2023-24 Gender-Based Analysis (GBA) Plus

Purpose

The Public Health Promotion and Disease Prevention Program provides First Nations and Inuit communities with flexibility to implement integrated and holistic health services and supports the transfer of these health services to First Nations and Inuit. Key activities supported by the program span across five elements: mental wellness, healthy living, healthy child development, communicable disease control and management, and environmental public health. These culturally relevant and community-based services are primarily delivered by First Nations on‑reserve and Inuit in Inuit Nunangat with funding and support from the Department for:

• Access to mental wellness services for inequities linked to intergenerational trauma, current day racism and discrimination and social determinants of health. The COVID-19 pandemic has exacerbated these impacts both in terms of mental wellness outcomes and access to services.
• Health promotion and disease prevention programs that provide education around healthy eating, food security, physical activity, commercial tobacco use, and chronic disease prevention, management and screening.
• Initiatives focused on prenatal and postnatal health, midwifery, nutrition, early literacy and learning, healthy relationships, and emotional and mental health.
• Responding to ongoing communicable disease challenges in communities and among Indigenous Peoples, and;
• Identifying and preventing environmental public health risks that could negatively impact the health of people in both the natural and built environment through exposure to contaminant-based environmental hazards or the health impacts of climate change. Most of these services are provided by certified Environmental Public Health Officers.

Focus Populations

Mental Wellness services support all Indigenous Peoples, including people who identify as Two-spirited, lesbian, gay, bisexual, transgender, queer, questioning, intersex, asexual, and all other sexual orientations and genders (2SLGBTQQIA+), people with disabilities, people with physical or mental health issues, Elders, children, and youth. Mental Wellness services have a balanced impact on men and women, and focus on increasing access to mental wellness services for First Nation and Inuit communities.

Health promotion and disease prevention services support all First Nations on reserve and Inuit living in Inuit Nunangat.

The Healthy Child Development suite of programs are focused on the health outcomes of First Nations and Inuit women, mothers, young children, and families.

Communicable diseases pose risks for all members of a community; however, intersectional or overlapping health and socioeconomic challenges create additional risk factors and barriers for certain populations within communities that elevate their risk related to communicable diseases. GBA Plus analysis and research has indicated that communicable diseases disproportionately impact groups such as women, children, the elderly, 2SLGBTQQIA+ people, and persons with disabilities, among others.

Environmental Public Health Services impact all First Nations individuals on-reserve south of 60°.

First Nations Environmental Contaminants Program impact all First Nations individuals on-reserve, with a specific focus on youth, Elders and other populations at higher risk of certain exposures; some examples are bottle fed infants, pregnant people, those who eat particular types and sizes of fish, or those going through dialysis.

Climate Change and Health Adaptation Programs impact all First Nations individuals on-reserve, with a specific focus on youth and Elders.

Data Collection

With a few exceptions, the program does not formally collect any data on mental wellness services or outcomes, but relies on external sources, particularly Indigenous-led monitoring, performance measurement, and evaluation, for tracking trends in mental wellness in Indigenous communities. Few exceptions to this are: the program does collect gender disaggregated data (with some limitations) relating to utilization of the Hope for Wellness Help Line and the Mental Health Services Tracking System database that provides the capacity to disaggregate data about gender identity from clients who have chosen to access mental health counselling.

Health promotion and disease prevention programs do not directly collect sufficient data to enable monitoring or reporting of impacts by gender and diversity. To support self-determination and eventual service transfer, program reporting requirements are minimal. The data collection instrument for the Nutrition North Canada Nutrition Education Initiatives implemented in 2022-23 was updated to gather some details on gender. Further, the Program continues to monitor data from relevant Indigenous-led surveys such as the Regional Health Survey (First Nations) to identify, when possible, gender and diversity-specific data.

The Healthy Child Development program cluster collects limited age and/or gender disaggregated data through recipient reporting on prenatal/maternal child health and early childhood development services. This information is particular to: pregnant people receiving and participating in services and activities by trimester; parents with babies that are breastfed; and children who have been screened, assessed and diagnosed with special needs.

For Indigenous Early Learning and Child Care, which is led by Employment and Social Development Canada, a co-developed results framework and the associated data collection (by Indigenous partners) is anticipated by 2023-24. This presents an opportunity for greater data disaggregation as determined by Indigenous partners.

The program collects sufficient data on many nationally notifiable communicable diseases outcomes which enable it to monitor trends, and report program impacts by gender. This includes COVID case data, Sexually Transmitted and Blood Borne Infections (STBBI) such as HIV, hepatitis C, infectious syphilis, active tuberculosis (TB), vaccine preventable diseases (e.g. chronic hepatitis B). In addition, data from the Public Health Agency of Canada, provincial STBBI surveillance systems, Non-Insured Health Benefits administrative data and regional offices and Partnership tables are being used to assess the GBA Plus impacts. Regions are encouraged to ensure that contract tracing, and pre- and post-diagnostic counselling, testing accessibility, and education is conducted in such a way as to taking into account privacy concerns, the unique needs of women of child bearing age, those engaged in sex work, 2SLGBTQQIA+ communities and individuals, and those facing Gender-Based violence.

