| Summary: | Abstract Introduction The current health status among Aboriginal people in Canada is lower than the health status of Canadians generally, and has been for many decades. Much of this disparity may be attributed to differences in lifestyle, environment, social determinants and historical factors, but another factor at play may be differences in access to health care programs and services. The manners in which Aboriginals access health care resources, as well as the format of these resources, therefore influence their health status. In recent years, there has been a shift in beliefs about how health care ought to be delivered and managed in order to achieve the best possible health outcomes, which has in turn led to a shift in the governance of health care. This paper attempts to determine the effects of this shift in governance models on health outcomes in Aboriginal communities in Canada. introduced the Indian Health Transfer Policy in 1988, allowing the responsibility for the delivery, management, and governance of health care to be transferred from the federal government to First Nations communities. This paper will first review the theoretical framework for decentralization in which the policy is grounded, and then move to examine the policy"s implementation over time. In the third section, the paper will analyze the implications and outcomes of the policy; the fourth section will finish by critically assessing the three main gaps in health care the policy fails to address. Though I make it clear in this article that the data necessary to specifically link governance models of health care to health status is lacking, my objective is to determine if the current transfer policy leads, as intended, to stronger health outcomes among Canada"s First Nations population.
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