The Manitoba First Nations Diabetes Strategy:

A Call to Action – Executive Summary

The Manitoba First Nations Diabetes Strategy: A Call to Action was developed by representatives from First Nation communities and Tribal Councils at the request of the Assembly of Manitoba Chiefs. The document was created to assist First Nation communities in developing community-based diabetes implementation plans and initiatives. It is the aim of the strategy to identify needs and use the existing strengths to deal with diabetes in Manitoba First Nation communities. The strategy identifies priority areas and actions needed at the community, tribal council and regional levels to address this public health epidemic.

The strategy has five main components:

  1. Prevention and Education – this section deals mostly with primary prevention of diabetes within First Nation communities. It also includes human resource training needs required for community-based workers.
  2. Care and Support – This portion addresses the care and support of those First Nation community members and their families affected by diabetes. This section also addresses secondary and tertiary prevention.
  3. Gestational Diabetes – Though many of the methods required to help address gestational diabetes are discussed throughout the diabetes strategy, this form of diabetes that affects both mother and child requires its own category. Issues surrounding this prevalent and serious condition are discussed in this section.
  4. Surveillance, Research, and Evaluation – Surveillance monitors the proportion of diabetes in the population, and helps to identify those at risk. Research is the information gathered regarding the many issues surrounding diabetes and its complications. Finally, evaluation concentrates on measuring the effectiveness of planning and actions.
  5. Policy and Infrastructure – This section talks about the organizational infrastructure necessary to deal with diabetes at the community, tribal council and regional levels.

There are many overlaps in each of these components. Research is often surveillance, and surveillance is often evaluation, and vice-versa. Furthermore, many of the goals and actions recommended are only possible if the policies and infrastructures are in place. However, each component is explained in a manner which it can be reviewed and understood independently. This has lead to repetition of some of the recommended actions from related issues.

The strategy was assembled by the Manitoba First Nations Diabetes Committee (MFNDC), a group formed in early 1999 consisting of representatives from each tribal council and non-affiliated First Nations. These individuals were chosen by the Health Directors to represent their First Nation communities’ interests relating to diabetes. In April, the group was asked by the Assembly of Manitoba Chiefs to create this strategy, and to identify the needs within the communities and how to address them. In July, AMC passed a mandate for the MFNDC to develop a diabetes strategic plan. After several meetings and much preparation, a draft form of the strategy was completed. The draft was sent out to the First Nation communities for their comments and input on the goals and recommendations. This was an important consultation process to allow those involved at the community level to confirm the needs and priorities set forth.

There have been other strategies put forth on diabetes with Manitoba First Nations mentioned in part. Manitoba Health was published and widely distributed their document entitled ‘Diabetes: A Manitoba Strategy”. A draft strategy has been completed by Health Canada, Assembly of First Nations, and several Aboriginal and Inuit organizations “Background Paper for the Development of a National Aboriginal (First Nations, Inuit, and Métis) Diabetes Strategy: Report of the Working Group”. It was recognized by AMC and the MFNDC that these strategies do not specifically speak for, or put to the forefront the needs of Manitoba First Nations people. With representation from most of First Nations in Manitoba, the Manitoba First Nation Diabetes Strategy focuses on the challenges posed by the diabetes epidemic.

This strategy was developed as a tool for primarily Manitoba First Nations communities. In order for this strategy to be successful, the actions suggested must be tailored to the communities’ needs and carried out at the community level. There must be education for all community members involved in the planning and implementation of these endeavors, and efforts must involve all community staff in an inter-sectoral team approach. Evaluation will also be a vital link to ensure ongoing successful community programming, and will help assure that the Manitoba First Nation Diabetes Strategy itself is successful.

Given the serious projections for increasing numbers of people with diabetes in First Nations, the recommendations in this strategy are a call to action to make positive change for the future. First Nations are facing a crisis in diabetes, therefore control is essential. The goal is physical, emotional, spiritual and mental health to foster a strong vibrant nation for many generations to come.

For the full Manitoba First Nations Diabetes Strategy “A Call to Action” go to Manitoba ADI orientation manual and click on Appendix 3.