Community Development & Capacity BuildingFirst Nations & Inuit Health Branch

September 2012

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CDCB Framework approach

• Indigenous community development is dependent on the combined capacities of the community’s individuals, public service and governance – community development happens from within.

Role and opportunity for governments and partners - to support the capacity of community individuals, organizations and governance excellence.

By supporting capacity which leads to community development, First Nations and Inuit communities will address their own social determinants of health, based on their own assets, including Indigenous knowledge and culture.

• This is the game-changer to improve health outcomes.

• For governments and partners - Strengthened knowledge and competencies in effectively partnering with communities (including cultural competence), and strengthened community partnerships are necessary elements for success.

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Theory of Change• Previous policies to implement community-centred approaches have

resulted in momentary shifts, but policy alone does not result in transformative change.

• CDCB is using an organizational change approach to increase the likelihood of transformative change:

Empower community members, FNIHB employees and external partners with knowledge and competencies – “to know more is to do better” (Elder Paul Skanks).

Encourage natural networks of people that provide supports and opportunities for discussion on how to implement Indigenous community development

Build champions at every level Maintain a vision of the future that generates hope and commitment

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Healthy Community is the Vision

Krawl, 1994, Indicators of healthy community

• people getting involved in their community

• greater sense of trust, caring and sharing among community members

• positive parenting • sharing of intergenerational wisdom

[and culture]• openness and communication among

community members, without blaming or shame

• clear role expectations and people taking responsibility

• sense of connectedness and sensitivity to one another which promotes healthy partnerships and collective action

• Adapted from Whanāu Ora, New Zealand approach to Māori family health and wellbeing.

• Community and family well-being will be realised when [extended] families are:

Self managing Living healthy lifestyles Participating fully in society Confidently participating in the

First Nations/Inuit world Economically secure and

successfully Involved in wealth creation Cohesive, resilient, nurturing

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Working Definition: Community Development

• The foundational value and belief of community development is that the people themselves can improve their community by working together, building consensus on priorities and actions, building on community assets, and developing individual and community capacity.

• Community development is a principled, values-based approach to support better outcomes in First Nations and Inuit health, by empowering communities to manage their own services, building on their own strengths including culture.

• Community development is not a program – the principle is to embed community development knowledge and expertise across the whole branch, in every policy and program.

Community development is not new

• This increasing level of health in Aboriginal communities must be built on three pillars. The first, and most significant, is community development, both socio-economic development and cultural and spiritual development, to remove the conditions of poverty and apathy which prevent the members of the community from achieving a state of physical, mental and social well-being. (1979)

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Commitment to Community Development

• Community development is a priority of the Health Canada Executive Committee workplan.

• FNIHB ADM’s speech to the AFN’s Health Policy Forum highlighted community development

• Linked to FNIHB draft Strategic Plan• FNIHB Regional Directors have shown their support

and commitment to the content and approach, and an RD co-chairs the National Advisory Committee

• AFN and ITK both participate and are co-chairs of the National Advisory Committee.

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Community Development

Community Capacity

Partnerships for Community

Health & Well-being

Government & Partners

Knowledge & Competencies

Indigenous Knowledge & Culture

Strength-Based

Community-Centred

Leadership in Community

Holistic Health & Well-being

Community Development and Capacity Building

Framework and Principles

Cultural Competence ©FNIHB-HC 9

Pillars of the CDCB Framework• Pillars or entry points to support

Indigenous Community Development (ICD) in communities.

Building our own knowledge and competencies in ICD and cultural competence, to be better partners.

Working with innovative partners such as other governments, corporations and non-profits to support community well-being.

Always supporting ongoing development of capacities in communities.

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Principles of the Framework

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Community Capacity – What is it?• Capacity of individuals + capacity of community organizations = building blocks for

community development. • For example: Capacities in communicating and sharing plans for the future,

working together to achieve a shared plan, and evaluating progress.

Why is it helpful?• Community development is built on individual and organizational capacities.• Successful communities have the capacity to identify and address their own

determinants of health.

In practice – how do we implement? • First do no harm – do not compromise community

capacity, decision-making, self-determination and hope• Focus on opportunities to leverage partnerships to support capacity development

in individuals and organizations.

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Community Capacity definitions

• What community insiders need to have, to know, to do, and to be, in order to effectively influence the primary determinants of health that are affecting them (United Nations Development Program).

• Sometimes described at three levels: Individual Level - development of conditions that allow individuals to

build and enhance existing knowledge and skills, the establishment of conditions that will allow individuals to engage in the “process of learning and adapting to change”

Institutional Level - aiding and supporting institutions/organizations in forming sound policies, organizational structures, and effective methods of management and controls

Societal Level - support the establishment of a more “interactive public administration that learns equally from its actions and from feedback it receives from the population at large.” Capacity building must be used to develop public administrators that are responsive and accountable.

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Individual Capacity

· Safety· Healing· Personal health

practices including culture

· Social supports· Ready to learn· Ready for work

Service Delivery

· Continuing education for work and career

· Communication· Project management· E-technology· Sector-Specific

Capacity: health, ECD and education, housing & public works, PSE, lands & resources, family & community supports, social development, economic development, policing, membership

Governance· Policy and decision

making· Communication and

negotiation· Organizational

design· Management &

controls· Community

engagement & moral authority

· Leadership· Partnerships &

Collaboration· Accreditation

Organizational Capacity

· Communication and negotiation

· Public administration· Policy and decision-

making· HR management· Financial mgmt &

fundraising· Strategic Planning· Information

management· Performance

measurement· Community engagement· Partnerships &

Collaboration· Accreditation

Public Service Capacity

Community Capacities

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Why is it helpful? • Strength of culture in community is a

determinant of community wellness.

