Seeking to improve collaborative capacity to enhance multilateral collaboration between First Nations, federal and provincial governments

Abstract

Over the years, a number of efforts have been underway to enhance health care collaboration between First Nations, federal and provincial governments. One of those more recent initiatives is the subject of this research – the Joint Action Plan to Improve the Health of First Nations in Alberta. The Joint Action Health Plan was developed in 2014 to enhance collaboration between First Nations of Treaty No. 6, Treaty No. 7 and Treaty No. 8 (Alberta), Alberta Health, Alberta Health Services and First Nations and Inuit Health Branch – Alberta Region (Health Canada) to achieve quality of health services. This participatory action research was conducted by interviewing 25 mid-to senior level individuals involved in the development and implementation of the Joint Action Health Plan. The theoretical foundation used to ground this research is collaboration theory. More specifically, this research is anchored by Wood and Gray’s definition of collaboration and the three-phase process of collaboration (preconditions, processes and outcomes). This is supplemented by the work of Foster-Fishman and her colleagues on the four elements of collaborative capacity (member capacity, relational capacity, organizational capacity and programmatic capacity). This research seeks to inform practice by providing 11 recommendations and identifying three key elements to enhance health care collaboration. First, the need for civil servants in First Nations, federal and provincial governments to take into account the impact of colonization on collaboration. Second, the need for reconciliation to enhance relationships between First Nations and governments as well as more broadly between First Nations Peoples and Settler society in Canada. And, thirdly the need to address the knowledge gap of federal and provincial civil servants, especially non-Indigenous employees, as we seek to develop meaningful collaboration between First Nations, federal and provincial governments. This research also contributes to research by: using collaboration theory within the context of health care collaboration between First Nations, federal and provincial governments; highlighting the cyclical rather than linear nature of collaboration; adding values to the definition of collaboration; and, demonstrating the interconnectedness of the four elements of collaborative capacity.