Indigenous women face unique challenges during pregnancy/birth-related medical travel due to systemic barriers, cultural differences, and geographic isolation. In Canada, Indigenous women frequently travel substantial distances for pregnancy care and birth. Many pregnant women in Northwest Territories (NWT) are mandated to travel to urban centres with secondary/tertiary hospitals between 36-38-weeks gestation. What are the experiences of Indigenous women in NWT regarding pregnancy and birth-related medical travel? How do cultural and community-specific, culturally informed, and accessible healthcare practices influence the experiences of Indigenous women during pregnancy-related medical travel? Across three NWT communities, 156 self-identifying Indigenous women who were pregnant or who had given birth in the previous three years completed a semi-structured interviewer-administered questionnaire. Qualitative data were analyzed using reflexive thematic analysis in NVivo. Of the 55 women who travelled for pregnancy care, 68.5 % felt prepared for medical travel and 57.4 % had a positive experience. Of the 52 women who travelled for birth, the mean length of stay after birth was 11 days (ranges from 1 to 90 days), with 63.5 % staying ≤ one week. Travel experiences, experiences with prenatal care and childbirth, and suggestions for improvement. The experiences involved loneliness, nervousness, logistical challenges, and communication and resource issues. Suggestions included improving cultural competency, expanding community healthcare, and incorporating Elder knowledge sharing. While many women reported positive experiences, improvements in medical travel and care access are needed to guide Indigenous maternal healthcare policy and planning.

Social determinants of health (SDHs) and the impact of colonization can make Canadian Arctic Indigenous communities susceptible to infectious diseases, including the coronavirus disease 2019 (COVID-19). This scoping review followed the PRISMA guidelines for scoping reviews and studied what is known about selected pandemics (COVID-19, tuberculosis, and H1N1 influenza) and SDHs (healthcare accessibility, food insecurity, mental health, cultural continuity, housing, community infrastructure, and socioeconomic status (SES)) for Canadian Arctic Indigenous communities. Original studies published in English and French up to October 2024 were located in databases (PubMed, Medline, and CINAHL), AlterNative: An International Journal of Indigenous Peoples, and through reference tracking. We included 118 studies: 6 relating to COVID-19, 5 to influenza, 5 to TB, 27 to food insecurity, 26 to healthcare access, 22 to mental health, 9 to SES, 8 to housing, 7 to cultural continuity, and 3 to community infrastructure. SDHs affecting Indigenous individuals include food insecurity, limited healthcare access, mental health challenges, low SES, suboptimal housing, and limited cultural continuity. These findings are relevant to other Arctic regions. It is crucial to understand how SDHs impact the health of Arctic communities and to utilize this information to inform policy and practice decisions for pandemic prevention, management, and treatment. Many SDHs pose challenges for preventing and managing infectious diseases.

Despite the progress towards Universal Health Coverage (UHC) in Canada, individuals experiencing socioeconomic disadvantages continue to face barriers to accessing necessary health services. This study explored the observational insights of social care providers (SCPs), who regularly engage with vulnerable populations and healthcare systems, to better understand these barriers in Edmonton, Canada. A qualitative descriptive design was employed, guided by COREQ criteria. Purposive sampling recruited SCPs from 22 community organizations serving Indigenous community members and people experiencing homelessness, substance use, and immigration-related challenges. Deductive thematic analysis, structured around the Effective Coverage (EC) framework, was used to analyze interview data. A coding framework was developed a priori, and inductive coding identified interpretive themes within each EC category. Sixty-five SCPs participated. Findings were organized into four EC categories: service availability, accessibility, acceptability, and utilization. Within these, ten themes were identified: insufficient service capacity, restrictive access policies, service denial, unaffordable care, transportation barriers, racism, stigma, patient-related deterrents to seeking care, language barriers, and barriers to navigating the healthcare system. These themes illustrate how institutional policies, resource limitations, and communication challenges intersect with socioeconomic disadvantages to hinder access to and quality of care. SCPs also described how their organizations often intervene to help clients overcome these barriers. SCPs can provide valuable observational insights into healthcare access barriers. While these perspectives do not represent direct patient accounts, they offer critical input for designing policy interventions to improve UHC. Applying the EC framework may enhance equity and support continuous quality improvement.

