Community Stories
Community Hubs, Health and First Nations - British Columbia
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By Mark Matthew
When the Transformative Change Accord (TCA), the First Nations Health PlanTripartite First Nations Help Plan (TFNHP) were signed, First Nations Health Directors and Managers in B.C. made it clear that implementing the TFNHP was not something that could occur "off the side of their desks."
While the First Nation Heath Council was not resourced to fund every community and every Health Center to engage in implementation of the TFNHP, there were sufficient resources available to invest in a more coordinated approach to supporting communities. Consequently the Council responded to this issue by providing financial support for First Nations communities to take a coordinated and collaborative approach to being an integral partner in the implementation of the TFNHP. These resources have been channeled through the creation and funding of Community Engagement Hubs.
Community Engagement Hubs (CEH) provide a vehicle through which First Nations communities can partner with the FNHC, Health Authorities and the Federal Government to participate in the TFNHP. CEHs are collaborations between First Nations communities working through one agreed-upon organization that the members choose. The purpose of CEHs is to develop planning, collaboration, and communication opportunities for member communities. The focus should be on the relationships and communication processes -- NOT the 'structure'.
The formation of CEH's encourages natural collaborations based on tribal and geographical factors, and provides resources to engage extra capacity to facilitate the coordination work between communities.
Benefits of Community Engagement Hubs include:
Providing a mechanism for communities to work together - Hubs enable a group of communities (usually through their mandated health organizations) to come together to discuss various common issues and to find common solutions. For instance, once members share their respective health plan aspirations with other communities, they may find needs that each has which could be solved through a joint solution. If some of the members are all having difficulties recruiting and paying for nurses for instance, then together they can recruit nursing capacity and share the resource and the cost.
Improving the linkage with the Health Authorities - Health Authorities have a responsibility to provide their services to First Nations on and off reserve but often they find it difficult to engage with First Nations and to develop solutions for service delivery that will work for communities. The hubs provide a forum for health authority personnel to meet with a group of linked communities, to look at ways of better serving those communities. This might include arranging outpatient clinics; providing mobile screening services; working to address public health and environmental health concerns. The hub members are also in touch with community members who use health authority services and often receive a high level of feedback from patients. Hub members can provide feedback to the health authority on issues that their communities are facing when entering hospitals and being treated there. These are problems which health authorities should remedy with the support and guidance of the hub.
Sharing Knowledge and Expertise - within the hub membership, there will be a wide range of skills and experience among the member's workforces, from management through to health service expertise. Some member communities may be advanced in their Community Health and Wellness Planning while others may be finding it difficult -- so there is opportunity to learn from one another and to help each other. Some communities may have made an arrangement with a service provider to bring them services (such as physicians or specialists) that other members can learn from and possibly adapt for their own situation. Some hubs have started their own newsletters and websites to make information sharing more accessible for the wider community.
First Nations Traditional Food Fact Sheets describe traditional foods in BC and provides nutritional information about them. | Best Practices of Traditional Models of Wellness Scan helps communities support Traditional and Alternative medicine in local health programs | The Active Spirit, Active History book features stories from people who have triumphed, mentored, or led in traditional and non-traditional sports, recreation, fitness, or physical activity. |
Sharing Innovations - Many hub members have developed new ways of doing things that they have trialed and tested in their various communities. Some communities have implemented best practices and formed relationships with other stakeholders to successfully implement their service innovations -- such as the BC Cancer Agency or the BC Diabetes Association. Some communities have developed new resources and informational material for the families, schools and Band Councils in their communities. Hubs provide a mechanism for communities to share these innovations.
Providing Peer Support - Many communities are isolated and as a result the health center workforce is often isolated. Health professionals, Managers and health workers often do not have opportunity to speak with their peers from other health centers to share issues, challenges and innovations -- and to give and receive support to each other.
Ramona Johnson from K'omoks First Nation on Vancouver Island. From the FNHC-produced book Active Spirit, Active History
Improving Access to Services - Collaboration and joint planning create efficiencies, and will provide better health services for BC First Nations people. For example, where it may not be feasible to have a mental health expert in every community, the hub concept would allow for planning to have one expert available to serve the member communities of the hub. In this way, collaboration and resource sharing between the nations in a hub can fill health gaps that otherwise would not be addressed.
Improving Communications - Hubs also act as a communications vehicle, allowing the First Nations Health Council to effectively communicate in an accurate and timely manner with all 203 BC First Nations.
For more information on the Community Hubs and the First Nations Health Council, contact Mark Matthew at: MMatthew@fnhc.ca
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Active Spirit, Active History