COVID-19 Pandemic Responses and Programs in Canada’s Northern and Indigenous Communities: Understanding Implementation and Implications

• Author / Creator

  Fleury, Katherine, E.A.

• The quick onset of COVID-19 left countries and communities worldwide in need of emergency management procedures. Analysis from previous pandemics, such as H1N1, showed that blanket approaches to health policy and public health messaging were not effective for Indigenous groups in Canada; rather, community-level voices needed to be integrated (Driedger et al., 2013). The Canadian Institute of Health Research (CIHR)’s Institute of Health Services and Policy Research (IHSPR) and local leaders in regional health authorities identified the need to document and compare health policy responses to COVID-19. The need to compare responses in Northern and Indigenous zones was deemed a priority as health systems in these areas have unique features to which they must adapt, including remote geographies and Indigenous values. Therefore, the purpose of this work was to describe and summarize the changes to health policy and programming in Canada’s northern and Indigenous regions that were implemented in response to the pandemic, as well as the impact living with restrictions had on community members.
  A sequential mixed methods research (MMR) project was consequently developed. This method was chosen as sequential mixed designs allow for the procedures from the later objective to build off the former. Therefore, the purpose of the mixed methods approach was for both complementarity and development, as defined by (Greene et al., 1989). Using MMR in this way increased the validity and interpretability of the results. While typically reserved for projects which combine both qualitative and quantitative data, MMR can be used within one field exclusively (Mayan, 2009). In this project, qualitative data generation strategies were used.
   
  First, a scoping review of grey literature was conducted to better understand health policy and program responses in Canada’s north. This project focused on the 18 northern health regions defined by Young et al. (2019). The review looked at policy and program adaptations relating to preventing viral transmission, ensuring workforce capacity, providing health services effectively, health financing, economic protections, and other measures. It was found that all regions, with the exceptions of Region du Saguenay-Lac-Saint-Jean, Région de la Côte-Nord, and Région du Nord-du-Québec, had pandemic responses adapted for Indigenous populations. The Indigenous populations within these three regions were 5, 16, and 6 percent, respectively.
  Following the scoping review, a case study approach was used to evaluate health policies and programs for their potential impacts on community members in the community of Behchokǫ̀, which is based in the Tłı̨chǫ̨ region of the Northwest Territories (NWT). This project involved in-depth, semi-structured interviews with Elders, community members, and local Tłı̨chǫ policy and health care service delivery staff. Audio-recorded interviews were transcribed and analyzed to understand how community members felt about pandemic responses, including restrictions and new programs that were developed, how involved the Tłı̨chǫ̨ government (TG) and the Tłı̨chǫ̨ Community Service Agency (TCSA) were in the planning of the pandemic response, and what participants felt would serve their community better in the future when it comes to emergency preparedness. Latent content analysis revealed three themes, including:

  1. Uncertainty in the uptake of public health restrictions and implemented programs
  2. A discrepancy between national and territorial health policy and Tłı̨chǫ̨ way of life
  3. The strength of community connection and knowledge

  Future studies evaluating program effectiveness will prove vital for the development of emergency preparedness procedures. Zoonotic diseases comprise an estimated 60% of emerging human infections and are influenced by factors including climate change and urbanization (Rahman et al., 2020). With more public health crises on the horizon, being prepared to employ effective emergency management strategies early will mitigate disastrous effects. COVID-19 responses can act as a case study to evaluate what kept communities safe, evaluated from local, regional, and national perspectives. Current policy development has utilized a top-down approach, with implementation having been altered to ensure cultural relevancy. Moving forward, we must ensure that traditions are acknowledged and respected as health policies and programs are developed.

• Subjects / Keywords

  • COVID-19 response
  • Indigenous Health Policy
  • Emergency Management
  • Tłı̨chǫ
  • Northern Health

• Graduation date

  Fall 2021

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/r3-xpws-yt06

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.