Charania Nadia A, Tsuji Leonard J S
Department of Environment and Resource Studies, University of Waterloo, Waterloo, ON N2L 3G1, Canada.
Int J Circumpolar Health. 2011;70(5):564-75. doi: 10.3402/ijch.v70i5.17849. Epub 2011 Oct 26.
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.
A qualitative community-based participatory approach.
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.
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.
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.
回顾性研究2009年甲型H1N1流感大流行应对期间，加拿大安大略省北部3个偏远且与世隔绝的亚北极地区原住民社区中负责提供医疗服务的参与者所面临的障碍及改进机会。
基于社区的定性参与式方法。
采用目的抽样法，对代表负责医疗服务的3个主要部门（即联邦医疗中心、省级医院和部落理事会）的成年关键信息提供者（n = 13）进行半定向访谈。数据通过演绎和归纳主题分析进行人工转录和编码。
报告的主要障碍包括房屋过度拥挤、人力资源不足和社区意识淡薄。主要改进领域包括增加人力资源（即护士和训练有素的医疗专业人员）、物资供应资金以及提高社区对疾病过程和预防的总体认识。
政府机构应考虑集中精力在人力资源、资金和教育方面提供更多支持。此外，各政府组织应合作改善住房条件并及时获取资源。这些建议应在未来的大流行计划中得到解决，以便安大略省亚北极地区西部詹姆斯湾偏远原住民社区和其他类似社区能为下一次公共卫生紧急情况做好更充分准备。
