On-the-Ground Realities of Health Program Delivery in Addressing Community Needs: A Community-Based Participatory Research Approach in the Moose Cree First Nation

Abstract

Indigenous communities in northern remote Canada face disproportionate health disparities, including high rates of food insecurity and prevalence of diet-related chronic diseases stemming from colonial disruption of traditional food systems and increased reliance on poor-quality market foods. This study described how Indigenous-led health programs, the Healthy Babies, Healthy Children Program and the Diabetes Prevention Program, in Moose Cree First Nation (MCFN) respond to food insecurity drivers and support community health and wellness. It also documents the on-the-ground realities of program delivery, including operational challenges faced by the programs. Grounded in community-based participatory research (CBPR), this research involved firsthand participation in program delivery alongside the Moose Factory Health Center coordinators, complemented by semi-structured interviews with community members (n=6) and health center staff (n=3), and participant feedback from program activities. High food costs, limited access and availability, and poor food quality continue to drive food insecurity in the community. Health programs responded through culturally grounded, family-oriented nutrition education activities, including cooking and gardening workshops, food demonstrations, and baby food preparation sessions. Beyond their formal objectives, these programs function as vital community support systems, providing tangible resources, fostering social connections, and serving as frontline responders to non-clinical immediate family needs. However, systemic barriers significantly constrained program delivery, including inadequate funding, limited infrastructure, staffing shortages, and ongoing COVID-19 impacts. The findings demonstrate that while Indigenous-led health programs play crucial roles in addressing food insecurity and promoting community wellness, they require sustainable funding models that reflect the true costs of service delivery in northern, remote communities. The study emphasizes the need for policy transformation from top-down approaches toward community-informed, Indigenous-led governance that supports holistic health programming aligned with Indigenous concepts of health and self-determination.