KEYWORDS:
American Indian, Alaska Native, Immunizations

BACKGROUND:
The provision of health care to American Indians/Alaska Natives (AI/AN) is an important issue for most states. According to the 2000 Census, forty of the US states have an AI/AN population of at least 10,000; the Indian Health Service (IHS) and tribal programs provide health care to AI/AN in 35 states. The health care system serving this population is complex, with IHS, individual tribes and states involved in the delivery of primary health care services such as immunizations.

OBJECTIVE(S):
The objectives of this presentation are to: 1. provide an overview of the sources of health care for AI/AN and the complex relationships among the federal government, tribes and states; 2. provide an update on current childhood immunization coverage rates for AI/AN; 3. outline current immunization activities in Indian country ; 4. discuss challenges in the delivery and monitoring of immunization services to AI/AN populations; and 5. discuss resources, opportunities and strategies to address these challenges.

METHOD(S):
An overview of the health care delivery system and immunization activities and coverage in Indian country will be provided.

RESULT(S):
A description of immunization activities and coverage levels in AI/AN communities will be presented.

CONCLUSIONS(S):
An understanding of the issues related to the provision of health care to AI/AN communities is important to ensure that immunization programs serving AI/AN communities receive support from federal, state and local immunization programs.

LEARNING OBJECTIVES:
Participants will be able to:
1. Understand sources of health care for AI/AN
2. Understand the concept of Tribal Sovereignty and the role this plays in federal, state and tribal relationships.
3. Understand the challenges to the delivery and monitoring of immunization services in AI/AN communities
4. Identify resources to develop strategies to address these challenges and improve the delivery and monitoring of immunization services to AI/AN communities.