ARCHIVED - Public Health Agency of Canada

Start Date: 1995-96

End Date: Ongoing

Description: Contributions to incorporated, local or regional non-profit Aboriginal organizations and institutions for the purpose of developing early intervention programs for Aboriginal pre-school children and their families.

Strategic Outcome: Healthier Canadians and a stronger public health capacity

Results Achieved: Completion of the annual process evaluation of all Aboriginal Head Start in Urban and Northern Communities (AHSUNC) sites in Canada, with data gathering being accomplished in the spring of 2008, and an impressive 100% response rate achieved. Results highlight national participation, activities related to the six Aboriginal Head Start (AHS) components, partnerships forged, and families at risk being reached.

During 2007-08, AHSUNC funded 129 projects throughout Canada and had over 4,500 children enrolled in pre-school programming on an annual basis.

Compilation of a highlights report of the findings of the 2006 national impact study of 10 AHSUNC sites in Canada indicated that AHSUNC advanced learning, child development, school readiness and the positive esteem of children.

The establishment of a national AHSUNC Evaluator's Network, comprised of regional evaluators and representatives from the national office, children's managers and the Centre of Excellence for Evaluation and Program Design, was undertaken.

In collaboration with local aboriginal stakeholders, a new project in Montreal received approval during December 2007. This project is expected to officially launch in November 2008.

Alberta Region designed and implemented a pilot project to conduct a longitudinal study with a sample of AHS participants. Key highlights from this study include the following: children demonstrated a cohesive group of school readiness and achievement, and problem solving skills. Based on the results of the pilot, a long-term research plan will be developed to assess AHS program impacts in the entire Alberta Region for 2008-12.

Manitoba and Saskatchewan Region developed and implemented a provincial database, housing project statistics, attendance, participation rates and parental and community involvement. The database used in this region is being considered for national implementation.

Comment(s) on Variance(s): Variance due to the reallocation of funds from other programs toward this children program.

Significant Evaluation Findings and URL (s) to Last Evaluation(s): A  summative evaluation was completed in 2006. It found that the AHSUNC program has a positive impact on children, parents and communities participating in the programs.

Significant Audit Findings and URL (s) to Last Audit(s): An Audit of Health Promotion Programs will be conducted in 2008-09 in order to assess the effectiveness of the Management Control Framework.

Name of Transfer Payment Program: Community Action Program for Children (CAPC)

Start Date: Launched in 1993

End Date: Ongoing

Description: Contributions to non-profit community organization to support, on a long term basis, the development and provision of preventive and early intervention services addressing the health and development problems experienced by young children at risk in Canada.

Strategic Outcome: Healthier Canadians and a stronger public health capacity

Results Achieved: 450 CAPC projects across Canada, served over 65,000 children and parents/caregivers in a typical month in more than 3,000 communities across the country. 

The 2007 National Formative Evaluation of CAPC demonstrated that CAPC advanced the work of the Agency by employing a population health approach to mobilize communities in support of at-risk children and their families. CAPC projects established substantial community-level support by developing partnerships and leveraging additional sources of funding and support, including in-kind resources and volunteer involvement. The Evaluation showed that 97% of CAPC projects reported forming community partnerships with more than 6,600 partners and received more than 68,000 hours of donated time from participant volunteers and community members. In addition, CAPC projects estimated receiving more than $6.7 million in in-kind donations and $21.7 million in additional funding nationally.

The Evaluation illustrated that CAPC is successfully reaching the intended population. Evaluation findings from a 2006 measure of national program reach reflected the diversity of CAPC in the demographic characteristics of the participants: 58% of CAPC household incomes fell below the Low Income Cut-Offs and 30% of CAPC households had total family incomes less than $15,000; 27% of parents and caregivers had not completed high school; 26% of parents and caregivers were single parents; 15% of parents and caregivers self-identified as Aboriginal; 22% of parents and caregivers were born outside of Canada; and 17% of parents and caregivers were caring for a child with special needs. A comparison of socio-demographic characteristics found that CAPC participants faced greater conditions of risk as compared to the general population.

Results from regional evaluations demonstrated that there are improvements in the children's social skills, cognitive skills, sensory skills, play skills, behaviour including reductions in aggressive behaviour, problem solving, better able to express emotions, school readiness and reductions in injury and improvements in child safety. Regional evaluations demonstrated enhanced parenting skills, confidence and satisfaction with parenting, increased self esteem, better awareness of community resources to support parenting, increased social support/reduced social isolation, increased positive interactions with children, reduced negative interactions with children, increased knowledge and awareness of culture and cultural identity, improvements in personal situations, increased hope for the future and improvements in family nutrition.

