care professionals, led the development of the revised Indigenous Health Values and Principles Statement and an Indigenous Health Primer, both released in 2019.
Regarding cultural competency training, Health Canada told CBC News it now includes “cultural competency training in its onboarding program for new registered nurses and nurse practitioners employed by its First Nations and Inuit Health Branch.”
But Health Canada said that it cannot mandate that other health care providers offer cultural competency training to their employees.
The Provincial Health Services Authority of British Columbia offers San’yas Indigenous Cultural Safety Training online. The program has also been adapted for Manitoba and Ontario workers.