Recommendations for Responsiveness and Distribution of Provincial Parent Resources, 2017

Recommendations for Responsiveness and Distribution of Provincial Parent Resources, 2017


Good morning my name is Sarah Callahan. I
am Cree, Metis and Irish and I am going to I am a masters student with Masters of Public
Health here at UVic and this is my culminating presentation. My practicum
was completed at the Ministry of Health in the maternal-child department and my
presentation today will focus on the creation of recommendations for
equitable distribution of the provincial parent resources. I’d like to acknowledge
the land the traditional Coast Salish lands that we’re meeting on
today and I’d like to take a moment to recognize Melanie Foster and Chelsea
Peddle who are my practicum supervisors at the Ministry of Health, the
instructors here at UVic and Dr. Nigel Livingston and Dr. Cathy Worthington along
and I would really like to take a moment to recognize my employer First Nations
Health Authority and specifically Brendan McDonald who is the Vancouver
Island regional director who provided me the space and opportunity to complete my
practicum while continuing full-time employment. Because of that because I was
employed full time I ended up doing this over the two semesters and it naturally
fell into a split of two parts. So the first part was the revision of Baby’s
Best Chance, Toddler’s First Steps and the Child Health Passport. This work is part
of an annual revision cycle and my piece of this work was completed in December.
The second piece of my practicum looked at the recommendations.
So historically approximately 50,000 copies are printed annually of both the
Baby’s Best Chance and the Toddler’s First Steps. However with the
trend for information gathering shifting to greater online access for the
Ministry of Health has decided to reduce the total number of each of the
resources being printed and they’re now printing approximately 35,000 of each
annually which is just not enough to blanket distribute or provide one for
each family for every baby born in BC. Therefore there is a need for an
informed distribution plan so the second part of my practicum focused on looking
at providing recommendations for the distribution of the available print
copies and this will be the focus of the rest
of my presentation. So I started with a lit review and looking at the concepts
of proportionate universalism and equitable distribution. So proportionate
universalism according to the UBC policy brief it refers to programs and services
and policies that are universal with a scale and intensity that is
proportionate to the level of disadvantage. Regarding resources
resources are distributed in a universal or blanket approach to the entire
identified population with tailored strategies for the sub population. And in
terms of Baby’s Best Chance and Toddler’s First Steps the universal approach is now
going to be online content for everyone to access with targeted strategies will
be the distribution of the print copies that are going to be for identified
subpopulations and in this case the subpopulations are people who have
limited or no access to the Internet. And I think it’s really important to
recognize here that lack of internet access is not always associated with
socioeconomic status and that is actually because of barriers related
to remote access with limitations to connectivity which I’m going to talk
about in a minute. So this is just an example of proportionate universalism.
It’s a graphic visual example. This is the universal approaches are the
parent benefits for the new moms and dads or health child check-ins which are
available to everyone and then the targeted or tailored strategies are the
follow-up from the check-ins or the minimal benefits aimed at eradicating
poverty which are focused for the specific identified subpopulations
within the larger population. So in looking at the concepts of equitable
distribution I first want to define what does equity mean. I think we’ve all seen
this graph here on Facebook. For equity relates to a sense of fairness
and can be confused with equality however equality is giving everyone the
exact same thing whereas equity is giving everyone what they need in order
to have the same experience which is which is what those those cases that
they’re standing on identify. In terms of equity in
healthcare in 1986 the World Health Organization explained that equity in
health implies that ideally everyone should have a fair opportunity to attain
their full health potential and that no one should be disadvantaged from
achieving this potential if it can be avoided. With Baby’s Best Chance and the
Toddler’s First Steps as there are a limited number of these print
resources now providers must ensure equitable access for all new parents and
if the resources are to be put in the most productive use according to Birch
et al in terms of promotion protection and restoration of well-being then they
must be allocated between populations on the basis of the relative needs for care.
Therefore we want to ensure that all new parents have the same opportunity to
access the information within Baby’s Best Chance and Toddler’s First Steps and
negate any potential for barriers to access which would be inability to
access the Internet. So a survey of vulnerable clients conducted by the
Ministry of Health and three health authority regions found that 75% of
participants indicated internet access via home computer and 55% indicated
access to a cell phone. So these figures actually demonstrate that Internet access
is not universal. So within the BC context issues within online access
are related to three things connectivity, affordability and literacy. So BC is so
regarding connectivity BC is a vast province with many remote communities
who experience challenges to Internet access. According to the BC government
high-speed Internet is available to 94% of BC households however that statistic
does not indicate usage it only indicates availability. So for example
fiber optic lines may be available for a community to connect with but because of
significant cost the community may not be able to afford the connection cost
for the last mile to provide service into community. And the last mile is the
final connectivity leg between the telecommunication service provider and
