Fare well to Nova Scotia? Public health investments remain chronically underfunded

Caldwell, Hilary A. T.; Scruton, Sarah; Fierlbeck, Katherine; Hajizadeh, Mohammad; Dave, Shivani; Sim, Meaghan; Kirk, Sara F. L.

doi:10.17269/s41997-021-00478-8

Cited by 6 publications

(3 citation statements)

References 6 publications

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“…They re ected on epidemiologically driven nature of public health and the need for improved availability of data for PH to continue advancing its work and the science. (42,43), even if there are variations across Canada (44). The need for su cient nancial means to support their work is thus a top priority, and PH decision-makers are also mindful that the COVID-19 pandemic shall not crowd-out all the other necessary PH interventions.…”

Section: Synthesizing Open-ended Comments Providedmentioning

confidence: 99%

Prioritization of Public Health Financing, Organization, and Workforce Transformation: A Delphi Study in Canada

Dedewanou

Allin

Guyon

et al. 2022

Preprint

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Background: The increased scrutiny on public health brought upon by the ongoing COVID-19 pandemic provides a strong impetus for a renewal of public health systems. This paper seeks to understand priorities of public health decision-makers for reforms to public health financing, organization, interventions, and workforce. Methods: We used an online 3-Round Delphi method of reaching consensus on priorities for public health systems reform. Participants were recruited among individuals holding senior roles in Canadian public health institutions, ministries of health and regional health authorities. In Round 1, participants were asked to rate 9 propositions related to public health financing, organization, workforce, and interventions. Participants were also asked to contribute up to three further ideas in relation to these topics in open-ended format. In Rounds 2 and 3, participants re-appraised their ratings in the view of the group’s ratings in the previous round. Results: Eighty-six public health senior decision-makers from various public health organizations across Canada were invited to participate. Of these, 25/86 completed Round 1 (29% response rate), 19/25 completed Round 2 (76% retention rate) and 18/19 completed Round 3 (95% retention rate). Consensus (defined as more than 70% of importance rating) was achieved for 6 out of 9 propositions at the end of the third round. In only one case, the consensus was that the proposition was not important. Proposition rated consensually important relate to targeted public health budget, time frame for spending this budget, and the specialization of public health structures. Both interventions related and not related to the COVID-19 pandemic were judged important. Open-ended comments further highlighted priorities for renewal in public health governance and public health information management systems. Conclusion: Consensus emerged rapidly among Canadian public health decision-makers on prioritizing public health budget and time frame for spending. Ensuring that public health services beyond COVID-19 and communicable disease are maintained and enhanced is also of central importance. Future research shall explore potential trade-offs between these priorities.

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Section: Synthesizing Open-ended Comments Providedmentioning

confidence: 99%

Prioritization of Public Health Financing, Organization, and Workforce Transformation: A Delphi Study in Canada

Dedewanou

Allin

Guyon

et al. 2022

Preprint

View full text Add to dashboard Cite

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“…As this literature largely focuses on direct pandemic response roles, it does not fully capture the extent of other roles PHNs are engaged in throughout the course of a pandemic. In a public health crisis such as the COVID‐19 pandemic, the majority of resources and PHN workforce capacity have been diverted towards the pandemic response, resulting in a reduced ability to deliver essential health promotion and prevention programs and services (Caldwell et al, 2021 ; Edmonds et al, 2020 ). Despite this diminished capacity, PHNs remaining in roles focused on delivering core public health services in the parameters of public safety (e.g.…”

Section: Introductionmentioning

confidence: 99%

Exploring the context, role and impact of public health nursing during COVID‐19: A multiple case study protocol

