About this section
This section of the toolkit provides guidance on how cancer programs can understand the needs of and priorities of First Nations, Inuit and Métis when it comes to the organization of cancer services and in meaningfully engaging them in the identification, development and implementation of models of care.
Many First Nations, Inuit and Métis experience inequities in accessing cancer services and diagnostics. Gaps can widen in times of system and resource pressures such as those experienced during the COVID-19 pandemic. Acknowledging and addressing these disparities is a direct response to the Truth and Reconciliation Commission’s Calls to Action.
Opportunities for cancer programs to engage First Nations, Inuit and Métis partners when developing models of care are summarized below.
Strengths-based community partnerships
First Nations, Inuit and Métis communities and organizations have developed strategies and resources to manage the health of their communities and understand their local challenges. Engagement should be done collaboratively to elevate and support these approaches.
Navigating the health system is complex for many First Nations, Inuit and Métis as it is ambiguous, multifaceted and multijurisdictional. There is significant value and utility in the community experience and knowledge of how to address these challenges. Engagement can facilitate improved communication and coordination of services, ultimately improving navigation.
Respectful engagement and consultation
Extensive engagement with First Nations, Inuit and Métis governments, organizations and communities is critical to co-designing culturally appropriate care and creating meaningful change:
- Work with First Nations, Inuit and Métis governments and communities to understand the strengths of existing models of care, in an effort to better understand how, through co-design, these can be enhanced to optimize available community-based supports.
- Recognize, acknowledge and respect the diverse priorities of First Nations, Inuit and Métis peoples across Canada. Invest time to build trust and establish sustained relationships that support these priorities in models of care.
- Learn and recognize the importance of relationship-building principles and cultural competency when working with First Nations, Inuit and Métis partners. Courses are available from San’yas Indigenous Cultural Safety Training.
Cultural Safety and the delivery of culturally appropriate care
The delivery of culturally appropriate care is an important component of cancer care for First Nations, Inuit and Métis people. A definition developed by Indigenous partners at the First Nations Health Authority in British Columbia states that cultural safety is an outcome based on respectful engagement that recognizes and strives to address power imbalances inherent in the healthcare system. It results in an environment free of racism and discrimination, where people feel safe when receiving health care.
Understanding First Nations, Inuit and Métis needs and priorities
Organizations and individuals within the Canadian health-care system should commit to learning about the historical and ongoing experiences of First Nations, Inuit and Métis in the land now known as Canada. A review and reflection of information and concepts included below is a good place to start:
- First Nations, Inuit and Métis are culturally rich, strong and resilient. It is important to understand the impact of past trauma on individuals, particularly during times of stress.
- Recognize critical and relevant legislation and principles including the Truth and Reconciliation Calls to Action, the First Nations data governance principles of ownership, control, access and possession – more commonly known as OCAP ® and existing jurisdictional contexts.
- First Nations, Inuit and Métis access health care services through federal programs which often presents unique jurisdictional and local challenges. Resources exist such as Ontario Health’s Indigenous Relationship and Cultural Safety Courses help organizations and teams better understand this structure and how services are delivered.