Strengthening Policy for First Nations Self-Determination in Health
Bibliographic record
Abstract
Medical travel, where a patient travels to a larger centre for services not available in their home community, is a critical element of the Northwest Territories (NT) health care system. For residents with a valid NT health care card who do not have other coverage for medical travel, the territorial government administers some travel benefits through the NT Medical Travel Program as well as the federally funded non-insured health benefits program. The Gwich'in Tribal Council (GTC) recognizes that medical travel constitutes a major burden and presents extraordinary challenges for Gwich'in living in small remote communities in NT. In 2020, the GTC conducted research that suggests current policy and programs provide only partial access to care. Informed by Gwich'in medical travel stories and drawing from literature on the concepts of health care access, knowledge, power, and Indigenous rights, this article reframes prevailing understandings of the problems, politics, and policy associated with medical travel in NT. The authors contend that relevant and equitable medical travel in NT depends on policy-making that engages First Nations as equal partners with different levels of government and describe key considerations relevant to policymakers in NT and throughout Canada. Les déplacements pour motifs sanitaires, dans lesquels un patient se déplace vers un centre urbain plus grand pour recevoir des services non disponibles dans sa communauté, sont un élément critique du système de soins des Territoires du Nord Ouest (TNO). Le gouvernement territorial offre des aides aux déplacements pour les résidents munis d’une carte de santé valide des TNO dépourvus d’autre forme de couverture pour déplacements sanitaires, à travers le programme de déplacement sanitaire des TNO ainsi qu’à travers le programme fédéral de services de santé non assurés. Le Conseil Tribal Gwich’in (CTG) a reconnu que les déplacements sanitaires représentaient un fardeau écrasant et des défis extrêmes pour les Gwich’in vivant dans des petites communautés isolées des TNO. En 2020, le CTG a conduit une recherche montrant que les programmes et politiques actuelles ne procure qu’un accès partiel aux soins. Cet article, en se fondant sur des récits de déplacements sanitaires de Gwich’in et en utilisant la littérature sur les concepts d’accès aux soins, la connaissance, le pouvoir et les droits autochtones, propose une autre lecture des problèmes et politiques liées aux déplacements sanitaires dans les TNO. Les auteurs affirment que des déplacements sanitaires de qualité et équitables dans les TNO seront le fait d’un processus de décision engageant les Premières Nations comme partenaires à part entière avec les différents niveaux de gouvernement et ils listent les considérations clés pour les décideurs politiques aux TNO et à travers le pays.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.026 | 0.029 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.012 | 0.028 |
| Scholarly communication | 0.011 | 0.012 |
| Open science | 0.002 | 0.016 |
| Research integrity | 0.014 | 0.013 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".