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


METHODS
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.
Department of Environment and Resource Studies, University of Waterloo, Waterloo, ON N2L 3G1, Canada. ncharani@uwaterloo.ca
Nadia A
NA
Charania
Leonard J S
LJ
Tsuji
D000328:Adult; D001291:Attitude of Health Personnel; D002391:Catchment Area, Health; D035082:Federal Government; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control; D033181:Information Dissemination; D008297:Male; D008507:Medically Underserved Area; D008875:Middle Aged; D009864:Ontario; D058873:Pandemics / Q000517:prevention & control* / Q000706:statistics & numerical data; D010342:Patient Acceptance of Health Care / Q000208:ethnology; D011369:Professional-Patient Relations; D012189:Retrospective Studies; D019035:Rural Health Services / Q000458:organization & administration*