Collaborative Data Governance to Support First Nations-Led Overdose Surveillance and Data Analysis in British Columbia, Canada

First Nations Peoples in the province of British Columbia (BC), Canada, have been disproportionately affected by the overdose crisis. In 2016, a public health emergency was declared by BC’s Provincial Health Officer (PHO) in response to the significant rise in opioid-related overdose deaths reported in BC. New surveillance systems were required to identify trends in overdose events and related deaths in the province as a whole, and for First Nations Peoples. Data sharing and analysis processes that adhered to the principles of OCAP® (ownership, control, access, and possession), and to the Truth and Reconciliation Commission of Canada’s Calls to Action, needed to be developed. The First Nations Health Authority (FNHA), BC Centre for Disease Control, PHO, and the BC Ministry of Health have worked collaboratively to facilitate identification of First Nations persons in surveillance data for appropriate analysis by FNHA. This paper outlines the data stewardship and governance context, principles, and operational considerations for creating overdose surveillance systems to measure overdose events among First Nations Peoples in BC.