Indigenous Health

Indigenous people experience significantly higher rates of chronic and infectious diseases than the general population in Canada. For example, type 2 diabetes rates are 3 to 5 times higher in First Nations populations.


Indigenous Health Partners Program: An Integrated Health Care, Research and Knowledge Translation Initiative

In 2014, we launched our Indigenous Health Partners Program (formerly: Aboriginal Health Partners Program) in partnership with Indigenous communities to deliver innovative and culturally appropriate health solutions in some of Canada’s most remote and underserved communities. After completing a feasibility study, we affirmed that Dignitas could play a meaningful role in partnering with Indigenous organizations and communities.

We acknowledge the historical and current factors that have led to our Indigenous people to experience many challenges to their health and wellness. We support the right of Indigenous people to determine their own health needs and to have ownership of the health system that serves their communities.

Rural and remote First Nations communities in Northern Ontario experience a very high burden of diabetes, which is linked to other serious conditions. These communities face unique barriers to accessing quality health care, including limited or no road access to hospitals and specialists, inadequate numbers of community-based health care staff and a lack of culturally safe care to meet community needs.

We are partnering with the Sioux Lookout First Nations Health Authority, which provides a variety of health services to 33 largely fly-in communities. There are over 30,000 people residing in these communities, of which we estimate that up to 25% have type 2 diabetes.

We are working together to address this critical health issue by developing a program to strengthen prevention and improve care for people living with diabetes. We will specifically train and mentor community health workers (CHWs) in diabetes prevention, management and support using customized and culturally appropriate training tools. CHWs are already on the frontline of delivering community care and our aim is to provide them with the support they need to better perform this challenging role. We will utilize quality improvement methods to measure performance and foster continual learning and improved practice.

 

CHW programs have been successfully deployed around the world to address a spectrum of health needs, particularly in remote and rural communities where there is often a shortage of highly trained health workers. Community health workers are often members of the community and therefore speak the local language and possess a deeper understanding of the cultural practices and issues impacting the community. The pilot phase will take place in four remote communities: Kingfisher Lake, Kitchenuhmaykoosib Inninuwug (KI), Slate Falls and Kasabonika Lake. 

Research and Evaluation

To inform the design of our pilot, we are building a strong foundation of research evidence. In 2014, we launched two pivotal studies: a participatory study to understand the complexity of diabetes services in Sioux Lookout from the perspective of patients, providers and community members; and the development of case studies on successful community health worker programs around the world.

To date, our researchers have documented best practices from six leading international CHW programs. This information is informing the design a customized pilot program with evidence from successful programs around the world.

We will study the pilot intervention to evaluate the impact on patient experiences, health outcomes, quality of health services, community satisfaction and cultural acceptability. If successful, the program will be scaled up to the other 29 communities in the Sioux Lookout Zone and disseminated to other First Nations communities across Canada.

Knowledge Translation

The Indigenous Health Partners Program incorporates a Knowledge Translation framework.

We work with First Nations health professionals and leaders to identify health care challenges, develop and study solutions based on international best practices and local knowledge. By piloting and testing this work, we generate evidence that can be applied on a broader scale. For example, evaluation results, lessons learned and best practices from the CHW pilot will feed into an online learning platform where other First Nations communities can instantly access practical learning, including how-to guides and tools needed to build and strengthen CHW programs.

Our body of work establishes strong scientific connections between the health outcomes and health care experiences of First Nations people in Canada and other populations around the world facing a high burden of disease and unequal access to services. To support these linkages, we are developing a first of its kind multidirectional knowledge translation network that engages policymakers, researchers and practitioners from Africa, South America and Canada to exchange and generate knowledge that will improve the health and wellbeing of these populations. 

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