Public health interventions that are targeted to the most affected populations have the ability to cause indirect harm by inadvertently disclosing an individual's infection, behaviour (i.e. person using drugs) or identity (i.e. 2SLGBTQQIA+) status to the other members of the public, or by reinforcing ethnically (i.e. First Nations) or age-related ("young and reckless") cultural stereotypes. Anticipated risks can be prevented and mitigated by maintaining high professional standards of care (including cultural safety and humility); with the ability to ensure a patient's confidentiality; by supporting culturally specific interventions to prevent new further infections, and to provide care, treatment and support to people living with these infections. Each community has unique health needs and resources and the program will continue to work with regions and other federal governments to address persistent public health outbreaks and emergencies in First Nations and Inuit communities.

While the program collects sex-based data on nationally notifiable communicable diseases outcomes, the reporting coverage is currently not universal or timely to inform targeted interventions. Existing data tools and processes in many communities are very manual-labour intensive, are compiled with 1-2 year delay and would benefit from transitioning to a more real-time reporting server-based platforms which could support community-level monitoring of the burden of diseases. A real-life example of such a platform would be the COVID case surveillance system in First Nations communities in the provinces developed by the Department to support communities and partner organizations in responding to the COVID-19 pandemic. ISC is currently developing a pilot to transition infectious syphilis reporting in First Nations communities from the existing annual excel-template based reporting to a server-based reporting that would be done on a more frequent basis.

Environmental Public Health Services collects data on the number of women and Indigenous Environmental Public Health Officers. Given the low numbers in this regard, through the work being undertaken in 2021, ISC is working to develop a recruitment and retention strategy for Environmental Public Health Officers who work in/with First Nations Communities. The goal of this strategy is the promotion and recruitment of both Indigenous and non-Indigenous people into the environmental public health profession to work with Indigenous partners and their communities, with an additional focus on women

Purpose

The Home and Long-Term Care Program consists of two streams: 1) home and community health care services that support the provision of essential services including client assessments, case management, nursing, personal care, in-home respite, referrals, data collection, and supportive services such as rehabilitation, in-home palliative care, adult day care, meal programs, and mental health care and, 2) assisted living social supports that fund the delivery of nonmedical home care, adult foster care, and institutional care services to eligible low-income seniors and persons with disabilities.

The program contributes to improving outcomes for some of the most vulnerable individuals living on reserve, in particular, low-income individuals, seniors, persons with disabilities and individuals living with chronic health issues or activity limitations by providing funding to ensure that vulnerable individuals and their families receive continuous services and supports to help them maintain their independence, remain in their home communities, or receive necessary services in a residential long-term care facility. In an effort to better address the long-term and continuing care needs in First Nations and Inuit communities, it also includes working with Indigenous communities on developing a new, more holistic distinctions-based long-term and continuing care framework that will cover the full spectrum of programs and services including but not limited to, supports for people living with disabilities, those with low incomes, seniors, as well as, members of the 2SLGBTQQIA+ community. This continuum will also address aging in place approaches, improvements to facility-based care, and could include services for youth previously served under Jordan's Principle.

Focus Populations

The home and community health care services are provided to First Nations ordinarily residing on-reserve and Inuit residing in their home communities. The funding supports for assisted living social supports (in-home, group-home and institutional care supports) is for eligible low-income First Nation seniors and persons with disabilities on-reserve and in the Yukon who have been formally assessed by a health care professional as requiring services, and who do not have the financial means to obtain such services themselves. The new long-term and continuing care framework will be aimed at helping men, women, youths, elders, 2SLGBTQQIA+ communities and individuals, people living with disabilities, individuals and families with low-incomes, rural/remote and geographically dispersed individuals, and First Nations, Inuit, and Métis peoples.

Data Collection

The program's existing data collection system collects little information that would be useful in determining gender and diversity impacts. The Program is currently engaging with First Nations and Inuit on a continuum of care approach to delivering long-term and continuing care services in their communities, and this will likely entail significant changes to the program and its data collection approach. Furthermore, the engagement also provides an opportunity for First Nations and Inuit partners to help inform the development of the programs GBA Plus reporting strategy. For example, the engagement process may provide information on the inequalities between women and men in their contributions to the delivery of informal caregiving on reserve allowing the targeting of specific supports. Appropriate measures for determining the program's impact on disproportionally impacted populations will be defined during the redesign of the Program's approach to data collection. The long-term health and social impacts of improvements to programs and services, and access to these, will also be measurable using a wide variety of data sources depending on the shape of the continuum of care and program framework which is co-developed with Indigenous partners once this work is complete.

Purpose

The Primary Health Care Program supports the delivery of and access to high quality health primary care services to First Nations and Inuit individuals, families, and communities. The Clinical and Client Care services element provides clinical and care services in remote and isolated First Nations communities. The Community Oral Health Services element of the Program provides direct oral health services including dental therapy services to Inuit and First Nations individuals and the Children's Oral Health Initiative. To support the provision of primary health care service delivery, eHealth Infostructure provides funding, advice, and expertise to Indigenous communities and organizations for the delivery of eHealth services and virtual care technologies.

The aim of these services is to improve health outcomes through the provision of in-person and digital health solutions for diagnostic, curative, rehabilitative, supportive, palliative and end-of-life care, and referral services and programming. Tools are developed and disseminated to support nurses in their assessment and management of clients, and accompanying educational or training supports through a Learning Management System.

Focus Populations

• For health services, First Nations community members in remote and isolated areas.
• For oral health and dental therapy services, all populations living within First Nations and Inuit communities, primarily, children aged 0-6 years, their parents/caregivers and pregnant women.
• ISC nurses and transferred and agency nurses working in remote and isolated Indigenous communities.
• For digital health services, it is anticipated that improving First Nations' capacity, governance and control in these areas will positively impact all First Nations community members including women, men, boys, girls, and gender-diverse individuals in different ways, based on their specific needs and interactions with health care services in Indigenous jurisdictions.

Data Collection

Health Data is collected at a point of care nursing station or health facility with treatment. The data is used in the delivery of health care only and is recorded against the medical history of the client. The data is typically collected on a region by region basis, respecting requirements around the protection of health data and the transmission and use of this data outside of treatment purposes. In the future, instead of relying on personal care data, the program will gather user feedback from nurses through the Learning Management System to assess Clinical Care Pathways and training modules from a variety of lenses, including the degree to which they adequately address GBA Plus issues of relevance to nurses and clients. With respect to specific virtual (ehealth) sessions, there is a shortage of disaggregated data available to measure impacts by sex or gender. The program has three main area of action (two and three are ongoing, whereas one has limited resources):

• Capacity building for greater availability of qualified, dedicated personnel for data collection in First Nations communities, First Nations regional organizations and regional Program offices. Funding for eHealth, while allowing for the maintenance of personnel and digital health components as they currently exist, does not make it possible to collect disaggregated data consistently across all regions.
• Consistency of indicators for regular analysis based on a core set of common indicators within and across regions. Yearly regional reports were redesigned to streamline information, and a reporting database was created to ensure consistent terminology use in regional reporting. eHealth will continue to advocate for the adoption of electronic medical records in First Nations health facilities to ensure all health information is captured and stored for reporting and security purposes.
• Alignment of legislation improving access to personal health information across the orders of government. Continued collaboration with federal, provincial, Indigenous health system and community representatives to explore ways of fostering cultural safety and building capacity in Indigenous communities, with an aim to prioritize equitable access to care and digital health solutions. A key area of focus is advancing interoperability through data content standards and technical standards.

For oral health and dental therapy services, the program collects data on the biological sex of the client and the community to which they belong. The program also collects data on age and geography, which facilitates analysis on differences in utilization of services and oral health outcomes by age and region. This data is used to identify any differences in utilization of services between male and female clients, as well as identify barriers in access to care by community, region, and age group.

Purpose

The Health Systems Support Program develops initiatives that work to transform health systems and move the department and First Nations towards service transfer and devolution. Program elements include Community Health Planning, the Health Systems Integration Fund, the Health Transformation initiative, British Columbia Tripartite Health Governance, Accreditation, Health Human Resources, and funding for Indigenous-led health surveys. Examples of these initiatives are:

• Supporting the voluntary accreditation of health services provided at First Nations Community Health Centres and ISC Nursing Stations to achieve accreditation from a recognized accrediting body.
• Providing training to community-based workers and health managers delivering health services in First Nations and Inuit communities through the Aboriginal Health Human Resources Initiative. Increasing the healthcare delivery workforce in Indigenous communities is an important way to advance health equity, particularly in rural and remote communities where health human resource challenges are greatest. Indigenous communities are currently experiencing inequitable critical shortages in health providers, including physicians, nurses, allied health workers, and unregulated health paraprofessionals. Staffing is a critical factor in impacting quality of care in nursing stations, health centers, and in the home environment, with clear links to safety outcomes.
• Managing the First Nations Health Authority's (FNHA) fiscal arrangements. Canada has the role of funder and governance partner and is responsible for administering a contribution agreement as per the commitments in the British Columbia Tripartite Framework Agreement.

Focus Populations

The component of the program that primarily supports Community Health Centres and nursing stations located in First Nations communities will help to ensure an adequately resourced Indigenous health workforce, along with community-focused measures to improve the quality of primary care and patient and nursing safety. First Nations individuals living on-reserve with health issues will benefit from improved access to high-quality, culturally safe, and patient-centred care.

Investments through accreditation initiatives will result in patient safety, nursing security and pharmacy management in nursing stations for First Nations living in remote and isolated communities and will improve the quality and safety of healthcare service delivery to everyone regardless of gender who will all benefit but in different ways based on their specific needs and interactions with the health care system. Accreditation also builds capacity of First Nations and Inuit organizations by ensuring they meet the same standards and guidelines of their provincial counterparts, while targeting the specific, culturally appropriate needs of the community in which the health facility is located.

Increasing the healthcare delivery workforce in Indigenous communities will improve health equity for First Nations and Inuit on reserve, and the British Columbia Tripartite Framework Agreement will benefit First Nations in British Columbia, including diverse groups of women, youth, gender-diverse individuals, Elders, persons with disabilities, and people living in remote or isolated communities.

Data Collection

The program does not collect sufficient data to enable it to use GBA Plus to monitor or report program impacts. To overcome data collection challenges associated with the principles of OCAP (ownership, control, access and possession) and privacy, the department works collaboratively with Indigenous organizations such as the First Nations Information Governance Centre. The Centre oversees the First Nations Regional Health Survey that collects self-reported information on Western and Traditional understandings of health and well-being, on reserve. Although the survey provides sex-disaggregated data that is broken down by age, the data is collected via a self-reported survey and linked to perceived health outcomes. The survey does not report on perceived health outcomes related to health infrastructure. Nonetheless, survey data can help to provide important context and considerations surrounding the regional health status of First Nations, which can support program implementation.

The impacts of the Health System Support program are measured through the Community-Based Reporting Template, first implemented in 2008-09. This combines performance information in a single template that recipients in communities must report on annually to satisfy requirements set out in their Contribution Agreements. The Template consists of 50 questions and collects four types of information relevant to the programs for a given reporting cycle, including some information organized by gender. The goal of the template is to measure the capacity for healthcare delivery in a community, rather than individual health outcomes, therefore, some aspects of GBA Plus analysis are not relevant.

With respect to the British Columbia Tripartite Health Governance, in June 2021, the Province of British Columbia and the FNHA released a baseline report called the First Nations Population Health and Wellness Agenda that expands the original suite of seven indicators to monitor progress and health improvements into a broader set of 22 indicators and targets that will be monitored over the next 10 years. These expanded indicators are grounded in First Nations teachings and guided by reconciliation and relationship building. This data will be disaggregated by sex (male and female). Indicators will be updated to reflect this report and data sets and will inform performance indicators as it relates to short, medium and long- term results on accessing culturally appropriate and improved health services for First Nations communities in British Columbia. ISC will work collaboratively to monitor progress and will incorporate lessons learned from tracking and reporting by monitoring the progress and working closely with Indigenous and provincial partners as progress advances. Reporting will also be built into the Governance of the FNHA and an annual report will be made available. Additional evaluations that are embedded into the existing agreements including the Memorandum of Understanding on Mental Health and Wellness evaluation will also be used (where GBA Plus data is available) to assess progress.

Purpose

ISC's Supplementary Health Benefits (also known as Non-Insured Health Benefits) Program is a national program that provides registered First Nations and recognized Inuit resident in Canada with coverage for a range of medically necessary health related goods and services which are not otherwise available through other private, provincial or territorial health plans or social programs. Program benefits include prescription and over-the-counter medications, dental and vision care, medical supplies and equipment, mental health counselling, and transportation to access medically required health services that are not available locally.

Focus Populations

Coverage under the Non-Insured Health Benefits Program is provided to all registered First Nation and recognized Inuit individuals in Canada (where not otherwise covered under a separate agreement, such as a self-government agreement). The Program contains design features to reduce barriers to access and ensure equitable coverage for all eligible clients including people with disabilities, people in rural/remote/isolated communities and the elderly.

Data Collection

Data collected by the Program can be disaggregated based on a variety of identity factors including age, gender and Indigenous distinction for analysis and reporting purposes. For example, the third generation of the Health Information and Claims Processing Services system, which came into effect in June 2020, includes "Gender X" data field as a non-binary gender identifier, allowing data to be further disaggregated. The Non-Insured Health Benefits Program continues to identify and implement policy and coverage interventions which take into consideration and/or are designed to address differential health impacts experienced by diverse NIHB clients including First Nations and Inuit women, men and gender diverse people of various age groups. These interventions are designed based on robust data, clinical evidence, and continuous policy analysis/development.

Purpose

Jordan's Principle and Inuit Child First Initiative works to minimize barriers and address gaps for eligible First Nations and Inuit children living in Canada by providing them with access to a wide range of health, education and social services they need, when they need them.

Focus Populations

The targeted populations for Jordan's Principle and the Inuit Child First Initiative are First Nations and Inuit children living in Canada who are under the age of majority in their province or territory of residence.

The initiatives take into consideration distinct community circumstances to ensure First Nations and Inuit children can access health, social and education products, services they need, regardless of where they live in Canada. Funding also supports the unique needs of children who are 2SLGBTQQIA+ and those living with disabilities. First Nations and Inuit children with disabilities benefit from the initiatives. Benefits include, but are not limited to, funding for access to psycho-educational assessments, assistive technology and electronics, and therapeutic services (i.e., occupational therapy, physiotherapy, speech therapy). Through these supports, First Nations and Inuit children with disabilities are provided the means to accessibly participate in their communities, thus eliminating some barriers to accessibility.

While the initiatives are designed primarily for First Nations and Inuit children, they also provide secondary benefits to caregivers, including parents, aunts, uncles and grandparents. Access to funding for supports like respite care can reduce stress derived from complex caregiving responsibilities and promote overall familial health.

Data Collection

Jordan's Principle and the Inuit Child First Initiative currently collects limited data to support the monitoring and reporting on the impacts to First Nations and Inuit children and youth from the lens of gender and other identify factors. Data collection during the administration process is limited to only the information elements required to adjudicate a request.

Current demographic variables that are collected include age, sex, geographic location (living on/off reserve) and chronic condition status.

Actions to be taken to enable enhanced monitoring or reporting on Jordan's Principle and Inuit Child First Initiative impacts by other gender identities and diversity will include the following measures:

1. Enhancements to the structured data collection method to enable applicants the option to select additional gender and gender identity elements, such as 2SLGBTQQIA+ identities.
2. Enhancements to existing analytic tools to monitor and report on trends observed from First Nations and Inuit children and youth applicants from a gendered and diversity lens.
3. Partnerships with Indigenous organizations that are able to collect data and evaluate trends in applicants once they've been approved for Jordan's Principle or Inuit Child First Initiative funds and the subsequent improvement/decrease of outcomes by gender.