Belita

Jack

Lokko

et al. 2022

Journal of Advanced Nursing

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Aim The purpose of this study is to: (a) describe public health nursing roles over the course of the COVID‐19 pandemic in Ontario, Canada; (b) describe the contextual factors that influence public health nursing role implementation; and (c) describe nurses' perceived impact of their roles on client outcomes and professional/personal nursing practice. Design Descriptive multiple case study. Methods Recruitment of public health nurses (PHNs), working in direct service or administrative leadership positions, in an Ontario public health unit will be conducted through purposive and snowball sampling. Nursing roles will be compared and contrasted across three cases differentiated by geographic setting: urban, urban–rural, northern. In each geographic case, a priori estimates of sample size will include 10 PHNs providing direct care and at least five nurses in an administrative leadership role; with an overall estimated study sample size of 45 individuals. Demographic data will be collected using an online anonymous survey. Individual semi‐structured interviews with PHNs, and focus groups with nursing administrators will be conducted via telephone and audio‐recorded. Individual interviews and focus groups will be transcribed verbatim. Reflexive thematic analysis will be used to generate emergent themes in each case and cross‐case synthesis will be used to compare and contrast patterns across geographic cases. Discussion Expected findings will provide an in‐depth analysis of the rapidly evolving roles and functions of PHNs throughout the COVID‐19 pandemic and their impact on individuals, families and communities. As well, findings will provide a new understanding about the contextual barriers and facilitators of PHN role implementation in their working environments. Impact Study findings can support decision‐making in relation to funding, resource allocation and supportive work structures and processes at a public health system and/or individual public health organization level.

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“…Toutefois, de nombreux commentateurs ont avancé que les systèmes de santé publique s'affaiblissent depuis le début des années 2010 au Canada (Guyon et al, 2017 ;Guyon and Perreault, 2016 ;Hancock, 2017). Cette observation est cohérente avec la part stagnante ou décroissante des dépenses de santé publique observée dans certaines provinces sur la même période (Caldwell et al, 2021 ;Fiset-Laniel et al, 2020). Le Québec figure parmi ces provinces (Borgès da Silva et al, 2021) et la croissance des dépenses de santé publique québécoise a été parmi les plus faibles au Canada depuis 1975 (Ammi et al, 2021).…”

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Effets de la pandémie de COVID-19 sur la réallocation des dépenses de santé publique par fonction : estimation de court terme et analyse prédictive contrefactuelle

Ammi,

Langevin,

Arpin

et al. 2024

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Les crises épidémiologiques comme celle de la pandémie de COVID-19 affectent les systèmes de santé dans de multiples dimensions. Au Québec comme ailleurs, ce genre d'événement majeur peut avoir influencé non seulement les dépenses totales en santé publique, mais aussi leur répartition entre les différentes fonctions de santé publique. Il est donc primordial de mieux comprendre les décisions et arbitrages dans l’allocation des dépenses entre les grandes fonctions de santé publique et aussi mieux comprendre les conséquences des choix qui sont faits. Ce rapport permet précisément d’améliorer notre compréhension de ces questions. Les analyses s’appuient sur des approches économétriques complexes et sur plusieurs sources de données de santé populationnelle, démographiques et socioéconomiques, et sur des données épidémiologiques de la COVID-19 par région et provenant du jeu de données ouvertes disponibles du Partenariat Données Québec et de l’INSPQ. Les auteurs montrent que la pandémie a conduit à une réallocation des sommes en privilégiant certains postes de dépenses aux dépens d'autres. Les dépenses en surveillance de la santé des populations, en promotion de la santé, en prévention des maladies et celles pour la lutte aux Infections transmissibles sexuellement et par le sang (ITSS) ont toutes baissé comparativement aux prévisions de ce qu’auraient été les dépenses dans ces catégories en l’absence de pandémie. Les auteurs suggèrent que la réduction des dépenses en promotion des saines habitudes de vie et en bonne santé mentale, lesquelles font partie des actions de promotion de la santé et de la prévention des maladies, pourrait avoir entrainé des effets délétères sur la santé des populations.

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Fare well to Nova Scotia? Public health investments remain chronically underfunded

Cited by 6 publications

References 6 publications

Prioritization of Public Health Financing, Organization, and Workforce Transformation: A Delphi Study in Canada

Prioritization of Public Health Financing, Organization, and Workforce Transformation: A Delphi Study in Canada

Exploring the context, role and impact of public health nursing during COVID‐19: A multiple case study protocol

Effets de la pandémie de COVID-19 sur la réallocation des dépenses de santé publique par fonction : estimation de court terme et analyse prédictive contrefactuelle

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