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Training to Retain: Strengthening the Role of Indigenous Community Health Workers

Indigenous community health workers play a critical role in rural and remote Indigenous communities, where access to healthcare is limited and health inequities are more pronounced. In these settings, community health workers help to fill service gaps by providing continuity of care that would otherwise be unavailable, particularly where physicians and nurses are absent or cycle in and out of communities on rotational schedules. Their role also becomes more important when other informal caregivers, including family members, are no longer present in the community.

Despite their critical role, Indigenous community health workers are often insufficiently supported, and there are not enough community health workers in Indigenous communities in Canada to meet healthcare needs. This shortage reflects the Truth and Reconciliation Commission of Canada’s call for the retention of Indigenous healthcare providers in Indigenous communities (Call to Action #23ii) and for closing the gaps in health outcomes between Indigenous and non-Indigenous communities in Canada (Call to Action #19).

This research responds to the Truth and Reconciliation Commission’s 94 Calls to Action by examining how Indigenous community health workers can be better supported, retained, and equipped to serve their communities, with a particular focus on training that is relevant to rural and remote Indigenous contexts.

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Key findings

Paid community-based training models, such as British Columbia’s Health Career Access Program, reduce financial barriers and support retention of Indigenous community health workers.

Indigenous community health worker training is funded through fragmented and inconsistent sources, resulting in uneven access to training across communities.

Remote and hybrid delivery models are often essential for learners in remote communities and were expanded through COVID-19-driven investments in digital infrastructure.

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