Renewing Health Governance: A Case-Study of Newfoundland and Labrador

There were several new policy reforms and discourses that intersected with the Canadian health public agenda during the 1990s. Despite new circumstances and widespread Pan-Canadian pressure and leadership calling for common health reforms, these transformations across jurisdictions or policy fields were not “inevitable” as often forecast by boosters. Our objective is to better understand the role of local contextual factors (culture, institutions, and interests) and how these have influenced provincial experiences with policy reforms. These contextual factors do not exercise similar degrees of influence upon policy change. Our goal is to explore and evaluate how health care reform evolved in Newfoundland and Labrador (NL)

Health human resources planning and the production of health: Development of an extended analytical framework for needs-based health human resources planning.

Traditional approaches to health human resources planning emphasize the role of demographic change on the needs for health human resources. Conceptual frameworks have been presented that recognize the limited role of demographic change and the broader determinants of health human resource requirements. Nevertheless, practical applications of health human resources planning continue to base plans on the size and demographic mix of the population applied to simple population-provider or population-utilization ratios. In this paper an analytical framework is developed based on the production of health care services and the multiple determinants of health human resource requirements. In this framework attention is focused on estimating the ‘flow’ of services required to meet the needs of the population that is then translated into the required ‘stock’ of providers to deliver this ‘flow’ of services. The requirements for human resources in the future is shown to depend on four elements: the size and demographic mix of the population (demography), the levels of risks to health and morbidity in the population (epidemiology), the services deemed appropriate to address the levels of risks to health and morbidity (standards of care), and the rate of service delivery by providers (productivity). Application of the framework is illustrated using hypothetical scenarios.health human resources planning, demography, epidemiology, standards of care, productivity

Workforce planning models for oral healthcare: A scoping review

BACKGROUND: For health care services to address the health care needs of populations and respond to changes in needs over time, workforces must be planned. This requires quantitative models to estimate future workforce requirements that take account of population size, oral health needs, evidence-based approaches to addressing needs, and methods of service provision that maximize productivity. The aim of this scoping review was to assess whether and how these 4 elements contribute to existing models of oral health workforce planning. METHODS: A scoping review was conducted. MEDLINE, Embase, HMIC, and EconLit were searched, all via OVID. Additionally, gray literature databases were searched and key bodies and policy makers contacted. Workforce planning models were included if they projected workforce numbers and were specific to oral health. No limits were placed on country. A single reviewer completed initial screening of abstracts; 2 independent reviewers completed secondary screening and data extraction. A narrative synthesis was conducted. RESULTS: A total of 4,009 records were screened, resulting in 42 included articles detailing 47 models. The workforce planning models varied significantly in their use of data on oral health needs, evidence-based services, and provider productivity, with most models relying on observed levels of service utilization and demand. CONCLUSIONS: This review has identified quantitative workforce planning models that aim to estimate future workforce requirements. Approaches to planning the oral health workforce are not always based on deriving workforce requirements from population oral health needs. In many cases, requirements are not linked to population needs, while in models where needs are included, they are constrained by the existence and availability of the required data. It is critical that information systems be developed to effectively capture data necessary to plan future oral health care workforces in ways that relate directly to the needs of the populations being served. KNOWLEDGE TRANSFER STATEMENT: Policy makers can use the results of this study when making decisions about the planning of oral health care workforces and about the data to routinely collect within health services. Collection of suitable data will allow for the continual improvement of workforce planning, leading to a responsive health service and likely future cost savings

Planning the oral health workforce: time for innovation

Contains fulltext : 232783.pdf (Publisher’s version ) (Open Access)The levels and types of oral health problems occurring in populations change over time, while advances in technology change the way oral health problems are addressed and the ways care is delivered. These rapid changes have major implications for the size and mix of the oral health workforce, yet the methods used to plan the oral health workforce have remained rigid and isolated from planning of oral healthcare services and healthcare expenditures. In this paper, we argue that the innovation culture that has driven major developments in content and delivery of oral health care must also be applied to planning the oral health workforce if we are to develop 'fit for purpose' healthcare systems that meet the needs of populations in the 21st century. An innovative framework for workforce planning is presented focussed on responding to changes in population needs, service developments for meeting those needs and optimal models of care delivery

In defense of territory : province-building under W.A.C. Bennett

The thesis is primarily an attempt to provide a better understanding on how territorial conflicts influenced infrastructural development in British Columbia between the years 1952 and 1972. Primary emphasis is placed upon exploring the territorial component of province-building in British Columbia. The major theme which emerges is that the spatial pattern of economic development witnessed in the province during these years was not merely the product of societal pressure, but instead, reflected the dreams, and ambitions of the W.A.C. Bennett government. Bennett's efforts to build a better integrated provincial society played a major role in strengthening the provincial government's control over the provincial territory. Six case studies on infrastructural development are investigated: railway transportation, oil and gas development, hydro development, ferry transportation, port development, and highway transportation. The thesis analyzes infrastructural development because it is assumed that the state-centred paradigm is much more useful for explaining provincial expansionism within this policy context. The thesis has four sections. The first section provides a review of province-building, and assesses how territorial conflicts influence state infrastructure development. The second section includes a review of the political setting. The third section presents the case studies. The final section provides a summary of the findings and concludes that the Bennett government's desire to exploit infrastructure for the purpose of building a more integrated and united territory had a major impact upon the spatial pattern of economic development in British Columbia.Arts, Faculty ofPolitical Science, Department ofGraduat