Abstract
The routine reporting of actionable statistics to improve system performance and prevent premature mortality has been promoted for decades. A key statistic produced nationally and globally is infant mortality. State governments define, collect and report vital events. In Canada, vital statistics is a provincial responsibility. The provinces, however, do not uniformly collect vital events for First Nations who are under Federal fiduciary responsibility or uniformly maintain a registration group field for disaggregation purposes. In 2008, Canada's Public Health Agency conceded that a lack of a First Nations identifier has obscured any understanding of First Nations perinatal health. Given these drivers of variability and the complex multi-jurisdictional vital statistics environments in which they occur, this paper demonstrates, using data linkage methods, a way to improve the estimation of infant mortality for the First Nations population in Manitoba, Canada. The method improved estimation, and demonstrated a persistent gap in infant mortality.