Quebec First Nations Health and Social
Services Governance Process:
A renewed approach to governance
fostering self-determination

First Nations in Quebec have noted for many years that the current health and social services system does not adequately meet their realities and needs. Initiated in 2013, the Quebec First Nations health and social services governance process stems from this observation made by First Nations regarding the need to renew the current governance structure.

Thus, the health and social services governance process aims to develop and support the autonomy of First Nations communities and organizations in a perspective of self-determination and improvement of their wellness. At the end of this process, the First Nations will have collectively built a new model of effective governance by and for First Nations that relies on a co-construction approach that is supported by environmental analysis and they will have worked towards its implementation.

More specifically, the process has two objectives:

- Build the local and regional decision-making capacity of First Nations communities and organizations with respect to the governance of health and social services in terms of existing programs, sectors and initiatives.

- Renew the partnerships between First Nations and government institutions, in accordance with a model of governance adapted to the needs and realities of First Nations in order to improve the service offer and access to services at the local and regional levels.


In February 2014, the Chiefs of the Assembly of First Nations Quebec-Labrador adopted a vision statement to guide the entire health and social services governance process:

“Through our self-determination, a global and concerted approach, individual and collective commitment, we will be healthy people connected to Mother Earth and our physical, mental, emotional and spiritual well-being will be balanced.”


We affirm that our ceremonies, values, languages, teachings and traditional medicines, are an integral part of our way of living healthy life.

We affirm that the First Nations healing journey will be strengthened when considering the person and the environment as a whole.

We affirm that the social determinants of health to First Nations are unavoidable to address health issues.

We affirm our right to self-determination and our inherent right to have and to freely pursue our own health, economic, social and cultural development.

We affirm that the ten Nations are responsible for First Nations health.

We affirm that responsibilities of the local and regional institutions are to manage, protect and enhance health and social services programs according to the mandates they received from Nations and First Nations communities.

We affirm that our regional institution supports First Nations in their autonomy quest in supporting strategic alliance building between First Nations with governments in their organisation of health care and services, development of expertise as well as knowledge transfer.

We affirm that the federal government has a legal and fiduciary duty and constitutional responsibility to provide adequate, sufficient and sustainable financial resources for the development, implementation, management and delivery of quality health programs and services that respond to our needs and taking into account the determinants of health.


  • Honesty
  • Respect
  • Autonomy
  • Community
  • Solidarity
  • Assistance

 “The status quo is no longer acceptable…the time has come to start making, together and collaboratively, the changes that will allow us to turn the table and make sure that the health and quality of life of First Nations changes radically.”

- Ghislain Picard, regional chief of the AFNQL

Process coordination

Since 2014, as per a motion adopted by the AFNQL Chiefs, the FNQLHSSC coordinates the governance process. Its role essentially consists in ensuring the participation of all communities and organizations so that the health and social services effective governance model is adapted to the needs and realities of First Nations in Quebec. 

The process is being carried out in collaboration with First Nations communities and organizations. Various mechanisms were implemented to ensure everyone’s involvement such as regional meetings, advisory committees and community visits.

Committees set up

In order to support and fuel the reflection of First Nations, several committees have been created to bring different sets of expertise to the table and help collect the necessary information and knowledge to develop the relevant governance model. 

Monitoring Committee 

This committee monitors the operational and logistical aspects of the project. Its role is to monitor the content and quality of documents that are produced and to ensure respect of deadlines and costs. 

Chiefs’ Advisory Committee

The objective of this committee is to look at the political concerns. Seeing that the Chiefs’ Assembly is a key regional authority, it is necessary to maintain an important link with it to ensure that account is taken of the Chiefs’ concerns.

Committee of Partners

It is imperative to mobilize the stakeholders to ensure productive collaboration. Each partner has an important role to play in carrying out this project and it is necessary to maintain productive exchanges as well as a quality communication link for allowing activities to be effectively carried out.