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The Canadian Institutes of Health Research (CIHR) have awarded three researchers from Nova Scotia funding to study the effects of the COVID-19 pandemic on various populations and to propose initiatives to respond to these populations’ needs.

The following researchers received funding:

• Janet Curran, PhD, RN, a clinician scientist at IWK Health Centre, Halifax, received $490,758 from CIHR and the New Brunswick Health Research Foundation to examine the wider impact of COVID-19 measures on the lives of children with complex care needs and their families.

• Alexa Yakubovich, cardura fatigue PhD, assistant professor of community health and epidemiology at Dalhousie University, Halifax, received $499,647 to identify and contextualize best practices in responding to violence against women during the COVID-19 pandemic.

• Janice E. Graham, PhD, research professor of infectious diseases at Dalhousie University, Halifax, received $489,566 to engage with social scientists, public health experts, and members of equity-deserving groups to develop recommendations for a more equitable and supportive healthcare governance framework in post-COVID Canada.

Complex Care Needs

“The overall theme of our research is to understand how COVID-19 public health restrictions and the service changes impacted the health and well-being of children with complex care needs and their families in the three Canadian maritime provinces of Nova Scotia, Prince Edward Island, and New Brunswick,” Curran told Medscape Medical News.

The project will examine the public health measures enacted from March 2020 to March 2022. “In the first phase, we will map the mandates and service changes by examining the public health news releases that notified the public daily and weekly,” said Curran. “We will then do content analysis and interview policy makers and service providers to understand what they were thinking when they developed the policy or service change, and how they constructed their strategy to communicate and implement this.”

In phase 2 of the project, Curran and her team will use the information obtained in phase 1 to guide interviews with 12 families from each of the maritime provinces to explore how they experienced these service changes. “We want to identify barriers to services, what worked, what didn’t work, so that we can move those forward into the future,” she said.

Importantly, parents will be active partners in this research, Curran said. “Our parent partners are working with us through all stages of this project. They are intricately involved with making decisions about our data collection strategy, how we plan to analyse the data, and they will guide us through development of recommendations and developing our knowledge dissemination plan,” she added.

Violence Against Women

Yakubovich and colleagues will examine violence against women in Ontario, Nova Scotia, and New Brunswick, and how well the services for abused women, such as women’s shelters, are meeting the needs of survivors.

“We know that violence against women is impacted by public health emergencies, and COVID was no exception, so violence against women has increased, both in frequency and severity,” said Yakubovich. “We also know that many women have had to shelter in place with violent partners, making it more difficult for them to access services.”

Services for women experiencing violence have been chronically underfunded, and the pandemic has further limited the ability to support women, Yakbovich said.

“Given all of the new challenges that they’re having to grapple with, we want to get a sense of how the limited funding has impacted their ability to support women, and what innovations they’ve been able to put in place. Organizations have definitely been resourceful and have found ways to advocate for women; we definitely want to make sure that we’re documenting those successes as well.”

Improving Public Health

“Like many nations, Canada was ill equipped to anticipate the COVID-19 pandemic, ill prepared to effectively meet its demands, and ill coordinated in its efforts to protect Canadians,” Graham told Medscape.

“Our reliance on provincial standards and interventions, which were driven in part by political objectives, caused unnecessary deaths, service breakdowns, and healthcare worker burnout. This clearly points to a pressing need for better standards, institutions, and practices organized by a more coherent governance framework, one that is more informed by groups profoundly impacted by the pandemic but habitually sidelined in the undertaking of governance design,” she said.

Such equity-deserving groups have often been left out of policy planning processes, which has led to poorer services and infrastructures that do not meet their needs, Graham noted.

“They might be poorly paid health service providers, like many who work in the long-term residential care sector, or non-unionized essential workers, or new Canadians working in meat packing plants, or Indigenous people seeking maternal care in the inner city. While many Canadians were able to work from home and access the services they needed, all Canadians experienced a decline in health services during COVID, but some much more than others,” she said.

“Our project will include the knowledge and experiences of those usually left out of these sorts of discussions. That’s why we applied for this grant, and clearly the reviewers thought it was important, too,” she said.

Ultimately, Graham’s goal is to generate an “evidence-formed” governance framework to create a Canadian Public Health Act.

“This is long overdue. We want to establish national standards and harmonized practices for a wide range of activities central to public health, such as national disease data, surveillance, and immunization systems, to serve local communities,” she said.

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