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Community-Centred Health Reform in Northern Canada: Workforce and Service Delivery Reforms in Nunavut between 2021
Jennifer Berry1, Lisa Little1, Jennifer Karach1
1Government of Nunavut, Department of Health, P.O. Box 1000 Station 200, Iqaluit, Nunavut, X0A 0H0, Canada.
Background:
Nunavut faces longstanding health system challenges shaped by geographic remoteness, workforce instability, and historical inequities. In response, the territory is advancing a series of reforms that place community knowledge and Inuit priorities at the centre of policy design, with the aims of stabilizing the health workforce, strengthening cultural safety, and expanding access to care through strength-based approaches.
Reform Context:
This analysis examines a set of converging policy initiatives implemented between 2017 and 2028, including the Canada-Nunavut Health Partnership Agreement (2023-2026), the Roadmap to Strengthen the Nunavut Nursing Workforce (2021-2026), the Virtual Care Action Plan (2023), the Aging with Dignity Agreement (2023-2028), and the Territorial Health Investment Fund (2017-2027). Together, these reforms reflect a coordinated effort to align federal investments with territorial priorities across workforce development, service delivery, digital health, and elder care.
Expected Results:
Early evidence suggests emerging improvements in workforce stabilization, including reduced vacancy rates, fewer community health centre closures, expanded mentorship, and strengthened professional development opportunities. Investments in digital health infrastructure, elder care services, and Inuit-led education and career pathways are also reinforcing cultural safety, local responsiveness, and continuity of care.
Conclusions:
While sustained effort is required to achieve full system transformation, Nunavut's experience demonstrates how aligned federal funding and community-centred policy approaches can advance equity, cultural safety, and system sustainability in northern and remote contexts. These early lessons offer relevant insights for other jurisdictions seeking to translate national investment cycles into locally grounded and context-specific health system reforms.
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