Decolonizing health in Canada: A Manitoba first nation perspective

Abstract

Introduction & Background Global persistence of health inequities for Indigenous peoples is evident in ongoing discrepancies in health and standards of living. International literature suggests the key to transformation lies in Indigenous efforts to control Indigenous health and healthcare. Previous authors have focused upon participation, structural transformation, and culturally appropriate healthcare recognized as a political right as fundamental tenets of Indigenous control. Contextualizing Indigenous health and wellness falls within a growing discussion on decolonization – a resituating of expertise that privileges Indigenous voice and interests. Methods The study is a qualitative, grounded theory analysis, which is a constructivist approach to social research allowing for generation of theory in praxis, through interactions and conversations between researchers and participants. One hundred eighty-three interviews with additional focus groups were held between 2013-15 in eight Manitoba First Nation communities representing different models of health delivery, geographies, accessibilities, and Indigenous language groups. Community research assistants and respected Elders participated in data collection, analysis and interpretation. Line-by-line coding and constant comparative method led to the discovery of converging themes. Findings Ultimately four main themes arose: 1) First Nation control of healthcare; 2) traditional medicine and healing activities; 3) full and meaningful community participation; and 4) cleaning up impacts of colonization. Joint analyses and interpretation of findings revealed substantial evidence that communities were looking profoundly into problems of improperly delivered services and health inequities. Issues were consistent with those highlighted by international commissions on reconciliation, health, Indigenous rights and liberties. To those documents, these findings add ground upon which to build the transformative agenda. Results & Discussion Communities discussed the need for creation of protocols, constitution and laws to ensure growth of a decolonizing agenda. Inclusive to the concept are holistic, preventative, traditional health perspectives, and Indigenous languages. Colonization impacts were of critical concern and in need of undoing. Sharing of social and political efforts is seen as pivotal to change and includes all members of communities.

Missing in action: a scoping review of gender as the overlooked component in decolonial discourses

“…Five papers had a focus on pandemics, ranging from prevention37 to transmission38 to response,39–41 and one highlighted the challenges surrounding the production and distribution of vaccines 42. Nine papers had a service delivery focus which analysed the impact of (de)coloniality on service provision21 25 39 43 44 and service providers,23 36 45 46 while seven analysed community engagement in research methods40 44 47–50 and programme design 38. Seven papers concentrated on Indigenous health, of which four studied the health of Indigenous peoples39 40 43 46 and three discussed Indigenous conceptions of health 34 37 49…”

Canada First Nations Strengths in Community-Based Primary Healthcare

“…In addition to ensuring all emerging themes had been thoroughly explored, we also compared data from participating communities as data were being gathered. Detailed descriptions of methods and engagement processes have already been published [ 30 , 63 , 64 ]. We used a semi-structured, conversational style, and we encouraged storied responses in which respondents were free to engage the subject matter expansively [ 65 , 66 ].…”

“…For instance, cultural colonialism has been analyzed as an extension of colonial state power through cultural knowledge, biomedical activities, and health institutions, as well as the systemic subordination of Indigenous conceptual frameworks and cultural identities. New knowledge amasses on global inequities and the cultural dimensions of present-day struggles for self-determination as decolonizing discourses critique political and socioeconomic systems [ 29 , 30 , 31 , 32 , 33 , 34 ].…”

Filipino Americans’ Social and Cultural Experiences of Type 2 Diabetes Management: Cultural Paradox, Ownership, and Success Definition

“…Colonial mentality is a type of internalized racism marked by a perception of ethnic or cultural inferiority or inadequacy (David, 2013;David & Nadal, 2013). The effects of colonialism on psychological health have been studied before on various ethnic groups (Chandanabhumma & Narasimhan, 2020;Decena, 2014;Eni et al, 2021;Gillson et al, 2022). Not surprisingly, a colonialist view is observed in many FilAms (David, 2013), including in their food practices (Orquiza, 2020).…”