Cultural Safety in the NWT Health and Social Services System

Frequently Asked Questions

What is cultural safety?

  • Cultural safety is an outcome where Indigenous peoples feel safe and respected, free of racism and discrimination, when accessing health and social services.
  • Health and social services are considered culturally safe when Indigenous clients say they are.

What is relationship-based care?

  • Indigenous residents have expressed a need for trusting, caring and ongoing relationships with their providers.
  • Relationship-based care is an approach that prioritizes relationship building between staff and clients, while removing barriers to achieving those relationships.

What is cultural competency?

  • Cultural competence refers to the skills, knowledge and attitudes of service providers and reflects the process of building effective relationships with Indigenous patients.

How is cultural safety achieved?

  • Working towards cultural safety requires transformation at all levels of the system in order to address inequities related to health outcomes and access to care.
  • This means that it must be practiced by both staff and the health and social services system.
    • Staff can be supported to practice cultural safety through cultural competency training and through the development of resources for respectful communication.
    • Leadership commitment, a diverse workforce, and culturally appropriate facilities support cultural safety at the organizational level.
  • Relationship-based care also supports cultural safety by focusing on building, developing, and nurturing relationships between staff and Indigenous clients.

Why is cultural safety important?

  • Cultural safety addresses difficult truths that the status of Indigenous health is a direct result of Canadian government policies; that the legacies of colonization and residential schools have impacted health outcomes and shaped the way services are delivered; and that the health and social services system has too often not been a place of healing for many Indigenous residents.
  • Cultural safety in health and social services aims to repair the history of distrust and work towards creating respectful relationships between clients and staff.
  • When Indigenous residents feel respected and safe, they are more likely to access the programs and services they need.

There are other marginalized groups in the NWT besides Indigenous people. Why does cultural safety and the action plan focus primarily on this population?

  • Cultural safety takes an equity approach by targeting the population in most need.
  • Indigenous people in the NWT comprise 50% of the population and experience disproportionate levels of health and social disparities compared to non-Indigenous people.
  • While this action plan targets Indigenous peoples, it does not mean that other marginalized groups will not benefit from this approach. Cultural safety promotes inclusiveness and awareness that all people are impacted by historical, social, political, and economic factors.
  • Moreover, cultural competency training teaches staff members to become aware of their own biases, assumptions, and privileges and how their opinions influence interactions with clients.
  • The cultural safety work is supported through third party funding from the federal Health Services Integration Fund (HSIF). The mandate of HSIF is to better meet the health care needs of Indigenous peoples in Canada.

What are the intended long-term outcomes of cultural safety?

  • Increased access and uptake of health and social services by populations in most need;
  • Improved client and community experience;
  • Improved health outcomes of Indigenous residents.

What are the Action Plan objectives?

  • Objective 1: Create an Organizational Culture of Cultural Safety
  • Objective 2: Strengthen Staff Capacity for Cultural Safety
  • Objective 3: Honour Traditional Knowledge and Healing Approaches in Care
  • Objective 4: Improve Client and Community Experience

How were the objectives selected?

  • The objectives and actions were informed by feedback from our knowledge sharing sessions and a review of best practices in the field.
  • Knowledge sharing sessions were held with NWT residents, staff from the department and health authorities, Regional Wellness Councils, and NGOs.

How will we know if we are meeting the objectives?

  • A monitoring and evaluation plan will track progress and overall achievement of the objectives through a number of methods.
  • A status update will be provided on the progress and achievements to date in the Department of Health and Social Services’ Annual Report.
  • Client reported experiences will be monitored from the administration of the Patient Experience Questionnaires for Health Services and the Community Counselling Program.

How does this fit into GNWT initiatives on reconciliation and cultural bias?

  • The Action Plan contributes to the GNWT initiatives on reconciliation and cultural bias in the following areas:
    • Cultural safety has an overall goal of addressing health disparities between Indigenous and non-Indigenous residents;
    • Piloting and developing cultural competency training for all staff;
    • Honouring traditional knowledge and healing approaches in care.

What kind of engagement with Indigenous people took place throughout the development of this Action Plan?

  • Knowledge sharing meetings and presentations, including one-on-one interviews, were held with a variety of Indigenous peoples and stakeholders in the NWT.
  • Indigenous people were engaged through:
    • Regional Wellness Councils;
    • Leadership Council;
    • Indigenous leadership at May 2018 Indigenous Government meeting hosted by the Minister of Health and Social Services;
    • Indigenous clients;
    • Indigenous staff at the Department of Health and Social Services and health authorities.

Which NGOs participated in the knowledge sharing sessions?

  • Arctic Indigenous Wellness Foundation;
  • Institute for Circumpolar Health Research;
  • Native Women’s Association of the NWT;
  • Rainbow Coalition.

Where can I learn more about the changes being proposed?