Grant: Cat Gr.: Policy Research for HST - IHSPR - Health Care Policy Res./Systems Res.

The capacity of Indigenous primary healthcare (PHC) to provide consistent quality healthcare service delivery to Indigenous peoples is impeded by limited clinical resources and sparse Indigenous PHC system infrastructure. The nature in which physicians are paid influences funding allocation for building critical PHC system infrastructure. The recruitment and retention of Indigenous-focused PHC providers also hinges on adequate PHC system infrastructure. Provincial health system and policy partners from Alberta (AB) and Ontario (ON) have identified a shared policy priority to develop key policy directives to build Indigenous PHC system infrastructure by reinforcing financial commitments and responsibilities, thereby fostering the development of a high quality and safe PHC workforce for Indigenous populations. The objectives of our comparative policy research project across AB and ON are to: (1) explain the relationship between payment/remuneration models and PHC infrastructure development in facilitating the delivery and organization of PHC services for Indigenous populations; (2) understand the contextual factors that shaped provincial policy-making on funding for Indigenous-focused PHC in AB and ON; (3) ascertain how provincial PHC policy actors, PHC providers and communities in AB and ON define the challenges related to inequities in Indigenous PHC funding and resources across different Indigenous PHC settings (urban, on-reserve and northern communities) and groups; (4) identify and learn from Indigenous PHC models in AB and ON that have innovated to build PHC system infrastructure; and (5) develop macro-level policy recommendations on changing funding structures that facilitate Indigenous PHC system infrastructure development.