CIHI is engaging First Nations, Inuit and Métis to support their health, wellness and data priorities. CIHI is on a learning journey, guided by what we have learned, and continue to learn, from Indigenous Peoples, communities, governments and organizations. Our work is grounded in cultural safety and humility, respectful engagement, and Indigenous-driven processes and partnerships.
Principles that guide CIHI’s work with First Nations, Inuit and Métis
- Cultural humility and safety are foundational to meaningful and respectful engagement.
- A distinctions-based approach acknowledges the distinct histories, interests and priorities of First Nations, Inuit and Métis.
- Indigenous-driven processes and partnerships are fundamental to the appropriate use of First Nations, Inuit and Métis data.
- Data and information about health and wellness are critical tools for self-determination.
- The inherent and collective sovereign rights of First Nations, Inuit and Métis to self-determination include ownership and governance of their data, irrespective of where it is housed, and control over their own health and health care priorities.
CIHI acknowledges the values, principles and calls to action laid out in the Truth and Reconciliation Commission of Canada’s final report and the United Nations Declaration on the Rights of Indigenous Peoples.
CIHI’s Declaration of Commitment to Advance Cultural Safety and Humility
This commitment reflects the high priority we place on cultural safety and humility and our intention to support First Nations, Inuit and Métis in addressing their health needs and data priorities. It also reflects our desire to serve as champions of cultural safety and humility in our work with other organizations.
In making this commitment, CIHI acknowledges that we are on a learning journey, guided by what we have learned, and continue to learn, from Indigenous Peoples, communities, governments and organizations. Our engagement has underscored the importance of Indigenous Peoples’ right to self-determination, including data governance, and its direct bearing on the outcomes of health and wellness for Indigenous Peoples.
Measuring Cultural Safety in Health Systems
Systemic racism results in poor health system performance, adverse health experiences and poor outcomes for Indigenous Peoples. This discussion paper introduces a framework for measuring cultural safety and is paired with a list of potential indicators. It is intended to contribute to the wider discussion about cultural safety and racism in health systems. Download the documents below to learn more and to provide your feedback.
CIHI’s 4 focus areas for Indigenous health
Develop foundational capacity by promoting and embedding cultural safety and humility within CIHI. This includes supportive policies, training, and processes.
Governance of Indigenous data
Develop a respectful approach to the governance of Indigenous data at CIHI. Aligned with the principles of Indigenous data sovereignty, CIHI policy requires that, before we release or disclose data that can identify Indigenous People or communities, appropriate First Nations, Inuit or Métis authorities must provide approval. For more information, please see A Path Forward: Toward Respectful Governance of First Nations, Inuit and Métis Data Housed at CIHI (PDF). To make an Indigenous-identifiable data request, please visit our Make a data request page.
Relationships and partnerships
Build relationships and partnerships locally, regionally and nationally with First Nations, Inuit and Métis Peoples, communities, governments and organizations to identify opportunities to work together in pursuit of Indigenous health and wellness.
Analysis and capacity-building
Enable actionable analysis and capacity-building by working in collaboration with First Nations, Inuit and Métis to identify analyses, products, services, training, data infrastructure and/or tools to support their health priorities, health planning and improvements in well being.
First Nations Health Managers Association (FNHMA)
In 2019, CIHI and the First Nations Health Managers Association (FNHMA) entered into a partnership agreement to strengthen our mutual commitment to addressing the need for actionable, high-quality data to support decision-making. Our common interests include advancing First Nations’ health; strengthening capacity for First Nations leaders and communities; strengthening First Nations’ ability to access and use data for planning, health service management and decision-making; and contributing to the broader national process of reconciliation.
Respecting OCAP® and supporting First Nations data governance: First Nations home care project
In alignment with the principles of OCAP®,Reference1 some First Nations communities in Alberta have chosen to work with CIHI to implement interRAI home care assessments to improve access to home and community care that is comprehensive, culturally safe, accessible, effective and equitable. The project is a collaboration between First Nations communities, Indigenous Services Canada’s First Nations and Inuit Health Branch (formerly a part of Health Canada), Momentum Healthware, the First Nations Technical Services Advisory Group (Alberta), Alberta Health Services, Alberta Health, interRAI and CIHI. The communities receive training from CIHI on how to use the assessment tools and have the option to share data with CIHI for community-specific reporting. Since implementation, wait times for assisted living and long-term care have decreased significantly in participating First Nations, and community nurses now have the tools to assess the care needs of their diverse client populations.
Indigenous Services Canada External link
Momentum Healthware External link
First Nations Technical Services Advisory Group External link
Alberta Health Services External link
Alberta Health External link
interRAI External link
First Nations Health Authority (FNHA) in British Columbia
CIHI and the First Nations Health Authority (FNHA) in B.C. share a valuable working relationship. In May 2017, both organizations entered into a memorandum of understanding that formalized a partnership with a shared goal of improving the health and well-being of First Nations in B.C. A shared work plan is maintained, with work focused on 3 streams: data and analytics (including tools such as CIHI’s Population Grouper); potential development of performance indicators to measure improvements in cultural safety and humility within B.C.’s health care system; and shared learning, including development of a joint statement on First Nations health data governance.
Sioux Lookout First Nations Health Authority (SLFNHA)
In 2018, the Sioux Lookout First Nations Health Authority (SLFNHA) started using CIHI Portal to access administrative health data on behalf of the 31 First Nations that it serves. This direct access to Portal has enabled SLFNHA to determine both regional and community-specific rates for emergency department visits and hospital admissions in Ontario and Manitoba, as well as the top causes of utilization.
In September 2018, SLFNHA released Our Children and Youth Health Report — its first regional report that provides information on the health status of infants, children and youth. Community-level information gleaned from the report helped to increase understanding of the distinct health care needs of each community and facilitate associated planning. Ongoing access to CIHI Portal helps SLFNHA fulfill its mandate to the region in acting as a data steward for the First Nations it serves. This includes further development of health status reports and health surveillance systems.
In April 2019, CIHI established its Indigenous Health team with dedicated staff and funding. If you have questions about the Indigenous Health program of work at CIHI, please contact the Indigenous Health team: