背景:有据可查,加拿大的医疗保健不能完全满足原住民的健康需求,因纽特人或梅蒂斯人。1996年,皇家土著人民委员会得出结论,必须通过土著世界观和文化中出现的战略和系统来满足土著人民的医疗保健需求。2015年,真相与和解委员会还呼吁卫生组织向土著“知识”学习,并将土著世界观与生物医学和其他西方知识方式相结合。这些电话尚未得到满足。同时,对社区内知识和证据的组织学习动态知之甚少,特别是当学习来自社区时,社区的知识方式与组织不同。通过对组织和卫生系统学习的探索,本研究将探讨组织如何从他们所服务的土著社区学习,并以特权土著知识和知识方式的方式(重新)概念化学习型组织和学习卫生系统。
方法:本研究将采用双眼观察文献综述和嵌入多案例研究。审查,基于土著和西方审查和综合知识的方法,将告知了解卫生系统从不同的知识方式学习。多重案例研究将研究西北地区三个不同政府组织的学习情况,加拿大北部的一个司法管辖区,具有支持社区健康和保健的作用:TVE政府,Gwich\'在部落委员会,西北地区政府。案例研究数据将通过访谈收集,会说话的圈子,文件分析。一个指导小组,由长老们和三个伙伴组织的代表组成,将指导项目的各个方面。
结论:检查造成健康差异的系统是加拿大医疗保健的当务之急。作为回应,这项研究将有助于确定和理解组织学习和尊重应用土著社区内持有的知识和证据的方式,以便支持他们的健康和健康。这样,这项研究将有助于指导健康组织在倾听和学习方面做出贡献,以促进医疗保健中的和解。
BACKGROUND: It is well documented that Canadian healthcare does not fully meet the health needs of First Nations, Inuit or Métis peoples. In 1996, the Royal Commission on Aboriginal Peoples concluded that Indigenous peoples\' healthcare needs had to be met by strategies and systems that emerged from Indigenous worldviews and cultures. In 2015, the Truth and Reconciliation Commission also called on health organizations to learn from Indigenous \"knowledges\" and integrate Indigenous worldviews alongside biomedicine and other western ways of knowing. These calls have not yet been met. Meanwhile, the dynamic of organizational learning from knowledges and
evidence within communities is poorly understood-particularly when learning is from communities whose ways of knowing differ from those of the organization. Through an exploration of organizational and health system learning, this study will explore how organizations learn from the Indigenous communities they serve and contribute to (re-)conceptualizing the learning organization and learning health system in a way that privileges Indigenous knowledges and ways of knowing.
METHODS: This study will employ a two-eyed seeing literature review and embedded multiple
case study. The review, based on Indigenous and western approaches to reviewing and synthesizing knowledges, will inform understanding of health system learning from different ways of knowing. The multiple
case study will examine learning by three distinct government organizations in Northwest Territories, a jurisdiction in northern Canada, that have roles to support community health and wellness: Tłı̨chǫ Government, Gwich\'in Tribal Council, and Government of Northwest Territories.
Case study data will be collected via interviews, talking circles, and document analysis. A steering group, comprising Tłı̨chǫ and Gwich\'in Elders and representatives from each of the three partner organizations, will guide all aspects of the project.
CONCLUSIONS: Examining systems that create health disparities is an imperative for Canadian healthcare. In response, this study will help to identify and understand ways for organizations to learn from and respectfully apply knowledges and
evidence held within Indigenous communities so that their health and wellness are supported. In this way, this study will help to guide health organizations in the listening and learning that is required to contribute to reconciliation in healthcare.