Purpose

The Government of Canada works in partnership with provincial and territorial governments, Indigenous Peoples, and other stakeholders to address the issue of family violence.

The Family Violence Prevention Program provides funding to support access to emergency shelter services, second stage housing, and family violence prevention activities for Indigenous women, children, families, and 2SLGBTQQIA+ people across Canada, including in the North and in Urban centres.

The Pathways Initiative supports Indigenous designed interventions and Indigenous definitions of safe, secure, and resilient communities. This allows for greater community control, innovation and alternative approaches that recognize the importance of traditional knowledge and practices. It includes a role for professionals - other than law enforcement - in contributing to greater community safety and well-being.

Focus Populations

Women, children, families, and 2SLGBTQQIA+ people across Canada, including First Nations, Inuit, Métis, and urban Indigenous communities, as well as Indigenous organizations.

Data collection

In 2023-24, revisions to the Family Violence Prevention data collection instrument (DCI) will better integrate a GBA Plus lens into program reporting. These revisions will increase the effectiveness in monitoring and reporting on shelter access, transition homes, and evolution of violence prevention programming. The redeveloped DCI will integrate an intersectional approach to collect disaggregated data to further identify the unique realities and needs of First Nations, Inuit, and Métis, including 2SLGBTQQIA+, the North, and Urban Indigenous Populations. This includes collecting information specific to the region, Indigenous distinction group, and age. In doing so, the Program will be more effective and efficient in identifying needs to co-develop culturally-appropriate solutions with Indigenous partners and regional colleagues.

Pathways Initiative data will be collected via project proposals and final project report regards to target population and reach (gender, distinctions based group, 2SLGBTQQIA+ community members, etc.). Data will be reported to the extent to which Indigenous partners and those reached by projects choose to self-identify.

Purpose

There are two distinct yet complementary Child and Family Services initiatives: 1) the First Nations Child and Family Services Program, and 2) the implementation of An Act respecting First Nations, Inuit and Métis children, youth and families (the Act). They are both working towards a common goal of reforming child and family services and supporting Indigenous self-determination, but vary in scope and structure.

The First Nations Child and Family Services Program provides resources and funding to First Nations child and family services agencies, which are established, managed and controlled by First Nations and delegated by provincial authorities to support appropriate delivery of prevention and protection services to meet the needs of First Nations children, youth, and families on reserve and in the Yukon. The department supports this initiative through providing funding for the ongoing provision of culturally appropriate prevention, including early intervention, least intrusive measures, and legislated protection services to respond to children at risk of harm or maltreatment, support family preservation and well-being, including cultural and linguistic connections.

The Act affirms the inherent right of self-government, including in relation to jurisdiction over child and family services, and establishes national principles to support the delivery of Indigenous-led child and family services to Indigenous children. The Act provides a pathway for First Nations, Inuit, and Métis communities, groups and Peoples to exercise jurisdiction and provide child and family services to their children in culturally appropriate ways that best meet their self-identified needs. ISC supports this initiative by providing capacity building and engagement funding, by establishing coordination agreement discussion tables when relevant, funding the implementation of Indigenous child and family services laws, and working with provincial, territorial and Indigenous partners to support the implementation of the Act.

Focus Populations

• For First Nations Child and Family Service program: First Nation children, youth (until 26 years old) and families living on reserve or in the Yukon
• For An Act respecting First Nations, Inuit and Métis children, youth and families initiative: First Nations, Inuit and Métis children, youth, families, communities, groups and peoples that hold rights recognized and affirmed by section 35 of the Constitution Act, 1982
• Considering women and Elders are more often care providers, these initiatives could have greater direct benefits and impacts on these two sub-population

Data collection

National distinctions-based data and reporting strategies are currently being developed as part of the Indigenous child and family services reform. These strategies are clear that the ownership of relevant data need to lie with Indigenous groups. As a result, the government's ability to collect data is dependent on the relationship with partners and safeguards of the government to protect data confidentiality. Partners have specifically raised concerns over the Access to Information Act and the Privacy Act's ability to protect information shared. In developing future data collection initiatives, ISC will continue to rely on practices rooted in the co-developed principles of mutual accountability, including co-developed approaches to address gender considerations and data gaps.

Purpose

Income Assistance provides funding for eligible individuals and their families living on reserve to cover their essential daily living expenses, such as food, clothing, and shelter (rent and utilities), as well as funding for case management and pre-employment supports to reduce barriers preventing individuals from participating in education or employment opportunities. Income Assistance's main objective has been to provide the same individual rates and eligibility criteria on reserve as the reference province and Yukon income assistance programs.

Focus Populations

Grants and contributions to eligible recipients under Income Assistance are intended to provide financial assistance to First Nations low-income on-reserve residents to support their essential living expenses and to eliminate barriers of access to education and employment opportunities in alignment with the rate schedule and eligibility criteria of the reference province or territory. Income Assistance is delivered in all provinces, and the Yukon (Nunavut and the Northwest Territories deliver their own income assistance programs).

Data collection

Income Assistance's existing data collection system collects binary gender information and data that is useful in determining impacts for gender and other basic identity factors such as age, family composition, and income, but expansion of the data collection in this area will be beneficial. As Income Assistance advances co-development of reform options with First Nations partners to make Income Assistance more responsive to the needs of individuals and families and to identify the supports required to help individuals better transition from income assistance to employment and education, consideration of the program's data collection needs will be addressed. This could include both quantitative and qualitative data collection methods, determined in partnership with First Nations. GBA Plus has been flagged as an area for key consideration when the data collection instrument is reviewed with First Nations partners as part of program reform.