the individual customer or in this case community. In BC baseline infrastructure is not in
place or available in all communities. The internet is accessible through three
different means one is land-based dial-up or phone service,
the second is cellular phone data and three is computer-based web. So in BC
cell phone towers and/or fiber optic lines are not in place in all of our
communities and dial-up internet while accessible is slow and does not provide
the bandwidth required for optimal viewing of both the Baby’s Best Chance
and Toddler’s First Steps. So the second piece around issues is around
affordability and affordability can be broken down into two separate parts. The
first part is community affordability. So community internet access requires
commercial-grade service and what that means is that for us as individuals
we have consumer-grade service which is commonly used by individuals or small
businesses and we share the bandwidth and often this is referred to as best
effort service whereas best-effort services oversubscribe the bandwidth
which is sold and compared to what’s actually available because not every
customer is using their connection at the same time. Whereas consumer-grade
service which is not appropriate sorry consumer-grade service is not
appropriate at a community level as it will not support bandwidth which is
needed so therefore communities require
commercial-grade service called dedicated internet access. However this
is very expensive and often not affordable for smaller communities. As
well the cost to run technology over fiber-optic lines along with maintenance
and upgrading can provide to be too costly. And the second piece around
affordability is individual affordability which is a person’s
ability to afford a home computer with internet or a cell phone with data. And
then the third piece is around literacy both language literacy and computer
literacy and with the parent resources the aim is that they are low barrier but
it is recognized that there’s improvement needed for literacy
accessibility and more so with the online content than with the print
resources. The second piece I wanted to talk about
in the BC context is around the health care providers so the parent resources
are currently provided to healthcare providers working in
health centers as they’re viewed as an optimal resource with consistent
information which is based on best practice and they’re also ideal for
using with in home care provision. And then the third piece
around the BC context is subsequent births so really it was a difficult word
to come up with on how to describe this but what that means is that people who
are having their second or third or fourth or so on child past their
first one. With the parent resources every family with a baby receives the
latest copy including those that have had previous children and have
previous versions of the resources. So my recommendations based on
all of that first was to encourage online access from people who were
provided with a copy of the parent resources with a previous child with a
caveat that they would be shown what the revisions were
to the version that is currently available. And secondly to encourage
online access to anyone who has a home computer or a cellular phone with data.
And the second piece of the recommendations was to provide print
copies of the parent resources to people who have limited or no connectivity who
do not have home computer access who have limited or no access to high-speed
Internet and if the high-speed Internet is what what is needed for optimal
viewing of the two resources or who have an inability to afford the cost of data
transfer and who are challenged by limited language literacy levels and
computer and literacy levels and finally health care providers who are doing home
visits and working in a health center with limited or no access should be
given a copy and those who do have access should access online for modeling
purposes. That’s all. Strengths and challenges we’ll
skip. These were my challenges and strengths.
Thank you. And thank you for your superfast and gracious wrap up. So who
knew that internet connectivity was an equity issue?
Alright so questions questions questions? Hi Sarah my fellow FNHA-er I’m so
excited we both work for FNHA. So around it’s always a challenge to identify who
has connectivity who doesn’t and how would you go about I understand the
recommendations and it’s that that’s just normal but how would you go about
finding out who does and who doesn’t and then connecting them with paper or
online? So it’s this is one of those things where we recognize that the
closer you get to the community the better expert in knowing what is needed
so with the Ministry of Health the resources are distributed to each of the
health authorities based on the population of a birth and then the
health authorities are then responsible to distribute those into the specific
communities and then the next step with that would be then working
with the health centers to identify where there are issues around
connectivity and where there’s not. Does that answer other
questions Hi so I did my BA practicum based
case and a lot of what we did in mine is working with remote older adults and one
thing that we kind of came to the conclusion of was the same thing they
don’t all have access to Internet services. Do you think that finding a way to
implement these are they called baby books or parent resources do
you think that it would work to have them kind of in a community center and
then they get distributed from there and potentially brought back almost in like
a library way because that was one thought that we never continued on but I
wonder if it would work. Actually I think that’s a really fantastic idea that
we hadn’t considered but yeah definitely a sharing system. The way it
works now is that the health care providers that are going into home have
the copies so they can go through them and then they will leave them if it’s
needed or they will model the internet like going through the internet and
showing people where they are at but I like the ideas of… We should make a
healthcare library. A library yeah definitely thank you. Okay
I think I’m not seeing any other hands so thank you Sarah and I
think next up

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