NUKA System of Care- Indigenous Innovation at its Best.

My latest post included an interview I did with my sister (who works for the Cree Board of Health and Social Services of James Bay (CBHSSJB)) that I did to highlight initiatives with regards to indigenous health in my home province. During the interview, she brought up that the CBHSSJB was getting more and more influenced by the Southcentral Foundation’s Nuka System of Care. This system is a ‘’relationship-based, customer-owned approach to transforming health care, improving outcomes and reducing costs’’(Southcentral Foundation, n.d. para 1). In my opinion, a system that has been the only organization awarded twice (2011 & 2017) the Malcolm Baldrige National Quality Award most definitely deserved its own blog post.

The entire system was not only created by Alaska Native People, it is also managed and owned by them. They went from 25 to 1500 employees and from government controlled to ‘’customer-owned’’ over the last 30 years (Gotlieb, 2013). Gotlieb (2013) reports that ‘’the change in Alaska did not happen overnight. By 1999, Alaska Native people were no longer “beneficiaries” of a government-run system, but, rather, chose to become self-determined “customers” and also “owners” of their tribally managed health care ‘’ (para. 4). This infographic presents a few of their impressive statistics.

Copied from : https://scfnuka.com/

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Vision Statement

A Native Community that enjoys physical, mental, emotional and spiritual wellness.

Mission Statement

Working together with the Native Community to achieve wellness through health and related services.

Key Points

Shared Responsibility

We value working together with the individual, the family, and the community. We strive to honor the dignity of every individual. We see the journey to wellness being traveled in shared responsibility and partnership with those for whom we provide services.

Commitment to Quality

We strive to provide the best services for the Native Community. We employ fully qualified staff in all positions and we commit ourselves to recruiting and training Native staff to meet this need. We structure our organization to optimize the skills and contributions of our staff.

Family Wellness

We value the family as the heart of the Native Community. We work to promote wellness that goes beyond absence of illness and prevention of disease. We encourage physical, mental, social, spiritual & economic wellness in the individual, the family, the community and the world in which we live.

Information copied from Gotlieb, 2013

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https://www.youtube.com/watch?v=9l34frUyadQ

In their paper, Richmond and Cook mention that we are at a critical point in our history in the making of healthy public policies (2016). There are currently no accountability in addressing the issue of youth suicide, Murdered and Missing Indigenous Women and Girls, and other highly inequitable Aboriginal-specific situations. '' Without healthy public policy in place – one that including targets, action plans, and means of evaluation – the government has no responsibility to act on Aboriginal issues throughout the continuum of the social determinants of health and no accountability for the poor quality of Aboriginal health care'' (Richmond and Cook, 2016).

As there are still constant battles between the Federal and Provincial Government with regards to healthcare delivery and policies in indigenous communities, could the NUKA system of care be part of the solution?

References:

Gottlieb K. (2013). The Nuka System of Care: improving health through ownership and relationships. International journal of circumpolar health, 72, 10.3402

Richmond, C.A.M., Cook, C. (2016) Creating conditions for Canadian aboriginal health equity: the promise of healthy public policy. Public Health Rev 37, 2

Southcentral Foundation, (n.d.) Nuka system of care. Retrieved from : https://www.southcentralfoundation.com/nuka-system-of-care/