Hay River Health and Social Services has released a report titled Honouring the Voices of Indigenous Peoples Creating Change Together: A Path Toward Culturally Safe Health Care in the NWT.
The report grew from a project led by the Cultural Safety Design Collaborative (CSDC), which brought together Indigenous voices, community insights, and organizational reflection to identify “clear, actionable ways” to improve health care experiences for Indigenous people across the territories.
“The CSDC is an initiative that aims to improve cultural safety, quality healthcare, and to address systemic racism experienced by First Nations, Inuit, and Métis,” said researchers.
“The goal is for this report to be used to inform HSS public policy decision makers with the power to make change, and to reflect the lived experiences and stories of Indigenous peoples in the NWT seeking culturally safe and equitable care,” said researchers in the report released this week.
The report is based on the findings of a project that began in 2023, with a team of researchers including Indigenous Patient Advocates, project managers, Tłı̨chǫ Community Services Agency and representatives from the Hay River Health and Social Services.
“When accessing health care today, many Indigenous peoples in the NWT do not feel safe, respected, or free from racism and discrimination; this discourages them from seeking care, resulting in negative health outcomes,” acknowledged researchers.
The work was guided by Indigenous teachings, including one the researchers called the “Do Nake Lani Nats’etso…Strong like Two People” approach, in which Western and Indigenous knowledge combine. The teaching of Piliriqatigiingniq, which comes from Inuit Qaujimajatuqangit (Inuit epistemology), and “embodies the concept of working together for a common purpose,” explained researchers.
The Haudenosaunee philosophy, that decisions made today should result in sustainability for seven generations, guided the project.
“The hope is that this report is a catalyst for meaningful change that generations to come can be a part of implementing and experiencing. Change can take time; it doesn’t always happen right away, but lasting change is necessary,” said researchers.
The project was also guided by the teaching researchers called the “Treat all living things, including yourself, with love, kindness, and respect. This will come back to you, your family, your community, and nation.” Researchers explained that this concept is inherent in the teachings of many Indigenous peoples.
“Applying this teaching in the HSS system involves fostering an environment of compassion, respect, and kindness among all partners – including patients, providers, leadership, IGs, and communities. A cycle of positivity can benefit individual interactions and enhance overall community health,” said researchers.
The researchers behind the report emphasized that the right to health for Indigenous peoples is closely linked to their right to self-determination and their inherent right to self-governance.
“Self-determination emphasizes Indigenous control over their health and well-being, which includes authority through their own governing bodies, jurisdictions, and laws. We acknowledge that self-determination and sovereignty are essential in healthcare,” they said.
Researchers with the health authority said they acknowledge Indigenous peoples’ rights to make decisions that reflect their cultural values and needs.
“This enables Indigenous peoples to develop and implement programs that are culturally appropriate and effective, leading to improved health outcomes. Indigenous peoples must have self-determination that allows for decision-making about funding for healthcare, not only provide input. Self-determination helps to build trust and collaboration between Indigenous communities and HSS providers, promoting a more equitable and responsive HSS system,” they said.
The health authority explained that they will use the findings of the report as a “tool” to “inspire reflection, dialogue,” and “real change” towards a health care model where everyone receives equal care.
The findings of the report outlined 13 Actions for change towards culturally safe care experiences for Indigenous people accessing the NWT health care system. The recommendations targeted four areas, including patient supports, staff supports, program design and institutional design and leadership
The researchers found that Indigenous residents accessing the NWT health care system confront interpersonal and systemic racism.
“They often face significant challenges accessing culturally appropriate care and services, participating in Indigenous cultural programming (especially Indigenous language support), and navigating negative experiences with medical travel,” said researchers.
The report recommended a number of action items, including:
“Develop a framework for responding to and meaningfully addressing reports of interpersonal and systemic racism.
Provide Indigenous patients with enhanced language support and communication with HSS providers.
Identify and address barriers that prevent the inclusion and promotion of traditional foods.
Respect the value and sacred nature of traditional healing practices for Indigenous patients and provide autonomy to integrate this into their care journey.
Provide Indigenous patients with more support when needing to travel for care. 6. Improve the experience for Indigenous patients accessing care and services in Stanton Territorial Hospital’s Emergency Department.
The report also found that Indigenous Wellness Program (IWP) staff felt “underappreciated” and felt that their work, including their specialized cultural knowledge, was not valued within the health care system.”
“A cultural disconnect often exists for non-Indigenous HSS employees in the delivery of culturally safe care to Indigenous peoples,” said researchers.
In response, the report recommended a number of actions, including:
“Support and value IWP staff for their contributions towards improving culturally appropriate care and supporting residents
Provide IWP and HSS system staff with additional targeted professional development opportunities
Researchers found that Indigenous patients frequently felt “unsafe and disrespected” in the NWT health care system.”
“As a result, services such as those offered through the IWP are essential for Indigenous patient wellness. Unfortunately, IWP services are only available at Stanton Territorial Hospital and due to constraints, these services are limited,” said researchers.
The report recommended these actions for change:
“Support the IWP and its staff to innovate and grow, enabling them to continually address the needs of Indigenous patients and families.
Track and measure statistics to guide continuous improvement.
Enhancing institutional design and leadership
The researchers found that a lack of designated Indigenous senior leadership and representation accumulates into “unmet needs” among Indigenous patients and staff.”
In response, researchers recommended a series of actions to help bring about change:
“Prioritize and establish senior leadership positions specifically for Indigenous professionals. Ensure that Indigenous perspectives and needs are consistently represented at the highest decision-making levels.
Use the Health Standards Organization (HSO) British Columbia Cultural Safety and Humility Standard to assess the HSS system’s progress to achieve a more culturally safe organization that better responds to the health and wellness priorities of First Nations, Inuit, and Métis peoples of the NWT.
HSS system leaders work towards dismantling systemic racism to advance cultural safety efforts, both individually and systemically.”
Anyone who would like to access the report can go to the Hay River Health and Social Services Authority website
https://www.hrhssa.org/newsroom.html
Anyone who has feedback, concerns or questions about the report is encouraged to reach out to the health authority at [email protected].
True North FM reached out to the Hay River Health and Social Services Authority for more insights about the report and will share those once they become available.
