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Addressing rural and Indigenous health inequities in Canada through accountable health partnerships

BMJ Open
Authors: Ray Markham, Megan Hunt, Robert Woollard, Nelly Oelke, David Snadden, Roger Strasser, Georgia Betkus, Scott Graham
Publication Date: November 2021


There are few examples of the practical application of the concepts of social accountability, as defined by the World Bank and World Health Organization, to health system change. This paper describes a robust approach led by First Nations Health Authority and the Rural Coordination Centre of British Columbia…Our innovative approach uses social accountability engagement to counteract persistent health inequities. This involves an adaptation of the Boelen Health Partnership model (policymakers, health administrators, health professionals, academics and community members) extended by addition of linked sectors (e.g., industry and not-for-profits) to the ‘Partnership Pentagram Plus’. We used appreciative inquiry and deliberative dialogue focused on the rural scale and integrating Indigenous ways of knowing along with western scientific traditions (‘two-eyed seeing’)…to bring about practical and positive change to rural and Indigenous communities.

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