Abstract

In Canada and New Zealand, policies support Indigenous participation in the planning and delivery of community-based primary health services. However, these services represent only a fraction of the health services accessed by Indigenous peoples. In New Zealand, legislation enacted in 2000 introduced mechanisms to ensure that Māori have a voice in the decisions made by health boards. In Canada, neither policies nor legislation currently ensure that Aboriginal communities are represented in provincial health systems or regional health boards. The New Zealand experience shows that adding mechanisms of participation to legislation and policies creates opportunities for Māori and health boards to engage in discussions about how to best allocate resources to reduce disparities between Māori and non-Māori health outcomes. In Canada, this dialogue may not occur. Requiring that such mechanisms be created in all Canadian jurisdictions would establish meeting places for dialogue, and assist in closing policy and access gaps that remain.

Acknowledgments

The authors would like to express their gratitude to the National Collaborating Centre for Aboriginal Health (NCCAH) for the support it provided for the Canadian study. The NCCAH is one of six national collaborating centres established by the Public Health Agency of Canada to renew and strengthen public health in Canada. This project has been made possible through a financial contribution from the Public Health Agency of Canada.

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