Seven new resource materials were completed in the most recent funding cycle of the CAPC and Canada Prenatal Nutrition Program (CPNP) National Projects Fund (NPF), ending in 2007-08. The NPF provides strategic, time limited funding to facilitate knowledge development and transfer and capacity building to address emerging public health issues identified by CAPC and CPNP projects and partners. Topics addressed included family violence, food security, fathering, attachment, teen pregnancy and breastfeeding. All projects received the resource materials and regional training events were held.

Comment(s) on Variance(s): Variance due to the reallocation of funds from other programs toward this children program.

Significant Evaluation Findings and URL to Last Evaluation: A formative evaluation was completed in March 2008  (http://www.phac-aspc.gc.ca/about_apropos/evaluation-eng.php). The formative evaluation found that the program successfully reached its desired target groups of families living in conditions of risk and advanced the work of the Agency by implementing a population health approach. This includes work in the area of capacity building, intersectoral collaboration and public involvement. The evaluation also provided a solid foundation for the summative evaluation, scheduled for 2009-10.

Significant Audit Findings and URL to Last Audit: The Audit of Health Promotion Programs will be conducted in 2008-09 in order to assess the effectiveness of the Management Control Framework.

Name of Transfer Payment Program: Canada Prenatal Nutrition Program (CPNP)

Start Date: 1994–95

End Date: Ongoing

Description: Contributions to non profit community organizations to support on a long-term basis, the development and provision of preventive and early intervention services at addressing the health and development problems experienced by young children at risk in Canada.

Strategic Outcome: Healthier Canadians and a stronger public health capacity

Results Achieved: In 2007-08, 330 CPNP projects reached close to 2,000 communities across Canada.  The program served about 50,000 prenatal and postnatal women.  An estimated 28,000 pregnant women and 1,800 postnatal women enter the CPNP. 

The on-going performance measurement and evaluation of the program found the CPNP continued to successfully reach its intended population. In 2007-08, a comparison of socio-demographic characteristics found that CPNP participants faced greater conditions of risk (i.e., lower income, younger age, lower education, more smoking, greater food insecurity) as compared to the general population.  Despite these differences, after the CNCP interventions, the comparison found key birth outcomes (e.g., birth weight, breastfeeding initiation) to be identical between the two populations.

A 2007 Participant Profile report of CPNP compared characteristics of CPNP participants to those of the general population in an effort to put the program reach and outcome data that has been collected as part of the program’s ongoing national evaluation into context. Findings from 2004-05 CPNP evaluation data compared to the general population though the Canadian Community Health Survey (CCHS) illustrated that:

• 51% of CPNP participants reported an annual household income of less than $15,000 compared to only 8% of CCHS respondents;
• 17% of CPNP participants are less than 19 years old compared to 4% in the general population;
• 69% reported achieving a high school degree or less compared to 9% of CCHS respondents;
• 34% of CPNP participants were born outside of Canada compared to 12% in the CCHS population;
• 31% of CPNP participants reported smoking during their pregnancy compared to 17% of the CCHS respondents; and
• CPNP participants indicated higher levels of food insecurity, with 50% and 47% responding sometimes or often true to two food insecurity statements, compared to 12% and 10% of CCHS respondents.

CPNP projects actively worked to address key health and social outcomes. Important foundations of children=s physical, cognitive and social development are linked with their prenatal and early postnatal environments. Maternal health, lifestyle behaviours and social support systems during pregnancy are important to their children=s development. CPNP projects established substantial community-level support by developing partnerships and leveraging additional sources of funding and support, including in-kind resources and volunteer involvement.

CPNP projects promoted positive health and social outcomes for pregnant women, adolescents, and their infants living in conditions of risk. CPNP participants demonstrated improvements in several health practices during their involvement with CPNP. Regional results revealed that participants increased their intake of prenatal vitamin supplements during their involvement in CPNP and reported that CPNP helped them to improve their eating habits, in ways such as making healthier food choices. High rates of breastfeeding were also reported, coupled with low rates of delivery complications, newborn health complications, and low birth weight. In addition, mothers reported significant improvements in their social support systems during their participation in CPNP. The overwhelming majority of participants also reported that their lives were improved as a result of their involvement in CPNP.

