The role of accounting in the delivery of health care to Canada’s Aboriginal population

• Main Author: Ufodike, Akolisa
• Other Authors: Everett, Jeffrey, Abdul-Rahaman, Abu Shiraz, Janovicek, Nancy Elizabeth Ann, Vredenburg, Harrie, Tsamenyi, Mathew, Warsame, Hussein
• Format: Doctoral or Postdoctoral Thesis
• Language: English
• Published: Graduate Studies 2017
• Subjects: Accounting; Practice theory; Schatzki; actor network theory; ANT; Latour; healthcare accounting; First Nations; Aboriginal; POOR; structure; Canada
• Online Access: http://hdl.handle.net/11023/4120; https://doi.org/10.11575/PRISM/28317

This study examines the role that accounting plays in the delivery of health care to Canada’s First Nations, relying on the Health Centre of the Paul Band as a case study. While prior studies of relations between government and First Nations have focused on power, this study explores how relationships are formed and sustained in a network of actors with divergent interests. Drawing on practice theory (Schatzki, (1996) and Actor Network Theory (Latour, 1987), I investigate how accounting functions as a control device, and the role it plays in causing and resolving tensions in the network. The study also highlights how health care actors who are employees of both Government and the health center translate expressed government strategies into practices that sometimes produce unintended consequences. The study furthers understandings of Government-First Nations relationships and shows reasons that the outcomes of First Nations health care may be sub-par despite current levels of government spending. The variation in outcomes of health care in this band compared with outcomes for non-First Nations Canadians is explained through a novel concept (Structure Vs Practice), which reveals themes common to oppressive relations faced by First Nations in Canada and other countries. In conclusion, I propose that five themes bear on the outcomes of Canada’s First Nations health care programs: funding, barriers, enforcement, compliance, and self-determination.