An effective health and social services governance

The First Nations in Quebec collectively decided to opt for an effective governance approach that will enable them to achieve the collective goal of improving First Nations wellness. Effective governance focuses on achieving results in order to evaluate all policies resulting from regulatory and intervention processes. To be effective, governance must involve all social players in the mode of governance and thus allow a better understanding of the achievement of objectives.


During the regional meetings in 2016 and 2017, First Nations were called upon to define the mechanisms and structures that will guide the planning, support and decision-making in the areas of health and wellness. After examining the current situation in connection with the responsibilities, First Nations identified the changes they sought and established four series of guidelines that served to develop an effective health and social services governance model.

A total of 57 guidelines were established in four areas :

  • Health and social services planning;
  • Health and social services support;
  • Health and social services decision-making and accountability;
  • Health and social services directors network.

During the regional meeting in November 2017, an effective governance model, developed using the suggestions and guidelines made, was proposed and adopted by the attendees.

Quebec First Nations' governance model

The proposed model comprises local governance, regional governance and the Tripartite Agreement, which itself consists of the four components of effective governance: authority, stakeholders involvement, regulation and intervention. The validation of the effective governance model by First Nations marked the transition between the second and third phases of the governance process, whose purpose is the finalization of this new model.

Quebec First Nations' governance model

In order to promote a common and in-depth understanding of the model, a more detailed representation of the model has been made:

New health and wellness governance model​