Recap – Navigating Complexities: Indigenous health, public policy, and intergovernmental collaboration - Dahdaleh Institute for Global Health Research

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Published on April 24, 2026

On Wednesday, April 1, Dr. Sandra Romain, Medical Anthropologist and senior policy leader in the Government of Canada, led a lecture on navigating the complexities of Indigenous health, public policy, and intergovernmental collaboration.

Dr. Romain began with an introduction to medical anthropology, including key elements of interpretive, critical, and ecological approaches. In addition, Dr. Romain discussed the integral need to understand positionality as it influences how individuals navigate and perceive systems.

Subsequently, Dr. Romain explained why understanding jurisdiction matters in global health, as it influences who is responsible for access, quality, continuity of care and clarity of roles. If these roles are unclear, it can contribute directly to gaps, delays, service fragmentation, and policy disputes.

Next, Dr. Romain discussed how poor health outcomes are the result of systemic, jurisdictional, and policy choices reflecting power and influence. Thus, jurisdiction also influences the rights of groups, which requires researchers to think critically on governance structures and equity-deserving groups, and the importance of a strengths-based perspective.

Further, Dr. Romain discussed the influence of jurisdiction on intergovernmental collaboration, engagement & governance, and policy implementation. Dr. Romain highlighted how Indigenous jurisdictional considerations can help to build conceptual tools and models of innovation that are applicable across global health systems, such as decentralization, sovereignty, and land-based healing.

Ultimately, research is political and can be an act of advocacy, whether it be through funding, methodology, quality of data or data sovereignty. Jurisdictional complexity can be attributed to a variety of elements and Dr. Romain discussed how understanding these complexities are important for researchers. For instance, this includes the recognition of the role of right-holders and acknowledgment of colonial systems.

To conclude, Dr. Romain discussed the impacts of her research, which looked at the policy versus practice through a community-based qualitative study of the realities of pharmacy services in Nunavut, Canada. Dr. Romain also proposed a toolkit for navigating jurisdictional complexity, as seen below.