Practitioners, policy-makers, and planners in Alberta note that quality primary care for Indigenous people is undermined by significant structural gaps and deficiencies. In spite of some recent innovations, Alberta seems to lag behind similar jurisdictions, such as Ontario and British Columbia, in mobilizing structures to improve primary care delivery that is culturally safe, acceptable and equitable for Indigenous people. In January 2016, the University of Calgary’s Department of Family Medicine in the Cumming School of Medicine convened Indigenous community members and leaders, as well as provincial health system leaders, primary care practitioners and researchers near Calgary, Alberta to share and explore these barriers. The aim was to optimize the potential for creative change stirred in the province following provincial and federal elections in 2015 that shifted policy landscapes. This report highlights innovations shared from other jurisdictions in Canada, and the opportunities that these innovations present to the Alberta context.
The event convened 65 Alberta-based stakeholders, with guest presenters from across Canada, from the: Vancouver Native Health Society (VNHS); Tui’kn Partnership in Cape Breton, Nova Scotia; and Cree Board of Health and Social Services of James Bay (CBHSSJB), Quebec. In small groups, presenters provided overviews of innovations in primary care developed by their organizations, including big picture strategies, and barriers/facilitators to innovation. Small group participants then reflected and explored how such innovations might make sense or be translated into Alberta’s diverse Indigenous contexts. Guest speakers and facilitators from Alberta Health Services (AHS), Health Canada, the Public Health Agency of Canada (PHAC), Siksika Health Services, and the Indigenous Physicians Association of Canada (IPAC) helped to integrate knowledge and experiences shared. The models presented were broadly grouped into urban, reserve, and system-level innovations. A physician lead and Elder from the VNHS presented their agency’s VIP Elder program that offers spiritual and emotional support to interested clientele; the health director from Eskasoni First Nation’s health centre shared the story of forging the Tui’kn Partnership with neighbouring communities for ownership and control of health data for improved care; and a lead physician gave an overview of the CBHSSJB’s life-cycle approach structuring all aspects of care.