Review of Core Competencies for Public Health

The National Collaborating Centre for Aboriginal Health (NCCAH) is pleased to announce the release of the Review of Core Competencies for Public Health: An Aboriginal Public Health Perspective. In this report, Dr. Sarah Hunt reviews and analyzes the seven categories and appendices of the 2007 Public Health Agency of Canada’s Core Competencies for Public Health in Canada 1.0 within an Aboriginal public health framework. Building on the international work of CIPHER: Competencies for Indigenous Public Health, Evaluation and Research, the review seeks to address issues of Aboriginal public health, including systemic factors related to colonialism, recognition of Indigenous knowledge, and First Nations, Inuit and Métis health governance. These issues are currently missing from the 2007 competencies.

Presently, there are no core competencies for public health practitioners working with Aboriginal people in Canada. Their development and application, however, could lead to improved quality of care and overall health status for First Nations, Inuit and Métis peoples by: providing the skills, knowledge and attitudes that public health practitioners could draw upon to provide culturally competent and safe health services to Aboriginal individuals and communities; improving academic curriculum, training programs, professional certification, health services planning, health policy, and health program evaluation standards; and providing standardized assessment criteria to help governments and organizations share best practices more efficiently and promote culturally safe health services.

The health of Aboriginal peoples in Canada is a complex pressing social and political issue that continues to call for dedicated resources, policies and public health frameworks. In recognition of the ongoing disparities between Aboriginal and non-Aboriginal peoples’ health, guidelines have been created by numerous professional health organizations to create competencies in culturally relevant care for Aboriginal people and communities. Additionally, new governance agreements are being formed between Aboriginal nations and federal and provincial governments which shift the responsibility and leadership for health care into the hands of Aboriginal people themselves.

In light of these recent initiatives in Aboriginal public health, the review provides specific recommendations for updating the seven categories and appendices of the 2007 Core Competencies for Public Health in Canada 1.0 in order to make them more relevant to the health care provision for First Nations, Inuit and Métis people. As well, recommendations are made so that the 2007 document is more consistent with an Aboriginal public health framework. These include:

• recognizing and naming First Nations, Inuit and Métis governing bodies along with federal, provincial and territorial governments, and engage them as partners in the development of the revised competencies;
• extending the relevance of the competencies to public health workers such as community health representatives, outreach workers and home visitors who often work with remote and rural Aboriginal communities;
• mentioning colonialism as a specific factor impacting public health in Canada;
• integrating a self-reflexive practice in which public health practitioners are aware of their own values within the context of cross-cultural work, rather than assuming all public health practitioners have the same values; and
• clarifying the meaning of self-governance within First Nations, Inuit and Métis community contexts.