Additionally, Income Assistance is currently developing an IM/IT system that will be able to provide valid and timely reporting, allow for linkages to be made with other data, and better measure program effectiveness.

Purpose

Urban Programming for Indigenous Peoples (UPIP) provides financial support to a wide range of front-line urban Indigenous service delivery organizations that offer programs and services for all Indigenous Peoples (First Nations, Inuit, and Métis), and help marginalized, vulnerable and at-risk Indigenous Peoples cope, navigate and survive within what are often harsh and complex realities.

UPIP consists of five funding streams: Programs and Services, Organizational Capacity, Coalitions, Research and Innovation, and Infrastructure.

The Program also supports other initiatives such as the Indigenous Community Support Fund which continues to help Indigenous communities and organizations address needs during the COVID-19 pandemic, and the Indigenous Community Infrastructure Fund which supports urban and off-reserve Indigenous communities and organizations address infrastructure needs.

Focus Populations

UPIP's Programs and Services stream provides project funding to urban Indigenous service delivery organizations for a range of activities that support First Nations, Inuit and Métis, and that focus on six key areas: women, vulnerable populations (e.g. 2SLGBTQQIA+, seniors, homeless persons, persons with addictions and disabilities), youth, transition services, outreach programs, and community wellness.

Data collection

A GBA Plus analysis was recently completed for UPIP. The results suggest that UPIP activities help support urban Indigenous Peoples of all genders who experience challenges that are exacerbated due to their Indigenous identity, gender, sexuality, disability, and age.

In an effort to improve the collection of sufficient data, part of UPIP's co-development framework aims to create a better base of knowledge of GBA Plus data collection. For example, Indigenous identities around topics of gender and sexuality framed outside of a settler colonial context are critical to understanding the unique challenges faced by Indigenous Peoples in the Two-Spirit community. This is an attempt to take the Two-Spirit identity and greatly expand upon it in a way that better represents Indigenous identities across Canada. For example: Nádleehí (Navajo) and Winkté (Lakota) are two words used to describe Two-Spirit individuals, but are terms that may also include varying identities that do not feel represented in non-Indigenous 2SLGBTQQIA+ spaces. In doing so, UPIP aims to create aggregated data that better represents the diversity included within GBA Plus data and provide more robust disaggregated data to help narrow in on specific issues that may be overlooked in a less comprehensive analysis.

Purpose

The Elementary and Secondary Education program provides funding to support:

• Elementary and secondary education for eligible students ordinarily resident on reserve;
• Students with moderate to profound high-cost special education needs to achieve their fullest potential through access to additional direct and indirect quality and culturally-sensitive programs and services;
• Capacity development of First Nations education administration organizations, establishing partnerships between First Nations and provincial or territorial education systems, and developing and implementing transformative education models such as regional education agreements;
• The development and implementation of best practices in innovative education programs and services for First Nations students; and
• First Nations control of First Nations education and the delivery of kindergarten to grade 12 educational services for all eligible students ordinarily resident on reserve. This funding enables better quality and consistent supports for students, schools, educators, communities and First Nations education organizations – conditions that help improve student outcomes.

Focus Populations

• Eligible First Nations students ordinarily resident on reserve aged 4 and above on December 31 of the school year
• First Nations students ordinarily resident on reserve with special education needs

Data collection

To monitor and evaluate the GBA Plus impacts of Education Program supports, specific performance indicators may be disaggregated by gender and other identifying factors (e.g. age, region). The Education Reports and Analysis Solution provides the ability to report on data (by student gender) through funding recipient reporting.

Future program enhancements may lead to analysis of First Nations students over 21 pursuing a secondary diploma or equivalent disaggregated by age and sex and may support the identification of barriers to participation in education for the generation between youth and seniors and seniors or baby boom generation.

Purpose

Provides First Nations, Inuit and Métis Nation funding through the distinctions-based Post-Secondary Education Strategies to directly support eligible First Nations, Inuit and Métis Nation post-secondary students, as well was the flexibility to fund complementary programs and services and Indigenous post-secondary institutions.

Promotes collaboration between Indigenous partners, ISC, provinces, territories, and other partners.

Provides funding to support complementary targeted programming, such as the First Nations and Inuit Youth Employment Strategy.

Focus Populations

• Provides distinctions-based post-secondary education funding to increase access to and enable success in post-secondary education for First Nations, Inuit, and Métis Nation students to help close the post-secondary education attainment gaps between Indigenous and non-Indigenous Canadians.
• Provides First Nations and Inuit youth with work experience information about career options and opportunities to develop skills to help gain employment and develop careers to help close the employment gaps between First Nations, Inuit and non-Indigenous Canadian youth.

Data collection

The Department has the ability, through the Education Information System and the Education Reporting and Analysis Solution, to collect and measure the activities undertaken and results achieved through the respective First Nations, Inuit and Métis Nation Post-Secondary Education Strategies, including: the number of students (by gender, region) who receive funding and the number of funded students who graduate with a post-secondary certificate, diploma or degree (with the exception of the Inuit Post-Secondary Education Strategy).

