IntroductionFirst Nation peoples (FNs) were unable to track their own health care trends due to limitations in datasets. The key linked file enables FNs to identify themselves within administrative datasets and work with Crown governments to bring equity in all services and departments to support FNs understanding of wellness.
 Objectives and ApproachFirst Nations Health and Social Secretariat of Manitoba (FNHSSM) was established by 2013 resolution of Assembly of Manitoba Chiefs (AMC) and incorporated in 2014. FNHSSM leads and supports research according to FNs criteria approved by the Chiefs in Assembly. Information Sharing Agreements (ISA) have been developed with federal and provincial governments to mandate the processes for data linkage. The ISA allows Indian Status Register (ISR) data of Department of Indigenous Services Canada (DISC) to be transferred to FNHSSM to provide oversight, and link to Provincial Personal Health Information Numbers (PHINs) to create the de-identified, scrambled, and encrypted Key Linked file.
 ResultsPrevious linkages were done in early 2000s with FNs approval and oversight. The 2018 linkage is the first time that ISAs have been formally d
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