1. Building a National FNHM Network Focus Group and Survey Findings

2. The potential for a national FNHM network or association was explored through the focus groups and survey. Focus group participants were asked: “How could a national network for FNHMs support you in your job?”

3. There was broad support for a national network or association to support FNHMs. A number of HMs emphasized that the network and its activities should be based at a regional level, because networking and idea-sharing is more pertinent and inclusive when conducted in smaller groups which reflect the local or regional First Nations context. One participant observed that, “[w]hen it’s called ‘national’ there is usually a huge dollar figure that really doesn’t benefit or filter down to a community level”.

4. Regarding the new FNHM website, some (but not all) participants had seen it. Comments included: “the website is a beautiful thing”; “I didn’t know how to enter – I didn’t have a username or password”; “Not all communities have the internet so newsletters are needed too”.

5. Some participants felt that annual national FNHMs conferences and forums would be useful to share ideas and learn from the collective experience. Some groups indicated that they felt the ‘focus group process’ used for this study and the interaction with their peers was a form of support and a learning experience.

6. Other ideas (in no particular order): Develop standards, ethical and best practice guidelines similar to a professional association Create a mentorship and job exchange process Develop a certification process for Health Director using developed curriculum and modules Create a network to support, share information, trouble-shoot and provide debriefing for Health Directors Play an advocacy role related to the health issues faced by First Nations, and to ensure adequate resources for Health Directors and for smaller communities Sponsor studies or research regarding: Health Director salary grids (to help communities determine what to offer a new Health Director); staff retention (especially nurses); retention, turnover and attrition rates of Health Directors; a clear description of the ‘role’ of a Health Director and the expectations for delivery of services.

7. On the survey, the question was posed like this: What types of support or services should be provided by a national network for First Nation Health Managers/Directors? (Check all that apply) □ A forum to discuss challenges and share promising practices with colleagues □ Provide accessible information resources that are relevant to your job □ Identify, develop and provide training/professional development opportunities Other: __________________________________

8. Survey results: A forum to discuss challenges and share80% promising practices with colleagues Provide accessible information resources87% that are relevant to your job Identify, develop and provide training/ 88% professional development opportunities

9. Other comments: “A framework where the network isn’t dominated by strong, politically motivated southern concerns” “Relevant to similar sized communities with similar issues” “We have very little support at community or regional level” “create awareness so people know our circumstances” “Lobby for resources and funding for FN health issues” “Some central opportunities; shared and experiential learning” “collaborative training programs with academic institutions” “opportunities to gather in person to talk, support, mentor” “have regional gatherings” “funding for training/education” “HR, recruitments and retention ideas; employments opportunities” “Form an alliance to address systemic problems with FNIH and provincial government services” “Training for chief and council regarding the importance of FN health issues”

10. Summary There was strong support for a national FNHM support network. In terms of what the network could do, the three options suggested on the survey were all very popular. Findings suggest that there needs to be a balanced approach between regional and national concerns and activities. In other words, consideration is needed to ensure that local needs are met through peer and regional processes, while not precluding the concept of national conferences and/or forums.

11. Small Groups Discussions Rank these bullets in priority, 1 being the top priority:  Create a network to support, share information, trouble- shoot and provide debriefing for FNHM; with a communications strategy to share information on all health- related information, including programs, management, HHR, etc.  Identify and provide training opportunities  Create a mentorship and/or job exchange process  Develop standards, ethical and best practices similar to a professional association.  Develop a certification process for FNHM.  Sponsor studies or research on salary grids, recruitment and retention, sample job descriptions, and other tools for FNHM.  Play an advocacy role for health issues brought forward by FNHM, and to ensure adequate resources for FNHM.