Addressing anti-Indigenous racism in health care: Funding
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Budget 2024: Addressing Anti-Indigenous Racism in Canada's Health Systems
The Government of Canada is taking action to implement Joyce's Principle and work to address anti-Indigenous racism in Canada's health systems to ensure the racist treatment experienced by Joyce Echaquan and other Indigenous patients is not repeated.
Building on the success from Budget 2021 investments, Budget 2024, reinvested $167.6 million over 5 years, starting in 2024-2025, to continue combatting anti-Indigenous racism in Canada's health systems.
The renewed funding supports initiatives focused on improving direct service delivery through the hiring and retention of Indigenous patient advocates, health system navigators, midwives and birth support workers. These investments also provide funding to national Indigenous health organizations to increase their capacity to advance efforts in dismantling systemic anti-Indigenous racism. By addressing racism at both the individual and systemic levels, the AAIR initiative helps reduce patient harm, foster inclusive and equitable healthcare environments for Indigenous patients, and contribute meaningfully to reconciliation and the elimination of health disparities.
Investments were made through the following streams of funding:
Indigenous health system navigators
Provides funding to Indigenous communities and organizations to hire and retain Indigenous health system navigators who assist Indigenous patients in accessing and navigating federal, provincial and territorial health services in a culturally safe manner.
Indigenous patient advocates
Provides funding to Indigenous communities and organizations to hire and retain Indigenous patient advocates. These advocates help patients access and navigate provincial, territorial and professional regulatory processes and work to resolve complaint issues within existing ombudsperson or complaint resolution frameworks.
Indigenous Midwifery
Provides funding to Indigenous communities to develop or expand community-based Indigenous midwifery services, including Indigenous midwifery education. Indigenous midwives are primary care providers who deliver culturally safe, patient-centered sexual and reproductive health care. Indigenous midwives can also help shield their patients from acts of anti-Indigenous racism in health systems, including forced and coerced sterilization.
This stream also provided funding to some Indigenous communities and organizations to train and fund Indigenous birth support workers, sometimes known as doulas. Birth support workers can increase access to a continuum of culturally safe prenatal, birthing and postpartum support services, including patient education and advocacy.
National Indigenous health organizations
Provides capacity funding to support national Indigenous health organizations to continue their efforts in addressing racism at the national systems level, including Indigenous women's organizations to support addressing Indigenous women's health and anti-Indigenous racism issues, and help ensure women's voices and perspectives are included in policy development.
Budget 2021: Addressing anti-Indigenous racism in health care
In response to the death of Joyce Echaquan and the accounts of racism shared at the 4 national dialogues, Budget 2021 provided $126.7 million over 3 years, 2021-2024, to take action to foster health systems free from racism and discrimination where Indigenous people are respected and safe. This included the creation of the Addressing Anti-Indigenous Racism (AAIR) in Canada's health systems initiative, which provides funding to Indigenous organizations and communities to implement a range of projects. Budget 2021 funding consisted of a suite of initiatives under 4 key themes:
Improve access to culturally safe services
- Expanding support for Indigenous midwives: Distinctions-based funding to improve access to prenatal, postpartum and birth supports to First Nations, Inuit and Métis families. The funding supported the development and expansion of Indigenous midwifery education pathways, including community-based education. It also contributed to the development of new and expansion of existing Indigenous midwifery services, which are reducing the need for Indigenous life-givers to travel for perinatal care, while also ensuring they receive culturally safe and relevant care from a known and trusted provider
- This stream also provided: Distinctions-based funding to improve access to prenatal, postpartum and birth supports to First Nations, Inuit and Métis families. Indigenous birth support workers are supporting families through their reproductive health journeys, including by providing support during hospital deliveries for Indigenous patients who have had to travel far from home for delivery
- Capacity funding for national Indigenous women's organizations: Distinctions-based funding to:
- support organizations in addressing Indigenous women's health and anti-Indigenous racism issues
- help ensure that women's voices and perspectives are included in policy development
- Funding for regional and grassroots organizations: Distinctions-based funding to organizations that serve women, 2SLGBTQQIA+ people, people with disabilities and other marginalized groups and work towards improving access to culturally-safe health services
- Strengthening youth sexual health networks: Expanding current activities to increase awareness of sexual and reproductive health rights, particularly in relation to the consent to medical treatment of any kind, including sexual or reproductive treatment
Adapting health systems
- Cultural and patient safety: Funding for activities and initiatives that help to integrate cultural and patient safety in health systems
- Indigenous representation: Increasing the number of Indigenous health professionals by funding community-based worker training and Indigenous-specific health education programs
Improve supports and accountability
- Health systems navigators: Distinctions-based funding for urban Indigenous service delivery organizations, Indigenous health centres or other Indigenous partners to hire new Indigenous health systems navigators, who would support Indigenous patients in navigating federal, provincial and territorial health services
- Patient advocates: Distinctions-based funding for Indigenous patient advocates or similar mechanisms to help patients navigate the provincial, territorial and professional regulatory complaints processes and work to resolve issues within existing ombudsperson and complaint resolution frameworks
- Tools and resources: Support for the development of a repository of wise practices, cultural safety and anti-racism tools and resources
- Data collection: Supporting targeted data collection to inform a longer-term approach to addressing anti-Indigenous racism
Provide federal leadership
- Continued dialogue: Convened Indigenous, provincial, territorial and health systems partners in the ongoing national dialogues and roundtables. Funding supported the capacity of Indigenous partners to participate in the discussions. This informed the development of transformative measures to help eliminate anti-Indigenous racism as part of a longer-term national approach
- Evaluating internal ISC programming: As part of the mandate to transform service delivery to First Nations, Inuit and Métis individuals, families and communities, ISC laid out in its strategic plan, a commitment to review its practices to ensure more culturally responsive and safe services. ISC continues to make progress on ensuring cultural safety within the federal workforce, including through:
- the introduction of a cultural competency baseline survey and cultural competency training for all ISC staff
- a commitment to increase the recruitment, retention and advancement of Indigenous staff, including through support for Indigenous employee networks, development programs and national and regional targets
- a review of human resource policies and processes through the lenses of diversity, inclusion and reconciliation and work to eliminate biases that discriminate against Indigenous Peoples