Purpose

ISC provides funding to Community Infrastructure programs which assist First Nations to build and maintain housing, develop education facilities, provide safe drinking water, support health systems, and fund other community infrastructure projects on reserve. The goal is to improve the quality of life and the environment for First Nation communities. This helps improve and increase public infrastructure located on reserves, on Crown land and on land set aside for the use and benefit of a First Nation. These initiatives support poverty reduction, and health and well-being by improving First Nations and Inuit , governance, and control over services.

Focus Populations

All members of First Nations communities, including:

• Women and girls
• Men
• 2SLGBTQQIA+ people
• Children/ youth
• Elders
• Pregnant peoples
• Persons with disabilities
• Persons with chronic illness
• Single parents
• Persons who are displaced

Data collection

As per the Program's authorities and objective, ISC does not directly collect sex or gender-disaggregated data to analyze and assess the immediate gender impacts of ISC infrastructure investments. As a result, it is difficult to predict the differential impacts this program could have on Indigenous women, men, elders, youth, single parents, people with disabilities or 2SLGBTQQIA+ people because each community develops their infrastructure plan according to their needs and priorities.

ISC and its federal partners support and engage Indigenous organizations to collect data on vulnerable sub-populations to understand the barriers they face, identify program and service gaps, and co-develop solutions to address them. In the case of First Nations on-reserve housing, this data may help to support First Nations decision-making with respect to the needs of various populations.

The Health Facilities Program has been enhancing its pre-capital planning process. The program has begun to engage with First Nation recipients more directly on the expected outcomes associated with new health infrastructure projects, including how infrastructure improvements are expected to address current health service needs. This will allow Health Facilities Program and First Nation recipients to better identify potential GBA Plus considerations related to health infrastructure projects, and which relevant data could be collected by First Nations to track performance.

Data collection for the Health Planning, Quality Management and Systems Integration Program is limited to community and organization levels across First Nations communities. Gender and diversity data is not collected as part of this program.

To overcome these data collection challenges, the department works collaboratively with Indigenous organizations such as the First Nations Information Governance Centre. The Centre oversees the First Nations Regional Health Survey that collects self-reported information on Western and Traditional understandings of health and well-being, on reserve. Although the survey provides sex-disaggregated data that is broken down by age, the data collected via a self-reported survey and linked to perceived health outcomes. The survey does not report on perceived health outcomes related to health infrastructure. Nonetheless, survey data can help to provide important context and considerations surrounding the regional health status of First Nations, which can be used by the Health Facilities Program throughout program implementation. GBA Plus impacts will be monitored using a community-based reporting template, which was first implemented in 2008‑09, and combines performance information in a single template that recipients must report on annually to satisfy requirements set out in their Contribution agreement.

Purpose

This program works with First Nation communities to develop innovative policy, process and systems improvements to increase the reserve land base and support sustainable management of land, environment and natural resources to leverage community and economic development opportunities thereby facilitating greater First Nation independence/self-determination in managing and/or taking on jurisdiction over these assets.

Focus Populations

First Nations community members including:

• Bands/Settlements and Communities, District Councils / Chief Councils, Tribal Councils, First Nations Organizations and Associations;
• First Nation women; and
• First Nation businesses and organizations.

Data collection

Disaggregated administrative data is not currently being collected. As the current reporting relationship with Indigenous partners does not stipulate this as a requirement, ISC's limited ability to collect data due to the administrative burden on communities and partners, and its wish to respect communities' self-determination. ISC will meet with the National Aboriginal Land Managers Association to discuss options for GBA Plus data collection. GBA Plus data is collected yearly though the Federal Contaminated Sites Action Plan performance indicators. The First Nations Waste Management Initiative is currently developing GBA Plus guidelines for application to program development, delivery and implementation as well as indicators to best capture the impact of applying GBA Plus guidelines on the Initiative.

Purpose

This program supports on-reserve First Nation communities to be prepared for emergency events, including public health emergencies and climate change impacts by supporting mitigation and preparedness activities, funding immediate emergency response, assisting during the response and recovery phases, and engaging in resiliency-building within communities following an emergency event.

Focus Populations

• On-reserve First Nation communities and individuals
• Women, especially pregnant people and lone parents or caregivers (predominantly mothers)
• Children and youth
• 2SLGBTQQIA+ individuals
• The elderly
• Persons with disabilities or illnesses

Data collection

This program does not currently collect sufficient data to enable it to monitor or report on impacts based on gender or diversity. This is partly due to the fact that ISC is often not the primary service provider for First Nation communities and funds other government jurisdictions and third party service providers to provide direct emergency management services. The program is committed to work in partnership with First Nations and emergency management partners to establish comprehensive emergency management service agreements that will define monitoring and reporting components to identify and address shortcomings for continuous improvement. The program is also committed to learn from after-action reports, documents or studies produced by emergency management partners and/or experts and scholars that can inform best practices in addressing GBA Plus considerations as it relates to emergency management and evacuations. Regional offices work closely with communities to learn from their experiences and collect qualitative and quantitative information to inform future practices. Some regional offices conduct exercises to assess how certain sub-populations, such as women and children, may experience an emergency event to better inform their emergency management responses. Lessons learned are used by both regional and national offices to understand gaps in services for disproportionally impacted communities, which can then be reflected in future service arrangements.

