Reconciliation in Practice: How First Nations Health Directors Enact the TRC Calls to Action Through Everyday Health Leadership in British Columbia

Since the transfer of federal health programs to the First Nations Health Authority (FNHA) in 2013, First Nations Health Directors have played a central role within British Columbia’s evolving health governance landscape. Health Directors are community health leads who oversee programs and service development in First Nations health centres and work with health partners to address community health needs. This mixed-methods study draws on a province-wide survey of Health Directors and five sharing circles to examine how Health Directors engage in reconciliation work through their everyday decision-making and relationship-building. Findings demonstrate that this daily community and governance related work contributes to incremental shifts that drive long-term system change, while persistent funding constraints, workload-related burnout, and anti-First Nations racism continue to shape and constrain these efforts.