Overall Summary of Session

Workshop Methodology

Each Sectoral Session provided that the majority of time be allocated to breakout group sessions where the participants were organized into one of the three distinct groups: First Nation, Inuit and Métis. The participant’s lists (Annex B) indicate that there were 35 identified participants in the Health First Nations breakout group; 31 participants in the Inuit breakout group; and 30 participants in the Métis breakout group. The agenda called for the distinct breakout groups to address the following policy issues:

• jurisdiction and control;
• improving access and integration;
• building capacity and sustainability; and
• broad determinants of health.

Launch questions for each theme were posted to help participants focus on recommended actions. These questions were a guiding tool and were contained on the agenda distributed to participants prior to the session. The launch questions were designed to help participants focus their discussion on issues that support achievement of the session objectives. Facilitators used the launch questions in tandem with other process questions to help participants drill down in their discussions when making recommendations. Where time permitted, participants were asked to apply short-medium-and long-term time frames to their recommended actions and prepare key message summaries of their small group discussions and recommended actions.

Within each of the above discussions and at the end of each day participants were asked to provide input into:

• defining success;
• recommended actions;
• how we will work together with other stakeholders; and
• how we will know that we are making progress.

Participants were also asked to apply two Alens” questions in their discussions on the aforementioned policy issues. The lens provided for the inclusion of perspectives on issues of gender equality and geographic residence (i.e. urban Aboriginal or rural/remote, northern and non status Indians). Specific lens questions were applied directly to each theme, and in some circumstances (e.g. the Métis breakout group) a separate discussion focused specifically on the lens was held. Generally the following questions were used to generate discussion on the crosscutting themes:

• Do the statements provide Aboriginal (i.e., First Nations, Métis, Inuit) women an opportunity to participate and/or address issues of concern to their health status?
• Have the needs and concerns of Aboriginal people (i.e., First Nations, Métis, Inuit) in urban, rural/remote and northern situations been addressed?

Each breakout group was facilitated by two co-facilitators selected from a list, recommended by the NAOs during the planning process. For each theme, facilitators used a variety of facilitation exercises to maximize input and output from the participants. The exercises included facilitated discussion methods that were adapted to fit the circumstances, such as time allotment, number of participants, size of the breakout room, and subject of the theme. In most cases, the exercises required participants to work in smaller groupings to gain greater participation from all participants.

The co-facilitators were also flexible in responding to the needs and issues identified by the breakout group participants. This flexibility resulted in slight variations among each breakout session. For example, in the First Nations breakout group a vision statement for health was developed in response to the agenda/facilitation requirement to address definitions of success. During the Inuit breakout session on the broad determinants of health, a strong emphasis was placed on the impact of other sectors on individual, family and community health. As well, the facilitators in the Métis and Inuit breakout groups added a brief discussion to evaluate the breakout sessions at the end of day two.

All participants were clearly notified that issues, options and/or recommendations had to be recorded on the flipcharts in order to be included in the final HSS Facilitators’ Report. When required, facilitators were flexible to record statements or opening remarks from participants on health issues. In the Inuit session, participants provided recommendations, which were building on the Inuit background paper provided by ITK. In specific cases this meant that recommendations that were included in the discussion paper were not always expanded on or discussed in the breakout session. It is therefore essential that the sections of this report that address Inuit issues be read in conjunction with the ITK background paper.

At the end of each day all participants were asked to return to the main plenary session to hear a summary of input that was generated by the facilitators on what they heard and had recorded for that day. These summaries were put into a PowerPoint presentation and shared with all participants. As well, it should be noted that Day 1 of the HSS was opened and Day 2 was closed by three Elders representing First Nations, Inuit and Métis. Their opening and closing remarks and invocations were often instrumental in setting the tone for the discussions to follow.

Overall Summary

Most of the participants indicated that a pan-Aboriginal² approach was not supported. It was stressed by many participants that addressing the issues impacting the health and wellness of Inuit, Métis and First Nations would require the implementation of specific strategies that were responsive to the unique cultural needs of these populations. However, two of the three breakout groups indicated that they would continue to meet with other Aboriginal partners on common issues. As well, the need for joint partnerships and greater collaboration from all levels of government was noted. While participants in each of the breakout groups provided distinct recommended actions, there were some that were similar in nature. The following is a brief look at the similarities among the three breakout groups.

Jurisdiction and Control

Participants in all three breakout groups spoke about expanding health authorities. Each group also indicated that greater collaboration between and amongst governments is needed to break down jurisdiction and control issues for First Nations, Inuit and Métis. They suggested that more partnerships and joint protocols are needed to move the health agenda forward.

Access and Integration

Participants recognized the importance of, and supported efforts directed at, strategic planning, accords and the use and accreditation of traditional approaches and medicines in health. Each breakout group identified solutions that would respond to the need to make program funding more flexible and long term. New models are needed, but these must be built with input from the community if they are to be successful.

Capacity and Sustainability

All the breakout groups emphasized that more attention and support is required in building human capacity at the community level and that more professionals are needed in all health fields. To accommodate this goal, significant educational programming, training and accreditation support is needed at all levels. Strengthening the relationships among governments and Aboriginal groups through partnerships, clarifying relationships, and changes to a non-population-based health funding formula were seen as providing a basis for sustainability as one option.

Broad Determinants of Health

The breakout groups recommended strong collaboration among sectors, particularly housing, education and environment. In each breakout group part of the solution included recommended actions calling on governments to work together and more collaboratively.

Application of the Crosscutting Themes

The lens questions were applied in three ways: to recommended actions after they were developed for each topic area; directly during the development of recommended actions; and, in some cases (e.g. Métis breakout), as a separate discussion point to ensure clarity regarding what the lens meant earlier in the breakout group.

The facilitators observed that initial uncertainty around applying the lens questions to the discussions and recommended actions in the breakout sessions was often clarified when participants were informed about what was meant by a gender-based analysis³ and that the lens questions were intended to ensure that the needs and concerns of these segments of the Aboriginal population were addressed, and were not necessarily about the needs and concerns of organizations.

The breakouts, particularly the Métis and First Nations, emphasized the need for increased:

• application of a gender-based analysis to the development and implementation of plans and strategies;
• involvement of women in consultations, decision making and leadership processes;
• access to current and gender-specific services; and
• recognition of the links between other broad determinants (e.g., housing and education) to improved health for Aboriginal women and First Nations, Inuit and Métis in urban/off-reserve/non-status rural/remote and northern circumstances.

Within the Inuit session environmental issues were considered as a crosscutting lens that is essential to the health and well-being of Inuit communities. Readers are also directed to the ITK background paper on health for additional information regarding this lens.

². On désigne par le terme « panautochtone » une approche appliquée à tous les peuples et groupes autochtones sans égard à la nation, à l'identité, à la situation géographique, au sexe ou au statut.

³. Gender-based analysis (GBA) is an analytical tool. It uses sex and gender as an organizing principle or a way of conceptualizing information-as a way of looking at the world. It helps to bring forth and clarify the differences between women and men, the nature of their social relationships, and their different social realities, life expectations, and economic circumstances. It identifies how these conditions affect women's and men's health status and their access to, and interaction with, the health system.

Table of Contents

The documentation contained on this website does not necessarily represent the views of any government or National Aboriginal Organization. The purpose of this website is to share information related to the Canada-Aboriginal Peoples Roundtable: background papers, Facilitator's sectoral and final reports, agendas and media announcements.

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