• In practice, how to implement:• Culture is an essential determinant of

health in communities, and an eligible expense in FNIHB health programs.

• It is the responsibility of FNIHB and of FNIHB employees to be culturally competent.

Indigenous Knowledge & Culture - WHAT is it?• Culture (traditional and cultural activities, indigenous intelligence) is an

important, and perhaps the most important protective factor in community. • Culture acts as a buffer against crisis. Cultural discontinuity is a risk factor,

particularly in mental health.

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Indigenous Culture & Knowledge• Culture

The commonalities around which a group of people have developed values, norms, family styles, social roles and behaviours, in response to the political, economic and social realities they face

Culture and identity are central to Indigenous perceptions and definitions of health and ill health.

• History matters: Colonization and residential schools discounted Indigenous cultures,

churches and society labelled culture as “evil” and uncivilized, and the federal government criminalized cultural practices.

Community healing from colonization and residential schools includes the process to reclaim and revive cultural knowledge and traditions – and this is a foundation for community development.

• Successful communities Community cultural identity, esteem and strength is associated with

strong social support networks, inclusive social structures, and sense of hope for the future.

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Strength-based - WHAT is it?• A strengths-based or assets-based approach balances risk and protective

factors, and respects the resilience of communities.• A recognition that every community has assets – some are just more

readily identifiable.

WHY is it helpful? • Builds trust• Builds individual and community

esteem• Supports potential and hope

In practice: • Design programs and policy starting

with community strengths including culture and social connectedness.

• Always look for strengths and assets.

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WHY is it helpful? • We all share a vision of communities self-

managing with control over their own social determinants of health, with support from governments and partners.

In practice: • Facilitate community initiative and ownership,

and reduce prescriptive policy and programs. • Facilitate community capacity in decision-

making, facilitation and strategic planning.

Community-Centred - WHAT is it?• Community-based: The majority of health risk and protective factors are local.

Capacity and activity to address them must also be local. A community builds on its own strengths and assets to address health risk factors.

• Community-paced – Sustainable action builds on capacity in the community, at the stage of community development (continuum).

• Community-led: The community’s sense of ownership and control over activities to address wellness is likely just as important as the activity’s outcomes.

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WHY is it helpful? • Formal and informal community

leadership is a protective factor against crisis, and an essential factor for success.

In practice: • Support short- and medium- term

leadership development and emerging leaders in communities.

Leadership in Community - WHAT is it?• Leaders create vision for the future: “The ultimate task of a leader is to

take his or her society to where it has never been.”• Community leaders include those paid to lead, and also those who have

leadership roles and influence in the community.

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WHAT is it?• First Nations, Inuit and Métis define health as holistic (physical, emotional,

mental and spiritual), and activities that have impact across the circle of health will have more impact than those which focus on only one.

WHY is it helpful? • Factors contributing to health and wellness,

and healthy communities, are larger than any one department or partner.

• Successful communities have innovative partnerships with neighbouring communities, NGOs and additional funders.

In practice: • Leverage commonalities and partnerships

within FNIHB, with other departments including AANDC.

• Facilitate relationships between First Nations, Inuit and Métis - and the NGO and private sectors.

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Cultural Competence

• Important enough to spend much of the afternoon on this foundation of the CDCB Framework.

• An expectation held by Aboriginal communities and clients

• A lens – principles are seen and interpreted through it

• A process - reflected in communications.

• An indicator and an outcome – evaluated by Aboriginal partners and clients

• A lifelong learning opportunity.

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Employees and organizations have knowledge and competencies in ICD and cultural competence, in order to build effective relationships with communities and clients.

ICD and cultural competence is implemented in FNIHB & AANDC daily work to develop policies and programs, and decision-making that affects communities.

FNIHB & AANDC are effective partners with communities to support their work to develop and address SDOH.

As communities request, innovative corporate and philanthropic partners support the development of community capacities, and contribute to improved health and well-being.

Communities have the capacities to plan, deliver and evaluate their own quality services and public administration, and negotiate effective relationships with provinces and territories to adapt the larger systems to better meet their needs (ie. Health, education, etc)

FNIHB & AANDC CDCB Framework Goals

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For more information:

Rose Sones LeMay

Branch Lead, Community Development and Capacity Building

FNIHB, Health Canada

Rose.sones@hc-sc.gc.ca

APPENDICES Draft Workplan

Lessons learned in CDCB Pilots

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Draft Workplan 2012-13

• Community Capacity Review options for FNIHB to actively support capacity in communities

including emerging leaders, and options on joint work with AANDC Complete pilot with Public Safety on community planning, and report on

outcomes• FNIHB Knowledge and Competencies

Train 20% of FNIHB in Indigenous Community Development course Develop structures to support ongoing learning including GC-Connex,

Forums Complete resource kit for regions to support communities in crisis,

perhaps with a specific workshop• Partnerships for Health

Contribute to knowledge translation on building and maintaining effective innovative partnerships

Increase corporate and philanthropic contribution to community capacity and health services delivery

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Lessons Learned in CDCB Pilots

Internal Organizational Change• Takes time in focussed training to build champions at

every level of organization

Indigenous Community Development curriculum

Community Capacity is the lever• Successful communities have strong capacities in how to

do strategic planning• Communities plan to their own internal authorities first• Community peer support networks can offer immediate

and sustainable supports, and better positioned to share messages about effective management and governance

Kitigan’zibi, joint funding with Public Safety, FN Health Mgrs Assoc

Innovative Partnerships• Negotiation skills, shared sense of benefit both important

to community partnerships with corporations, non-profits, other governments

Ahp-cii-uk

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