Typology of Indigenous health system governance in Canada
Typology of Indigenous health system governance in Canada
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DOI：
10.1111/capa.12441
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发表时间：
2021-11-10
影响因子：
1
通讯作者：
Harrold, H. James
中科院分区：
文献类型：
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作者：
Marchildon, Gregory P.;Lavoie, Josee G.;Harrold, H. James
土著人管理的卫生系统最初是作为自决的一种表现而建立的，现在在形成加拿大卫生方案和服务的提供方面发挥着重要作用。这些土著卫生系统在非常不同的地理、政治和社会背景下运作，具有高度的异质性。为了更好地理解这些差异，一个类型的基础上构建的三个领域的决策空间：治理规则，融资和问责机制。还评估了土著社区与联邦、省和地区政府之间关系的性质，特别是土著社区对各自卫生系统的控制程度。由此产生的五级分类法将土著卫生系统分为广泛和强控制到中度和狭义控制。虽然这一类型是基于目前的治理安排，但它为研究土著卫生系统的未来创新以及土著政府和组织参与省级和地区政府的新类型提供了一个基线。
Originally established as an expression of self-determination, Indigenous-governed health systems now play an important role in shaping the delivery of health programs and services in Canada. Operating in very diverse geographic, political and social contexts, these Indigenous health systems are highly heterogeneous. To better understand these differences, a typology is constructed based on three areas of decision-making space: governance rules, financing and accountability mechanisms. The nature of the relationship and in particular, the degree of control exercised by Indigenous communities over their respective health systems in relation to federal, provincial and territorial governments, is also assessed. The resulting five-level typology organizes Indigenous health systems into broad and strong control to moderate and narrow control. Although this typology is based on current governance arrangements, it nevertheless presents a baseline for the study of future innovations in Indigenous health systems as well as new types of provincial and territorial government engagement by Indigenous governments and organizations.