EXECUTIVE SUMMARY

PURPOSE

The National Indian Health Board developed the Tribal Prenatal-to-Three Policy Agenda to raise
awareness regarding the most impactful and culturally appropriate policy levers and strategies
to support American Indian and Alaska Native (AI/AN) health and wellbeing in the earliest years
of life, from the prenatal period through age 3. These recommendations chart a path forward to
health equity and improved outcomes for AI/AN families, infants, and toddlers.

CONTEXT AND PERSPECTIVE
Several core principles and values guided the development of this policy agenda, including
ensuring that the resulting resources and recommendations:

• Honor Tribal sovereignty
• Build on a variety of knowledge sources, including lived experience, Indigenous knowledges,
  academic literature, and others
• Take a holistic, intergenerational, and strengths-based approach
• Reflect Indigenous perspectives and uses the Indigenous Determinants of Health as a
  guiding framework

Taking a collaborative approach to policy, NIHB conducted a series of interviews, roundtables,
document reviews, and Tribal listening sessions to gather input, recommendations, wisdom,
and expertise from Tribes across the country and Tribal subject matter experts in a wide range
of critical disciplines. We have made every effort to ensure the following recommendations are
truly Tribally led and authentically reflect the priorities, perspectives, and needs of Indian
Country. At the same time, we acknowledge that AI/AN communities across the country are
diverse and face wide-ranging circumstances, in addition to a continually evolving policy
landscape. Therefore, this policy agenda is not the final word on any of these topics, but
instead represents a robust starting point for equitable and effective policymaking.