The Development of an Alcohol Strategy for the Northwest Territories, Canada

Background
The Northwest Territories, Canada has the highest rates of alcohol-related harm in the country, and five to six times the number of alcohol-related hospital admissions as other jurisdictions.  In order to address these harms, the Northwest Territories (NWT) has developed an alcohol strategy, designed to prevent and reduce alcohol-related harm for all community members, across the lifespan.  
Methods
Development of the alcohol strategy involved a literature review, four targeted engagement activities, and iterative validation by advisory groups and community and Indigenous leadership.  These activities were used to develop recommendations, evaluate, modify or reject these recommendations, and validate the final actions that were included in the NWT Alcohol Strategy.  
Results
Fifteen actions were included in the final alcohol strategy, in the areas of communication, policy, prevention, public safety and treatment.  The final actions differed considerably from the gold-standard policy changes that are described and assessed by the Canadian Alcohol Policy Evaluation (CAPE), due to contextual considerations including what is culturally acceptable within the Indigenous population, and the geography and population distribution in the region. 
Conclusion
The development of a strategy to address alcohol is dependent on a variety of contextual factors.  Organizations developing approaches to address alcohol use must take into consideration the geography, political climate, and cultural context of the region for which they are being developed, in order to develop actions that are applicable, acceptable and feasible.