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????????? ?? ??????????? ??? ????????Miyupimaatis
iiwin aah aapitishiishtikiniwich utih
iiyiyiuschiihchDirection régionale de la santé
publique des Terres-cries-de-la-Baie-James (Eeyou
Istchee)Regional Public Health Department of the
Cree Territories of James Bay (Eeyou Istchee)

• Presented by Dr Robert Carlin
• interim Public Health Director

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Plan of the Presentation

• History JBNQA, CBHSSJB, Public Health
  Department
• Planning
• Vision
• Mission
• Strategic Planning
• Tactical Planning
• Our current organization

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JBNQA

• Signed in 1975
• Section 14 defines Cree Health and Social
  Services

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Territory Covered by JBNQA
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CBHSSJB - CCSSBJ

• Cree Board of Health and Social Services created
  in 1978
• Quebec health region 18
• Legal mandate defined by Law S5, whereas other
  health regions are under Law S4.2
• Both the JBNQA and the S5 require the
  establishment of a community health (or public
  health) department

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Territory Covered by the CBHSSJB
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DRSP Terres-cries-de-la-Baie-James (CBHSSJB)

• 1999 - Meeting between the Cree and the MSSS
  including specific task forces
• Diabetes
• Public Health
• 2002 - Modification of the laws (including the
  S5) for the creation of a Regional Public Health
  Department
• 2004 - Strategic regional plan of the CBHSSJB led
  to increased funding

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Normative or Policy Planning

• Planning a change in
• Ideology in order to reach systems goals
• Values which will guide in reaching the goals
• The result is a policy

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Normative or Policy Planning

• Decision usually taken
• at the level of ministries, or large
  organisations
• Usually long term
• 1020 years
• What should we be aiming for? Ideally?

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Vision

• Vision
• outlines what an organization wants to be
• a long-term view and concentrates on the future
• 1999 Eeyou Nation established a vision
  statement on Health and Social Services

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Eeyou NationVision Statement

• Holistic Approach Health and social development
  touch on all program areas.
• Balance Crees need to be balanced Mentally.
  Spiritually. Physically. Emotionally.

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Eeyou NationVision Statement

• Nation Building As opposed to simple
  decentralization of services that affect us in
  common.
• Capacity Building Improving our ability to
  solve our health and social problems ourselves.

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Eeyou NationVision Statement

• Traditional Values and Practices. Moving beyond
  the Western medical model, incorporating
  traditional healing and care-giving practices,
  basing programming on Cree family and cultural
  values.

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Eeyou NationVision Statement

• Economic Viability Adequate resources must be
  available to sustain the system.
• Sustainability Promote a healthy environment
  that supports the continued reliance on renewable
  resources that is key to our social and economic
  well-being.

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Eeyou NationVision Statement

• Control and Empowerment Crees need to take
  charge of their social welfare and health,
  exercising total jurisdiction as a nation.
• Responsibility and Accountability Cree agencies
  will be responsible and accountable to a strong
  Cree Nation government.

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Values

• Values Beliefs that are shared within an
  organization.

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Eeyou Values

• Respect
• Honesty
• Loving
• Caring
• Sharing

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L.R.Q., chapitre S-2.2Loi sur la santé publique


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Strategic Planning

• Action of Planning change in
• Mission, mandate and strategies
• The goal of your organisation
• What should we do?

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Strategic Planning

• Decision usually taken
• at the level of organisations
• But can occur at various other levels
• Usually long term
• 5 10 years

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Mission

• Mission Defines the fundamental purpose of an
  organization or an enterprise, succinctly
  describing why it exists and what it does to
  achieve its vision.

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Mission

• Miyupimaatisiiun
•  Striving to maintain and promote the health of
  our people 

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Mandate

• An Act respecting Health services and social
  services for Cree Native persons, R.S.Q. c. S-5
  63.3
•  The regional council shall
•    1) establish a public health department
•    2) ensure the security and confidentiality of
  the personal or confidential information obtained
  by the public health department in the exercise
  of its functions
•   3) entrust the management of the regional
  public health action plan to the public health
  director appointed
•   4) organize services and allocate available
  resources for the purposes of the regional public
  health action plan.
•  

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Mandate

• An Act respecting Health services and social
  services for Cree Native persons, R.S.Q. c. S-5
  63.10.
• The public health director shall, in particular,
  assume the functions provided for in section 373
  of the Act respecting health services and social
  services (chapter S-4.2), within the regional
  council and with respect to the population of the
  territory.