Objectives: Early oral hygiene and care help prevent early childhood caries (ECC). As remote Indigenous communities in Canada have limited access to dental care, this project explores Indigenous women’s oral hygiene practices during and after pregnancy and in regard to children (0–36 months) within three communities in Northwest Territories (NWT), Canada. Methods: A mixed‐methods study design was employed. Self‐identifying Indigenous women who were pregnant or had given birth within the 3 years preceding data collection (2019) were invited to complete a semi‐structured, interviewer‐administered questionnaire. Results: 156 Indigenous women participated. Of participants who gave birth in the last 3 years ( n = 145), 78.8% started brushing infants’ teeth/gums. Of participants whose infants had teeth ( n = 114), 27.9% had taken the infant to a dentist. Factors impacting infant oral hygiene practices included personal experiences, access to supplies, and health literacy. Among pregnant participants ( n = 28), 38.5% had visited a dentist during pregnancy. Among participants who had given birth within 3 years ( n = 145), 67.9% had since seen a dentist. Factors impacting dental care utilization during pregnancy included service availability and safety concerns. After giving birth, factors included service availability and competing priorities. Conclusions: Within Indigenous communities in NWT, inaccessible oral health care, information, and supplies made it challenging for mothers to meet oral health recommendations during and after pregnancy and in regard to young children. The findings of this project suggest the need for long‐term, collaborative strategies focused on increasing the availability and accessibility of dental care professionals and services within communities and improving oral health literacy via culturally appropriate and collaboratively developed informational initiatives.

Introduction: This project explores influenza and human papillomavirus (HPV) vaccine utilisation among a multi‐ethnic group of youth (aged 11–23 years) in Edmonton, Alberta, Canada. Method: Using a cross‐sectional design and purposive sampling, influenza vaccine utilisation over 3 years was assessed via questionnaire. Female participants also reported on HPV vaccine utilisation. Multinomial logistic regression was used to explore the factors associated with vaccine utilisation. Results: In the project sample, 16.7% of males and 14.7% of females had received the influenza vaccine each year. The lowest rates of influenza vaccination were reported by African/Middle Eastern/Latin American youth (8.3%), Indigenous youth (10.8%), and youth > 18 years (12.6%). For the HPV vaccine, 61.1% of females reported having received all doses, while 21.9% were unvaccinated. Rates of HPV vaccine utilisation were lowest among females of Asian origin, females aged 18–23 years, and females residing in Canada for < 5 years. Discussion: Observed associations between age, ethnicity, and vaccine utilisation in this study highlight potential barriers and warrant further research to inform policymaking.

Background: Prenatal stress is linked to adverse perinatal outcomes. Indigenous women in Canada face high risks for adverse maternal and perinatal health. Objectives: This project aimed to understand levels and sources of stress experienced by Indigenous women during pregnancy and utilization of and experiences with available support. Design: The project employed a mixed-methods cross-sectional design. Methods: The project was conducted in three communities in Northwest Territories, Canada with varying road and healthcare accessibility. Indigenous women who were pregnant or had given birth within three years were invited to participate in a semi-structured interviewer-administered questionnaire, which included open and close-ended questions on pregnancy history, stress levels, healthcare access, available support, and experiences during and after giving birth. Descriptive statistics, regression modelling, and deductive thematic analysis were used. Results: Of 156 participants between the ages of 17 and 47 years (mean age: 29.7 years; SD=6.0), 93.0% had given birth in the past three years, 18.0% were pregnant, and 85.3% were multiparous. Most participants reported pregnancy as somewhat stressful (49.7%) or very stressful (27.5%). Multiparity was associated with greater odds of reporting stressful pregnancy compared to first-time pregnancies (OR = 3.31, 95% CI: 1.22-8.97, p = 0.0186). Qualitative themes included reaction to pregnancy, stress during pregnancy, community support, and professional support. Factors contributing to prenatal stress included personal responsibilities, financial insecurity, housing concerns, and family issues. Support varied, with some feeling inadequately supported. Conclusion: While various social supports exist, some participants reported inadequate support. The findings suggest the urgent need to expand community support programs in remote areas, both in numbers and access, is crucial for addressing maternal health concerns. Including kin and community supports and supporting community-driven initiatives would be effective strategies and require future exploration as to the impacts on addressing prenatal stress in Indigenous women in remote communities.