New review highlights gaps in care for First Nations children in Canada Sadie Harley Scientific Editor Andrew Zinin Chief Editor A new study finds that First Nations children still face long-standing inequalities in health care access in Canada despite improvements made through the application of Jordan's Principle—a policy designed to ensure First Nations children receive the services they need. The work is published in the Journal of Indigenous Social Development. Jordan's Principle was created after the tragic case of Jordan River Anderson, a First Nations child who died in the hospital while governments argued over who should pay for his home care.

The policy requires that the first government contacted pay for services right away, putting the child's needs first. While this "child-first" approach has the potential to transform care for First Nations children by improving access to services such as therapies, medical equipment, educational supports and cultural programming, many families are not benefiting fully from the program, the researchers say. In fact, they found that many children still face delays and barriers because of a lack of awareness and complex application processes.

"Jordan's Principle represents a powerful step toward fairness for First Nations children, but its impact depends on people knowing it exists and how to use it," says lead author Sarah Boudreau, a BSW graduate of Algoma University. "Without awareness, families may miss out on services that could change a child's life." Millions of services have been approved under Jordan's Principle in recent years, demonstrating its potential reach. However, the authors found that systemic barriers, such as complicated paperwork, inconsistent decisions and delays, continue to limit access.

"Even with expanded eligibility, First Nations families often face a maze of requirements that can delay care," says co-author Rose E. Cameron, an associate professor at Algoma University who is Anishinaabekwe. "We need systems that truly reflect the urgency of children's needs and reduce the burden on families." A key finding of the review is that the role of allied health professionals, including social workers, therapists, nurses and rehabilitation specialists, is critical in helping families navigate the system.

These professionals often provide the documentation required for applications and can guide families through the process. "Allied health professionals are in a unique position to connect families with vital supports," says Meghan J. Bird, a recent Master of Social Work graduate of the Factor-Inwentash Faculty of Social Work (FIFSW) at the University of Toronto.

"When they are informed and engaged, they can act as powerful advocates for children and families." Unfortunately, the researchers found that awareness of Jordan's Principle remains limited among health professionals, reducing the policy's effectiveness and contributing to ongoing inequities in access to care. "Improving training and awareness among social workers, nurses, doctors and other health professionals is essential if we want this policy to achieve its full promise," says senior author Esme Fuller-Thomson, a professor at the FIFSW and director at the University of Toronto's Institute for Life Course & Aging.