A new era of First Nations health in British Columbia

British Columbia First Nations are making history by undertaking a transformative process to change the way health care is delivered to their children, families and communities. The Tripartite First Nations Health process underway in BC is a case study in the power of many Nations coming together and speaking with a common voice to find a path forward to better health outcomes.

The area of what is known as BC is home to the most diverse cross-section of First Nations across this country, with 203 unique communities. The importance of health and wellness emerged as common ground upon which BC First Nations communities could unite to work toward change necessary for the health of their people. This cooperation and the vision shown by Chiefs, Leaders, Health Directors, and Health Leads was the foundation that allowed for the initiation of the current Tripartite process.

Supportive partners in Health Canada, the Province of BC, our five provincial Regional Health Authorities, and others have created the space for a meaningful collaborative process to evolve and grow with BC First Nations positioned as equal partners along this shared journey.

Through innovative engagement processes like our annual Gathering Wisdom for a Shared Journey Forums, Regional Caucus Sessions in all five areas of the province, Community Engagement HUBS, comprehensive reporting and communications, First Nations Health Council Table, and other mechanisms, space is created for each First Nations community voice to be heard. This comprehensive engagement and approvals process coupled with our principle of reciprocal accountability is a cornerstone of this health system’s transfer and transformation process, with communities leading the discussion.

A series of precedent-setting agreements between the Tripartite partners, including the 2005 Transformative Change Accord, the 2006 Transformative Change Accord: First Nations Health Plan,  the 2007 Tripartite First Nations Health Plan, and the 2011 British Columbia Tripartite Framework Agreement on First Nation Health Governance has led to the creation of the new First Nations Health Governance Structure of the First Nations Health Authority, First Nations Health Council and First Nations Health Directors Association – a first in Canada.

These agreements would not have been possible without the extensive community engagement process, engagement and approvals pathway, and leadership and unity shown by BC First Nations in electing to move forward with the historic transfer of health services from Health Canada’s First Nations Inuit Health Branch – Pacific Region to the First Nations Health Authority.

Our Seven Directives developed throughout the hundreds of provincial, regional, and sub-regional community meetings, workbooks and guiding documents describes the fundamental standards and instructions for the new health governance relationship.

Directive number one, ‘Community-Driven, Nation-Based’ captures the essence of the new First Nations Health Governance approach. With a united voice from BC First Nations leadership and through meaningful participation, willing partnerships, and a vision for better health outcomes, communities are mapping out the creation of a more effective, and innovative health system that will bring to life the vision of healthy, self-determining and vibrant BC First Nations children, families and communities.

Follow the First Nations Health Authority on Twitter @FNHC

This blog is republished with the permission of the Health Council of Canada.

The comments section is closed.

  • Marta Nahaczewska says:

    Hey Trevor,

    Great blog post. You didn’t get into the finer details of what changes to the health care system we can expect to see in the near future. Care to elaborate?

    Thanks :)


    • Trevor Kehoe says:

      Hello Marta,

      I would refer you to the FNHA Annual Reports for the most up-to-date info on the specific transformative changes underway (www.fnha.ca/about/governance-and-accountability/annual-reports). Also sign up for the eBlast newsletter on the homepage for regular updates :).


  • Sharon Wilton, Project Share says:

    B.C. is an interesting place.
    As opposed to Ontario… social services perspectives dominate (and replicate like rabbits).
    They are the bane of local governance.

    Inside municipal service options the skill base for identifying or defining how the plan to devolve, deregulate, and downsize might occur in smaller centers…. is unknown and much fumbled.

    In larger centers government bypasses proliferate and $ can easily move to/ from foundations to business trusts ensuring all current players are paid .
    If anything …they are an example of how Foundations can be best funded, and refunded , in the future “IF /when” $ are shared at the Program level … NOT …. payor funding the Project level .

    Aboriginals should be wary as this article profiles the move from “local” to provincial” ( which is well disguised in bafflegab ) in terms of medical and some social determinants of health.

    This leaves the field of non-medical determinants and workplace impact wide open. e.g. the one thing B.C. Aboriginals do have is an internal lead in Aboriginal education and a genuine capability in capturing the lead in Sustainability Studies ….
    [ especially in ecoprojects linked to permaculture companion plantings in forestry management ( which was the economic base that built Canada). ]
    Considering Population Health categories this Sustainability Studies is relevant to ultimately impacting all health categories and determinants…… and one where they actually are the leaders.

    • Sharon Wilton, Project Share says:

      P.S Paul Martin has $ 25 million for Aboriginal projects …. give him a call on a permaculture program “building capacity” in forestry management. :)

      • Trevor Kehoe says:

        Hi Sharon, this process is about First Nations peoples self-determination where they are in fact leading the process of change. It is not about creating a new level of government but rather transferring the control and decision-making power from what was previously delivered by Health Canada into a First Nations Community-Driven, Nation-Based health and wellness organization. I would encourage you to read more about the years of work it took to get to this place and what the responsibilities of the FNHA are. This is a good resource to start at: http://www.fnha.ca/about/news-and-events/news/our-story-the-made-in-bc-tripartite-health-transformation-journey




Trevor Kehoe


Trevor Kehoe is a Communications Officer with the First Nations Health Authority on Coast Salish Territory in West Vancouver.

Republish this article

Republish this article on your website under the creative commons licence.

Learn more