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The purpose of this paper is to present a study of the transformation of First Nations’ health governance, describing the development of partnerships between First Nations and provincial and federal governments for co-creating solutions to address First Nations’ health inequities in British Columbia (BC). The paper frames this transformation in the context of a Canada-wide reconciliation initiative stimulated by the Truth and Reconciliation Commission.

This qualitative case study was a joint initiative between Simon Fraser University and the BC First Nations Health Authority (FNHA), involving interviews with senior leaders within the BC health system, FNHA and First Nations communities. In addition, a policy roundtable was held in February 2015 which gathered 60 participants for further dialogue on the process.

Key themes included: partnership and relationships, governance and reciprocal accountability, First Nations perspectives on health and wellness, and quality and cultural safety. Findings indicate that significant transformational changes have happened in the relationship between First Nations and the mainstream health system. The creation of the FNHA has led to more representation for First Nations people at all levels of governance and health service planning, which will ultimately lead to more culturally safe health services that incorporate a First Nations perspective of wellness.

The transformation of First Nations health governance in BC can serve as an example in other indigenous health settings both within Canada and internationally.

This paper describes a transformative health governance process in First Nations communities that is an historical first in Canada.

This article starts from the theoretical assumption that successful multicultural integration of immigrants and ethnic minorities is critically dependent on providing them with opportunities to engage in public debate and in policy‐making. Empowering cultural groups is important in particular to the traditionally vulnerable individuals in these groups, such as women. The argument is applied to Canada, a country whose turn to multicultural policies and an accompanying ethos of appreciating cultural diversity have created new opportunities for immigrant and minority groups to advocate for a pluri‐cultural opening of the health care system. These opportunities can be found in state‐monitored forms of community outreach and partial inclusion in the policy process, as well as in grassroots initiatives from immigrant or minority associations or professional networks. Promoting cultural diversity in the Canadian health care sector and empowering minorities in the system are depicted as challenging and, in spite of considerable progress over the last decade, successful primarily with respect to some exemplary practices and initiatives. Examples are drawn from the complex political fight of women with an immigrant or minority background for inclusion, diversity and social justice in the health care system.