The federal government has in the past defined involvement in Indigenous health at the federal or provincial/territorial level: “The federal government provides some health services to First Nations on reserve and Inuit, including public health activities, health promotion and the detection and mitigation of hazards to health in the environment” (Health Canada, 2005, p.3).

“The majority of health services available to Inuit, Métis, non-status Indians and status Indians living away from communities are provided by the provinces and territories in the same manner that services are available to all citizens. Some provinces/territories provide innovative, culturally-specific programs and services to meet the particular health needs of First Nations, Inuit and Métis” (Health Canada, 2005, p.7).

In 2017, the federal government embarked on an important restructuration. Indigenous Services Canada was co-created with Crown-Indigenous Relations and Northern Affairs Canada from what was formerly Indigenous and Northern Affairs Canada and the First Nations and Inuit Health Branch of Health Canada. It collaborates with partners in linking First Nations, Inuit and Metis with high quality services (Indigenous Services Canada, 2013, 2018, 2019). As of 2019, the process of transitioning previous programs to Indigenous Services Canada is in progress.


Responsibilities for Indigenous health are delegated to the Saskatchewan Health Authority which was created in December 2017 and consolidates 12 former regional health authorities (with the exceptions of Indigenous-led health authorities such as the Northern Intertribal Health Authority and the Athabasca Health Authority) (SK Health Authority, 2019).

The Saskatchewan Health Authority formed the Indigenous Health Working Group whose mandate is “to engage with the First Nations and Métis communities to develop recommendations for improvement” (SK Health Authority, 2018a, p. 14).  The Indigenous Health Working Group worked in close collaboration with the regional health authorities on the strength of the recommendations of the 2016 Saskatchewan Advisory Panel on Health System Structure Report. The 2009 Saskatchewan Patient First Review had previously recommended more equitable, respectful, and culturally safe care for Indigenous peoples (SK Health Authority, 2018b, p. 4).

Indigenous authorities are recognized under The Public Health Act of 1994 which states that health authorities can reach agreements with a Band council. “For the purpose of carrying out this Act according to its intent, the minister may enter into agreements with a local authority, the Government of Canada or its agencies, the government of another province or territory of Canada or its agencies, an Indian band or any other person” (The Public Health Act, Section 4). This is reiterated in the Provincial Health Authority Act (2017, Section 4.3(h)).


In the most northern part of Saskatchewan, the population is served by the Athabasca Health Authority. The Authority opened its Athabasca Health facility in 2003. The Athabasca Health Authority is not a regional health authority pursuant to The Regional Health Services Act (2017). “Saskatchewan Health and the federal government annually enter into a funding agreement with the Athabasca Health Authority for the provision of health services to be provided to those residing in the Athabasca Basin” (Government of Saskatchewan, 1999).

The Athabasca Health Authority “provides health care services to five main communities in the north … the 2 First Nations Communities of Black Lake and Fond Du Lac, as well as Stony Rapids, Uranium City, and Camsell Portage” (Athabasca Health Authority, n.d.).

In addition, the Northern Saskatchewan Population Health Unit (PHU) is responsible for health surveillance and health status reporting. “It is a major collaborative initiative of the Athabasca Health Authority (AHA) and the former Keewatin Yatthé and Mamawetan Churchill River Regional Health Authorities, formalized through a Co-Management Partnership Committee Memorandum of Understanding” (Athabasca Health Authority, 2018, p. 51). Other partners include: First Nations and Inuit Health Branch, Northern Medical Services, and the Northern Inter-Tribal Health Authority.

The Northern Inter-Tribal Health Authority (NITHA) was created in 1998, comprised of four Indigenous organizations in Northern Saskatchewan, to deliver health services, including public health programs (population health assessment, disease surveillance, health promotion, health protection, and disease and injury prevention) (Northern Inter-Tribal Health Authority, 2019a, 2019b).

The NITHA is a partnership of the Meadow Lake Tribal Council, the Lac LaRonge First Nations, the Peter Ballantyne Cree Nation, and the Prince Albert Grand Council. These Tribal Councils and First Nations collectively represent nearly half of First Nations in Saskatchewan. The NITHA provides education and technical support to its partners in the area of communicable disease control, epidemiology and health status monitoring. (National Collaborating Centre for Aboriginal Health, 2011, p.8). “NITHA is funded through a contribution agreement with FNIHB [Health Canada's First Nations and Inuit Health Branch]” (National Collaborating Centre for Aboriginal Health, 2011, p.32).

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