Purpose

Indian Oil and Gas Canada's mandate is to fulfill the Crown's fiduciary and statutory obligations related to the management of oil and gas resources on First Nation lands and to further First Nation initiatives to manage and control their oil and resources such as governance.

The Strategic Partnerships Initiative (SPI) is a horizontal mechanism with 22 federal partner departments and agencies created to ensure Indigenous communities' participation in complex economic development opportunities.

The Community Opportunity Readiness Program addresses the financial needs of Indigenous communities when they are in pursuit of, and wish to participate in, an economic opportunity. The program is a consolidation of the former community economic opportunities program, the major projects investment fund, and the community-based components of the Indigenous business development program.

Focus Populations

First Nations, Inuit, and Métis communities including women, elders, youth, and individuals whose lifestyle is sustained by the land (i.e. hunters, fishers).

Data collection

The Strategic Partnerships Initiative collects a limited amount of data, in an effort to reduce the administrative burden on communities. However, the Initiative is currently looking at ways to improve our data collection, including through the introduction of new indicators (such as jobs created). Opportunities to improve data collection and collect further data, especially disaggregated data, are still being identified. While sub-program activities include the collection sufficient data on diversity (the number of First Nation and Inuit communities accessing the funding), the impacts of the funding of community-owned businesses on sub-populations of communities is not available. Indian Oil and Gas Canada's role does not provide the opportunity to collect sufficient data to enable monitoring and reporting of potential project impacts on gender or other identity factors, such as age, sexuality, income level or socio-economic status.

Indigenous Entrepreneurship and Business Development

Purpose

The Indigenous Governance and Capacity program supports First Nation and Inuit communities in the implementation of strong, effective and sustainable governments. It does this through addressing inequities in legislation and policies, and providing First Nations with predictable and flexible funding, and the autonomy to design and deliver services.

Focus Populations

• First Nations communities and the populations they serve/represent
• Inuit communities and the populations they serve/represent
• Métis Nations and the populations they serve/represent
• Indigenous communities and/or individuals on reserve, or in urban, rural, remote/isolated, Inuit Nunangat, and Northern regions

The Indigenous Governance and Capacity program provides supports for Indigenous governments. Impacted groups include First Nation and Inuit communities and the populations they serve/represent. Individuals that hold elected and administrative governance positions in communities are likely to be most impacted.

The Transformational Approach to Indigenous Data supports First Nations (on- and off-reserve), Inuit, and Métis Nations with suitable age group, gender and geographic disaggregation. Disaggregated data and Indigenous-led, distinctions-based approaches are key to GBA Plus, where the "plus" acknowledges all individuals have multiple identity factors like race, ethnicity, age, etc., which intersect to shape their outcomes and lived experiences. Indigenous Peoples have called for the Government of Canada to support Indigenous data sovereignty and to improve the visibility of Indigenous Peoples in Canada's national statistics by producing data that are culturally relevant and robust enough to be broken down along multiple (intersectional) lines.

The New Fiscal Relationship Grant benefits citizens (inclusive of gender, age, disability, sexuality and other identity factors) of all First Nations who have already moved or will move to the Grant, by providing them the flexibility to invest in and plan for services in a manner that reflects community priorities.

Election and governance frameworks support all First Nation communities that are defined as "bands" pursuant to the Indian Act and not operating within a self-government agreement. Specific considerations are provided to off-reserve members to ensure that they are able to participate in leadership selection processes.

Data Collection

The program tracks the number of requests and eligible individuals. Data is collected as part of registration activities, which can be extracted and analyzed. The Indian Registration System and Secure Certificate of Indian Status Web Application collect gender information from which the program can extract data to measure and assess the impacts on gender and diversity. As it relates to GBA Plus, the most relevant data would be age, gender at birth and province of residence as this information is provided by the individual through the registration process. Other data points would be limited. Due to known past sex-based inequities in the Indian Act, the program can use life events, such as birth and marriage, to assess how sex at birth has impacted entitlement to registration under the Indian Act. Although, individuals may choose to wait until later in life to apply for registration, they could then share their gender information.

As of December 10, 2020, individuals can select a non-binary gender identifier on the application form when applying for Indian status or a status card: M (male), F (female) or X (another gender). This will allow for more fulsome data collection on a go forward basis.

Through the National Outcome-Based Framework, which is a key component of mutual accountability in the New Fiscal Relationship, ISC would monitor socio-economic gaps between First Nations and non-Indigenous Canadians. Depending on the availability of data, the Framework, once finalized would provide disaggregated information on a variety of factors, including, gender, age, geography and income.

As the department does not currently have any processes for tracking gender identities or sexual orientation of candidates, there is currently no data to reflect the number of 2SLGBTQQIA+ candidates. At this time, the Band Governance Management System has been updated to include Two-Spirit as an option under Gender for those elected officials who choose to identify themselves as such. This will allow for a further disaggregation of data as time goes on.

Although the Transformational Approach to Indigenous Data is primarily oriented to supporting Indigenous-led data strategies and data capacity, it also includes funds to increase the visibility of Indigenous Peoples in Canada's national statistics in the more immediate term. The department has earmarked $5.6 million for 2023-24 and 2024-25 for data collection investments in support of distinctions-based (disaggregated) Indigenous data. These future investment, through Statistics Canada's survey ecosystem, will be informed by known data gaps and assessment of priority areas for indicator development. They will allow better capacity to report on impacts by gender and diversity.