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Mandate

• (S4.2) 373. The public health director shall be
  responsible, in the region, for
• (1) informing the population on its general state
  of health and of the major health problems, the
  groups most at risk, the principal risk factors,
  the interventions he considers the most
  effective, monitoring the evolution thereof and
  conducting studies or research required for that
  purpose

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Mandate

•  (2) identifying situations which could pose a
  threat to the population's health and seeing to
  it that the measures necessary for its protection
  are taken

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Mandate

• (3) ensuring expertise in preventive health and
  health promotion and advising the agency on
  prevention services conducive to reducing
  mortality and avoidable morbidity

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Mandate

•  
• (4) identifying situations where intersectoral
  action is necessary to prevent diseases, trauma
  or social problems which have an impact on the
  health of the population, and, where the public
  health director considers it appropriate, taking
  the measures considered necessary to foster such
  action.

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Strategic Regional Plan - Goal

• Health
• Health indicators for the Cree population should
  be at least equal to those of the general
  population of Quebec.
• The incidence of disease, and mortality and
  morbidity rates, among the Cree population should
  be at reduced to levels at least equal to those
  of the general population of Quebec.

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Strategic Regional Plan - Goal

• Social
• Social wellness indicators for the Cree
  population should be at least equal to those of
  the general population of Quebec.
• Indicators of social dysfunction or distress
  among the Cree population should be reduced to
  levels at least equal to those of the general
  population of Quebec.

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Strategic Regional Plan Objective 2004-2014

• General health
• Life Expectancy
• Increase life expectancy in good health among
  women by at least eight years and among men by at
  least two years so as to match that of the
  general population of Quebec

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Strategic Regional Plan Objective 2004-2014

• Chronic disease and life style
• Obesity
• Reduce prevalence for women and for men so as not
  to exceed current general Quebec prevalence
• Diabetes
• Reduce incidence so as not to exceed current
  general Quebec prevalence

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Strategic Regional Plan Objective 2004-2014

• Chronic disease and life style
• Tobacco Use
• Reduce the rate of tobacco use among Cree youth
  so as not to exceed current general Quebec rate
  for youth.

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Strategic Regional Plan Objective 2004-2014

• Dental Health
• Improve dental health of the population. Reduce
  dental diseases (reduce prevalence of dental
  decay among five year olds, gum disease, dental
  infection, malocclusion, etc,) to a comparable
  provincial level. Improve the access to dental
  services from present 12 months waiting period to
  a comparable provincial waiting period (2 to 4
  weeks).

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Strategic Regional Plan Objective 2004-2014

• STI
• Reduce prevalence of Chlamydia so as not to
  exceed current general Quebec prevalence.

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Strategic Regional Plan Objective 2004-2014

• Trauma
• Reduce the rate of injury and death caused by
  accidents so as not to exceed current general
  Quebec rate.

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Strategic Regional Plan Objective 2004-2014

• Environment Health
• Reduce the risk on the health of environmental
  problems, including
• Poor Housing Improve the number and condition of
  housing in order to address problems of
  overcrowding and related serious health and
  social problems.

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Strategic Regional Plan Objective 2004-2014

• Environment Health
• Dust Pave roads within communities in order to
  reduce dust and air-borne contaminants and
  associated health complaints.
• Mercury and Lead Reduce relatively high levels
  of mercury and lead among Cree population.

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Strategic Regional Plan Objective 2004-2014

• Mental Health
• Reduce prevalence to level not exceeding that of
  general Quebec population

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Strategic Regional Plan Objective 2004-2014

• Mental Health
• Reduce prevalence to level not exceeding that of
  general Quebec population

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Strategic Regional Plan Objective 2004-2014

• Post-Residential School Trauma
• Heal the multi-facetted trauma associated with
  past attendance at residential schools,
  including Post-traumatic disorder Physical,
  psychological and sexual abuse Intergenerational
  breakdown

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Strategic Regional Plan Objective 2004-2014

• Ethno-stress
• Study the consequences of the problem and address
  this symptom of post-colonialism

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Strategic Regional Plan Objective 2004-2014

• Abuse / Violence
• Zero-Tolerance to Intergenerational abuse and
  Conjugal violence

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Strategic Regional Plan Objective 2004-2014

• Suicide
• Address root causes of suicide and para-suicide
  and seek to eliminate them

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Strategic Regional Plan Objective 2004-2014

• Youth protection Youth Healing Services
• Reduce the level of youth under youth protection
  and placement.
• Implement the action plan adopted by the Cree
  Health Board in November 2002.

