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BMC Public Health
Published in: BMC Public Health 1/2022

Open Access 01-12-2022 | Tuberculosis | Research

Exploration of inter-jurisdictional TB programming and mobility in a Canadian First Nation community

Authors: Apeksha Heendeniya Vidanaral, Richard Long, Courtney Heffernan, Sylvia Abonyi, Sherry Clarke, Paul Hackett

Published in: BMC Public Health | Issue 1/2022

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Abstract

Background

Colonially imposed jurisdictional boundaries that have little meaning to Indigenous peoples in Canada may confound tuberculosis (TB) prevention and care activities. This study explores how inter-jurisdictional mobility and the current accommodation of mobility through policies and programming sustain a regional TB epidemic in northwestern Saskatchewan, and northeastern Alberta.

Methods

A qualitative instrumental case study was performed using a community based participatory approach. Semi-structured interviews were conducted with First Nations peoples from a high-incidence community in Canada including community-based healthcare workers. These interview data are presented in the context of a multi-level document analysis of TB program guidelines.

Results

The location of the community, and related lack of access to employment, services and care, necessitates mobility across jurisdictional boundaries. There are currently no formal federal or provincial guidelines in place to accommodate highly mobile patients and clients within and across provincial TB prevention and care programs. As a result, locally developed community-based protocols, and related ad-hoc strategies ensure continuity of care.

Conclusion

Indigenous peoples living in remote communities face unique push/pull factors that motivate mobility. When these motivations exist in communities with increased risk of contagion by communicable infectious diseases such as TB, public health risks extend into increasingly large areas with competing jurisdictional authority. Such mobility poses several threats to TB elimination. We have identified a gap in TB services to systematically accommodate mobility, with specific implications for Indigenous peoples and reconciliation. We recommend clearly defined communication paths and inter-jurisdictional coordination to ensure maintenance of care for mobile populations.
Appendix
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Literature
1.
Hogan A, Jewell B, Sherrard-Smith E, Vesga J, Watson O, Whittaker C, Hamlet A, Smith J, Ainslie K, Baguelin M, Bhatt S, Boonyasiri A, Brazeau N, Cattarino L, Charles G, Cooper L, Coupland H, Cuomo-Dannenburg G, Dighe A, Hallett T. (2020). Report 19: The potential impact of the COVID-19 epidemic on HIV, TB and malaria in low- and middle-income countries. Imperial College London. https://​doi.​org/​10.​25561/​78670
2.
3.
Canadian Lung Association, Canadian Thoracic Society, Public Health Agency of Canada, & Centre for Communicable Diseases and Infection Control (Canada). (2014). Canadian tuberculosis standards.
4.
5.
Hackett P. From past to present: Understanding First Nations health patterns in a historical context. Can J Public Health. 2005;96(Suppl 1):S17-21.CrossRef
6.
7.
Wherrett GJ. (1977). The miracle of the empty beds: A history of tuberculosis in Canada. Toronto, University of Toronto Press
8.
Long R, Hoeppner V, Orr P, Ainslie M, King M, Abonyi S, Mayan M, Kunimoto D, Langlois-Klassen D, Heffernan C, Lau A, Menzies D. Marked disparity in the epidemiology of tuberculosis among Aboriginal peoples on the Canadian prairies: The challenges and opportunities. Can Respir J. 2013;20(4):223–30. https://​doi.​org/​10.​1155/​2013/​429496.CrossRef
9.
Public Health Agency of Canada. (2016). Tuberculosis in Canada 2014—Pre-release. Ottawa, Minister of Public Works and Government Services Canada
10.
11.
12.
13.
14.
15.
16.
17.
18.
Taylor J, Bell M. (Eds.). (2004). Population mobility and indigenous peoples in Australasia and North America. London, Routledge
19.
20.
21.
22.
23.
Greenwood M, De Leeuw S, Lindsay NM, Reading C. (Eds.). (2015). Determinants of indigenous peoples’ health in Canada: Beyond the social. Toronto, Canadian Scholars’ Press
24.
25.
Aspler A, Chong H, Kunimoto D, Chui L, Der E, Boffa J, Long R. Sustained intra- and inter-jurisdictional transmission of tuberculosis within a mobile, multi-ethnic social network: Lessons for tuberculosis elimination. Can J Public Health. 2010;101(3):205–9.CrossRef
26.
Long R, Heffernan C, Cardinal-Grant M, Lynn A, Sparling L, Piche D, Nokohoo M, Janvier D. Two Row Wampum, Human Rights, and the Elimination of Tuberculosis from High-Incidence Indigenous Communities. Health Hum Rights. 2019;21(1):253–65.
27.
28.
29.
30.
31.
32.
33.
Government of Alberta, Verma G, Byers B, Nguyen V, Thuha N, Chorney S, Der E, Fleischauer M, Fur R. (2014). Tuberculosis in Alberta Surveillance Report 2010–2012. Edmonton, Government of Alberta
34.
Long R, Heffernan C, Cardinal-Grant M, Lynn A, Sparling L, Piche D, Nokohoo M, Janvier D. Two Row Wampum, Human Rights, and the Elimination of Tuberculosis from High-Incidence Indigenous Communities. Health Hum Rights. 2019;21(1):253–66 JSTOR.
35.
Saskatchewan Health Authority. Saskatchewan TB Program Worker Handbook. 2015.
36.
37.
Saskatchewan Health Authority. TB Prevention and Control Saskatchewan Clinical Policies and Procedures. 2018.
38.
39.
40.
41.
42.
43.
Metadata
Title
Exploration of inter-jurisdictional TB programming and mobility in a Canadian First Nation community
Authors
Apeksha Heendeniya Vidanaral
Richard Long
Courtney Heffernan
Sylvia Abonyi
Sherry Clarke
Paul Hackett
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2022
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-022-14756-8

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