Connaught PhDs for Public Impact<\/a> fellow, she\u2019s currently crafting a unique mixed-methods dissertation: its aim is to create public-facing reports and policy recommendations designed to lead to more equitable service provision.<\/p>\nQuelch says people are often surprised to hear about the differences in what each province and territory considers worth funding. Gender-affirming care, for example, is covered in all of them \u2014 but the list of covered procedures that fall under that category varies from place to place.<\/p>\n
When it comes to fertility, says Quelch, \u201cB.C. recently announced that it\u2019s going to be funding in-vitro fertilization (IVF). But Ontario\u2019s been funding it for years; so has Quebec. And Alberta doesn\u2019t fund it at all.\u201d<\/p>\n
Abortion, though theoretically available everywhere in Canada, has faced significant practical restrictions.<\/p>\n
In Prince Edward Island, for example, abortion was unavailable until 2017 \u2014 almost 30 years after the procedure was decriminalized in Canada. Access to Mifegymiso \u2014 the brand name of the abortion pill in Canada \u2014 also varies across the country: while it is universally covered in most provinces, people in some areas may have to pay out of pocket or rely on private insurance.<\/p>\n
What accounts for these variations? Quelch\u2019s research suggests there are numerous factors.<\/p>\n
\u201cProcedures such as IVF, gender-affirming care and abortion are contentious,\u201d she says. \u201cThese are things that can be prickly politically and contested medically. Depending on what province you live in, you\u2019re going to have a pretty different level of access to health care, especially for those services that are linked to the reproductive body.\u201d<\/p>\n
But it isn\u2019t just a matter of which party is in power: Quelch points out that both the NDP government in BC and the conservative Saskatchewan Party have both introduced recent policies to fund IVF, though using different mechanisms.<\/p>\n
A nationwide doctor shortage and a rural-urban split may also explain the variation.<\/p>\n
\u201cA small town like Celista, B.C. is not going to open an IVF centre \u2014 and that makes sense,\u201d she says. \u201cIt\u2019s very expensive: You need the technology and you need specialists. And there\u2019s a shortage of these things. So this is not something that\u2019s going to be accessible everywhere. That said, some provinces do a good job with travel funding, so that people who live in smaller places can get to these clinics if they need to.\u201d<\/p>\n
Quelch\u2019s PhD work will determine the extent of these differences, and the reasons behind them.<\/p>\n
\u201cI first built an index to capture what the variation looks like \u2014 scoring provinces and territories and using policy documents to piece together a map of the healthcare landscape, province to territory. Until now research has been sort of piecemeal, with one thing studied at a time. We don\u2019t currently have a big-picture view.\u201d<\/p>\n
Next, she conducted a survey of health care consumers. \u201cWe got about 2,000 responses across six provinces, trying to quantify how people understand medical necessity when it\u2019s linked to women\u2019s health or reproductive health care,\u201d she says.<\/p>\n
\u201cAnd coming this fall I\u2019ll interview policy makers to see if that group understands medical necessity the same way. How did a province or territory decide to fund something? Are they getting pushed by other political parties? Are provinces and territories learning from each other?\u201d<\/p>\n
The end result will be a resource that can be used as a guide for policy makers.<\/p>\n
\u201cI\u2019m cognizant that our health care system is under a lot of strain and Canadian provinces and territories are trying to get their dollars in the right place,\u201d Quelch says.<\/p>\n
\u201cBut these are procedures that can change your identity, and what your family looks like. I think the fact that we\u2019re seeing so many gaps in reproductive health care speaks to the fact that these issues have to be looked at more thoughtfully.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Canada boasts a health care system where all citizens have access to publicly-funded services. In reality, however, this…\n","protected":false},"author":3,"featured_media":11204,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[210,1141,1142,67,132,68],"class_list":{"0":"post-11203","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-health","9":"tag-health-care","10":"tag-healthcare","11":"tag-united-states","12":"tag-unitedstates","13":"tag-us"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/114739355521962030","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/11203","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=11203"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/11203\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/11204"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=11203"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=11203"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=11203"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}