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Strategic Regional Plan Objective 2004-2014

• Dependency
• Alcohol and Drugs Reduce the negative
  consequences of the alcohol and drugs abuse.
• Gambling Raise the awareness of the population
  related to negative consequences of habitual
  gambling and reduce such consequences.

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Tactical planning

• Action of Planning a change in
• Programmes
• Plan activities, as well as resources needed
• What are we going to do and How are we going to
  do it?
• The result of this step is a programme plan
• This step can also be called  programming 

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Tactical planning

• Decision usually taken
• At the level of different files
• But can occur at various other levels
• Usually more medium term
• 3-5 years

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Tactical Planning

• Revised at 2013 Department Meeting
• Regional Public Health Action Plan
• Includes strategies, goals, and objectives for
  each team developed over past year

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Tactical Planning

• Regional Action Plan should be aligned with the
  vision and values of the organizations, the
  mission and mandate of public health, and the
  strategic goals and objectives of the
  organization
• Will adjust our current action plan based on the
  Iiyuu Ahtaahwin process

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Tactical Planning Executive View

• How does the Executive summarize our core
  activities and accomplishments to others?
• Presentation on Wednesday will review current
   tactical  plan for the department.

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Public Health Responsibilities/Programming

• Implementation of  Mâshkûpimâtsît Awash
• Baby-Friendly initiative promotion of
  breast-feeding
• Perinatal care program continuity of program
  since 1970s in all 9 communities, major program
  revision, nurses CHR trained in the new
  practices
• Immunization childhood vaccines coverage rates
  are relatively high
• Infectious Diseases -
• Tuberculosis rates are relatively low
• Coordinated response to influenza H1N1 pandemic
  with emergency measures
• 24 hr call system to respond to public health
  questions from clinical staff 

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Public Health Responsibilities/Programming

• Healthy Sexuality development and distribution
  of STI materials implementation of youth STBI
  screenings and clinical services
• Chi Kayeah program a relationship and healthy
  sexuality program in the schools
• School health program in all communities
• Cree Regional Intersectorial Working group on
  dependencies

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Public Health Responsibilities/Programming

• Tobacco control cessation programming
  implemented in all communities
• Breast cancer screening 73 participation in
  2008 (vs. 54 for the whole province), ongoing
• Developed and implemented healthy nutrition
  policy in over 15 regional childcare centres
• Physical activity promotion campaigns are tied to
  local activities during several months of the
  year (Summer programs, Winter Programs)
• Addressed numerous situations regarding indoor
  air quality and provided awareness and training
  on the effects of mold in 4 communities
• Conducted culturally adapted injury prevention
  campaigns to reduce firearm and vehicle related
  injuries
• Produced diabetes DVD Sweet Blood
• Diabetes information pamphlets developed for our
  region are now being adopted for use not just in
  this province but in other provinces
• Nutrition promotional initiative developed for
  our region using placemats has been adopted for
  use by other health organizations across Canada

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Public Health Responsibilities/Programs-Accomplish
ments

• Surveillance
• Updated profile on maternal infant health
• Stats for midwifery planning
• Preliminary report on cancer
• Article on infant anemia
• Comprehensive update on injuries
• Cree Diabetes Information System
• Annual Report on Diabetes prevalence
• Clinical management system for diabetes and
  infectious diseases
• Evaluation
• Assessment for CMIP
• Evaluation support to nutrition, diabetes, Awash
  Team
• Research projects
• Five major research projects
• Communications
• Yearly ads in the Nation
• Radio public services announcements, Cree Health
  shows
• Publications on Creehealth.org

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Operational planning

• Action of Planning
• The implementation of the activites
• Schedule of tasks and operations
• Who is going to do what when in what order?
• The result of this step is a plan of operations

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Operational planning

• Decision usually taken
• at the level of different files
• but can occur at various other levels
• Usually more short term
• 1 year

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Operational planning

• Goal of the second and third day of this meeting.

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Meegwetch