Summary

Tribes are sovereign nations with both the right and responsibility to protect their citizens’ health. In Indian Country, Tribal Health Organizations are the main providers of public health services. However, while Tribes have always engaged in the promotion of health and wellbeing, the formal development of separate, Tribally-operated public health systems is in its infancy. Healthcare, and public health governance, structures, and scope vary among Tribes. All Tribes have the inherent right to govern their health systems using the methods that are most relevant for their communities. Instead of promoting standardization, Tribal self-determination should be supported by partners and funders, and resources should be provided to strengthen and build Tribal public health systems.