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Ilusiliriniqmi Pigutjiutini Qimirruniq: An Overview
In 2004, a reform of the provincial Act Regarding Health and Social Services (ARHSS) requested that each region of Québec revise their service provision and create a local integrated network for wellbeing. That process was named the clinical project.
In Nunavik, this process was launched in 2009 and is called ilusiliriniqmi pigutjiutini qimirruniq. This process has three broad objectives in Nunavik:
- Strengthen or develop services identified as regional priorities by the partners
- Strengthen partnerships between local and regional organizations because social and health problems are complex and need to be addressed collectively
- Change the way the health and social services are planned in the region so that Inuit input and leadership are at the center of the designing and decision making process
In 2009, the Inuulitsivik & Ungava Tulattavik health centres identified the focus of that process in the region for the coming years: youths in difficulty, addictions and mental health service programs.
In June 2010, during the Orientation Committee of the Partners for Health and Well-Being in Nunavik, regional cross-sector partners, Inuit associations and community organizations have identified nine services to be strengthened or developed as regional priorities in regard to the three aforementioned areas.
Since the fall of 2010, several committees have been set-up to conduct research, consultations and analysis in order to draft recommendations regarding the services to improve and develop as a priority. Since then, several recommendations were completed, approved by the partners, adopted by the NRBHSS’ board of directors and funded by the Québec government. Although the NRBHSS coordinates the process, these recommendations are drafted collectively by the partners of the health and social services network actively contributing to the work of the various committees.
So far, more than 40 organizations and more than 150 individuals have been actively involved in Ilusiliriniqmi Pigutjiutini Qimirruniq. This process marks a major change in the philosophy of the health and social services network in Nunavik. The guidelines for development of the system result from a collaborative and partnership-based procedure centered on the needs and desires of Nunavimmiut.
The Orientation Committee of the Partners for Health and Well-Being in Nunavik
The service provision of the three service programs under review is broad and priorities needed to be identified quickly. It was decided to organize a regional meeting of the partners of the health and social services in Nunavik in order to collectively prioritize the services to be enhanced or developed first. This regional meeting has been named the Orientation Committee of the Partners for the Health and Well-Being in Nunavik.
Because of the complexity of the health and social situation in Nunavik, a wide array of organizations were invited to take part in the Orientation Committee. In total, 33 organizations and departments delegated more than 65 participants to the meeting that was held in Kuujjuaq from June 2nd to June 4th, 2010. One of the guiding principles in the organization of this meeting was to secure a central role for the Inuit representatives in the decision making process. For this reason, a considerable effort has been made to ensure the strong representation of Inuit associations, organizations and communities.
In preparation for the Orientation Committee, the NRBHSS conducted a scientific and government literature review as well as a broad consultation with all stakeholders affected directly or indirectly by the situation of youths, mental health and addictions. During the meeting, the three service-programs under scrutiny were looked at sequentially. For each of them, firstly, an overview of the situation was presented and discussed. Secondly, the current service supply at the time was presented and discussed in order to establish a diagnostic and identify the gaps between the services offered and the needs identified. Thirdly, the highlighted gaps were discussed and a vote was held in order to identify three services the members of the Orientation Committee wanted to improve or set-up first.
The last day of the meeting was dedicated to determining a process that would lead to the drafting of recommendations regarding the nine services identified as priorities by the Orientation Committee. A vigorous debate about the ways to properly secure significant Inuit participation in the development of recommendations ensued. At the end, although no specific process was agreed upon, it was decided that each of the organizations interested in the drafting process would have the opportunity to participate. The NRBHSS committed to shortly submit a formal proposal.
In that logic, during the fall of 2010, it was agreed by every organization that for each service-program under review, a broad regional advisory committee would be created in order to exert collective control over the final recommendations. On the advisory committee, every major stakeholder interested would be represented by a person in authority. This advisory committee would have the mandate to overview the work of smaller working committees in charge of drafting recommendations for the specific services that were prioritized during the Orientation Committee. The membership and functioning of the committees on both levels had to facilitate Inuit leadership in the reflection and decision-making process.
See Complete report: Orientation Committee of the partners for health and well-being in Nunavik