Reclaiming Health Systems through Peoples-Centered Approaches: Why Strengths-Based, Rights-Based, and Distinctions-Based Frameworks Matter

In health systems across Canada and beyond, there is a growing recognition that traditional biomedical models alone cannot fully meet the needs of diverse populations, particularly those who have been historically and systemically marginalized. To move toward truly equitable and just healthcare, we must adopt Peoples-Centered Approaches that are not only responsive to communities but rooted in their inherent strengths, rights, and identities. This calls for an intentional shift to strengths-based, rights-based, and distinctions-based approaches in policy, practice, education and research.

Strengths-Based: Centering Community Strengths

A strengths-based approach begins with the assumption that individuals and communities are strong, capable, and resilient — not defined by deficit, disparity, pathology, or risk. This lens shifts narratives away from what is “lacking” to what is already present and powerful within Peoples, families, and Nations. For Indigenous Peoples, whose ways of knowing, being, and doing have ensured the survival of lands, cultures, languages, and healing practices despite centuries of on-going colonial violence, a strengths-based approach is not a strategy — it is a necessity. It centres cultural reclamation, cultural resurgence, intergenerational knowledge, and collective wellness, rather than positioning communities as passive recipients of care.

Rights-Based: Advancing Health as a Human Right

Health is not a privilege — it is a right. A rights-based approach ensures that healthcare systems are accountable to human rights standards, including the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) and the Truth and Reconciliation Commission’s Calls to Action. In practice, this means confronting systemic inequities, addressing colonial power structures, and ensuring that health services uphold the dignity, autonomy, and sovereignty of all individuals. Rights-based frameworks compel institutions to shift from charitable models of inclusion to justice-oriented models of redress and accountability.

Distinctions-Based: Upholding Specificity, Not Sameness

Too often, well-meaning inclusion efforts collapse diverse identities under broad, homogenizing terms. A distinctions-based approach recognizes and respects the unique rights, histories, and governance of First Nations, Inuit, and Métis Peoples, as affirmed in national frameworks and legal obligations. This is essential in avoiding pan-Indigenous assumptions and ensuring that services are designed and delivered in partnership with, and under the leadership of, distinct Nations and communities. Distinctions-based approaches honour self-determination, enabling communities to define what care looks like on their own terms.

Toward Transformative Systems

When these three approaches are brought together, they hold the power to transform health systems from places of harm to spaces of healing and wellness. Peoples Centered systems are not reactive, they are relational, accountable, and grounded in trust. They create space for cultural safety, affirm Indigenous knowledge systems, and shift power to those most affected by healthcare decisions.

These frameworks are not optional enhancements or symbolic gestures, they are essential to delivering ethical, effective, responsible and accountable care. As we move forward, the path must be led by Indigenous communities, grounded in relationships, and built on the truths of strength, rights, and distinction. This is not innovation — it’s the overdue return to what Peoples and communities have always called for.

Kukwstsétsemc, Thank you

Nikki Rose