Study Recommends Inuit-Led Approaches to Address Tuberculosis in Nunavik

A research team primarily composed of Inuit and First Nations members conducted interviews with 156 Inuit in Nunavik between 2022 and 2023 to assess tuberculosis treatment experiences. The findings, published in the Canadian Medical Association Journal, highlight challenges in accessing care close to home.

Nunavik, located in northern Quebec, faces high tuberculosis rates amid ongoing public health efforts.

Tuberculosis cases in Nunavik reached 116 by the end of 2023, marking record highs for the region. As of April 10, 2024, the Nunavik Regional Board of Health and Social Services reported 40 cases since the start of the year. The board noted that factors like overcrowded housing and food insecurity contribute to disease spread in remote communities.

Treatment Access Challenges The study found that most of Nunavik's 14 communities have outpatient clinics, but only Kuujjuaq and Puvirnituq offer hospitals with radiography access.

Many patients with severe cases require transfer to southern facilities for hospitalization and specialized care. This displacement often deters individuals from seeking testing, as noted in the interviews. Language barriers also emerged as a concern, with medical staff in the region frequently not speaking Inuktitut.

Researchers visited communities including Kangiqsualujjuaq, Salluit, Akulivik, Kuujjuarapik, and Kangiqsujuaq, selected due to their high tuberculosis incidence at the time. Inuktitut-speaking team members gathered more detailed accounts from participants.

Proposed Actions The study advocates for an Inuit-led approach to tuberculosis management, emphasizing community involvement in awareness and case finding.

Researchers outlined seven calls to action: increasing Inuit control over services and data; providing person-centered care; expanding local services to reduce patient displacement; implementing community-wide screening adapted to local needs; training and hiring more Inuit care workers; reducing stigma; and delivering Inuit-led cultural safety training for healthcare workers.

The Nunavik Regional Board of Health and Social Services stated that it manages most cases locally but relies on transfers for severe ones. The board is awaiting a response from the Quebec government on funding requests to address the crisis.

It has initiated efforts toward an Inuit-centered approach, including community-based programs.