The 2009 H1N1 pandemic response in remote First Nation communities of Subarctic Ontario: barriers and improvements from a health care services perspective

Abstract

Objectives. To retrospectively examine the barriers faced and opportunities for improvement during the 2009 H1N1 pandemic response experienced by participants responsible for the delivery of health care services in 3 remote and isolated Subarctic First Nation communities of northern Ontario, Canada. Study design. A qualitative community-based participatory approach. Methods. Semi-directed interviews were conducted with adult key informants (n=13) using purposive sampling of participants representing the 3 main sectors responsible for health care services (i.e., federal health centres, provincial hospitals and Band Councils). Data were manually transcribed and coded using deductive and inductive thematic analysis. Results. Primary barriers reported were issues with overcrowding in houses, insufficient human resources and inadequate community awareness. Main areas for improvement included increasing human resources (i.e., nurses and trained health care professionals), funding for supplies and general community awareness regarding disease processes and prevention. Conclusions. Government bodies should consider focusing efforts to provide more support in terms of human resources, monies and education. In addition, various government organizations should collaborate to improve housing conditions and timely access to resources. These recommendations should be addressed in future pandemic plans, so that remote western James Bay First Nation communities of Subarctic Ontario and other similar communities can be better prepared for the next public health emergency. (Int J Circumpolar Health 2011; 70(5):564-575)

Factors influencing H1N1 vaccine behavior among Manitoba Metis in Canada: a qualitative study

“…In fact, when reflecting on the H1N1 pandemic response, similarly-styled community information sessions were also suggested by members of remote First Nations communities in Canada. They believed that such forums, even held inter-pandemically, could help to prepare community members for future public health risks and pandemic scenarios and also help educate about vaccinations [ 76 ]. These suggestions could have significant potential to help establish a better dialogue between health systems and community members, while concurrently addressing misconceptions, providing greater assurances of vaccine safety, and informing about vaccine testing and approval processes [ 64 ].…”

Cocirculating Epidemics, Chronic Health Problems, and Social Conditions in Early 20th Century Labrador and Alaska

“…The findings we have presented for the 1918 pandemic in Labrador and Alaska and those of others for the 2009 H1N1 influenza pandemic have clear implications for infectious disease planning, including distributions of economic (e.g. housing) and human resources (nurses and other trained health care professionals), and stockpiling and distribution plans for vaccines and antivirals (Charania and Tsuji ; Wenger et al. ).…”

“…The findings we have presented for the 1918 pandemic in Labrador and Alaska and those of others for the 2009 H1N1 influenza pandemic have clear implications for infectious disease planning, including distributions of economic (e.g. housing) and human resources (nurses and other trained health care professionals), and stockpiling and distribution plans for vaccines and antivirals (Charania and Tsuji 2011a;Wenger et al 2011). Programs to improve housing conditions and crowding, for example, may help reduce disease transmission in climates where a higher proportion of daily life is conducted indoors because of colder and harsher climates than elsewhere.…”

“…Air travel was not introduced into Alaska before the late 1920s and in the following decade it was expanded to include even the most remote villages (Philp and Lackman ). However, the continued remoteness and extreme isolation of many indigenous communities, a significant number of which continue to be accessible only by plane year‐round, is still a barrier to recruiting and retaining nurses and trained health care professionals and complicates access to advanced medical care (Charania and Tsuji ).…”

Communicating Risk to Aboriginal Peoples: First Nations and Metis Responses to H1N1 Risk Messages

“…While efforts were made to provide targeted communications to the Aboriginal population (i.e., through the Aboriginal People’s Television Network, translated radio announcements in local dialects, and a special information campaign through the Manitoba Metis Federation to its citizen membership), the impact of these efforts is unclear. To date, evaluations of pandemic H1N1 in Canada specific to Aboriginal people has concentrated on access and delivery issues in one remote area [45], case rates [16], [17], and how Aboriginal Canadians responded to the H1N1 vaccine [46].…”