Comment(s) on Variance(s): Variance due to the reallocation of funds from other programs toward this children program.

Significant Evaluation Findings and URL to Last Evaluation: A summative evaluation is underway and will be completed by March 31, 2010.

Significant Audit Findings and URL to Last Audit: An audit of the Health Promotion Programs will be conducted in 2008-09 in order to assess the effectiveness of the Management Control Framework.

Name of Transfer Payment Program: Population Health Fund (PHF)

Start Date: 1999-2000

End Date: Ongoing

Description: Provides grants and contributions to Canadian voluntary not-for- profit organizations and educational institutions to increase the ability of communities and individuals to improve their health by developing models, increasing knowledge for programs and policy, and by building collaborative approaches which address the determinants of health.

Strategic Outcome: Healthier Canadians and a stronger public health capacity

Results Achieved: The PHF supported projects to encourage action on health at the national and regional level. Projects to develop and implement tested community models, to develop knowledge to be used in programs and policy, and increase partnerships and collaboration have been accomplished. Evaluation indicates that the programs have achieved these results.

Actions to address the determinants of health and emerging health issues have been undertaken across Canada.  Official Language Minority Communities have had the opportunity to address health issues that are unique to their communities. Sustainable development initiatives that are linked to public health have taken place in the Quebec region to meet the requirements of the Agency’s sustainable development strategy.  Atlantic region and Ontario region also addressed this priority. Key public health partnerships and intersectoral initiatives have been enriched and new stakeholders have been engaged.

Name of Transfer Payment Program: Federal Initiative to Address HIV/AIDS in Canada

Start Date: January 2005

End Date: Ongoing

Description: Contributions towards the Federal Initiative to Address HIV/AIDS in Canada.

Strategic Outcome: Healthier Canadians and a stronger public health capacity

Results Achieved: Through funding provided to community-based organizations, the Agency’s Federal Initiative transfer payments improved access to more effective HIV/AIDS prevention, diagnosis, care, treatment and support for eight key populations most affected by HIV and AIDS in Canada (gay men, people who use injection drugs, Aboriginal peoples, prison inmates, youth at risk, women, people from countries where HIV is endemic, and people living with HIV and AIDS).

In 2007-08, the Agency’s National Transfer Payment Funds supported:

• 22 projects through the Non-reserve First Nations, Inuit and Métis HIV/AIDS Project Fund, to help in the reduction of HIV incidence among Canada’s Aboriginal Peoples and to facilitate access to quality diagnosis, care, treatment and social support for all Aboriginal Peoples living with HIV and AIDS;
• 7 projects through the National HIV/AIDS Voluntary Sector Response Fund, to increase coordination and action to respond to HIV/AIDS and other related diseases across the voluntary sector; enhanced the capacity of front-line organizations to plan and deliver programs and services to address HIV/AIDS and other related diseases; increase national level engagement and leadership of people living with HIV and AIDS and key populations in the policies and practices that affect their lives; and increased the capacity of the voluntary sector to engage in strategic communications to increase Canadians’ awareness of HIV/AIDS and the seriousness of the Canadian HIV/AIDS epidemic;
• 7 projects through the Specific Populations HIV/AIDS Initiatives Fund, to support national policy, program and social marketing initiatives that increased the prevention of HIV infection amongst Canada’s populations most affected by HIV and AIDS and most vulnerable to infection, and improved their access to appropriate diagnosis, care, treatment and support; and
• 1 project under the National HIV/AIDS Knowledge Exchange Fund. Through this fund, the Canadian AIDS Treatment Information Exchange (CATIE) established as the knowledge broker for information on HIV/AIDS, spanning the full spectrum, from prevention, to access to diagnosis, care, treatment and support. CATIE gathered, synthesized and communicated relevant research, epidemiological data and other evidence-based information such as best practices, to the front lines to increase their capacity to plan and deliver programs and services in prevention, care, treatment and support. This was accomplished through multiple channels, including regional and national networks, exchanges at national and regional conferences, on-site trainings, web-based information as well as interactive learning modules.

The Agency’s Regional Transfer Payment Funds, through the AIDS Community Action Program (ACAP), supported 52 time-limited and 74 operational projects across Canada. These projects created supportive environments for those living with HIV and AIDS; prevented HIV/AIDS in key populations; facilitated health promotion for those living with HIV and AIDS, and strengthened community based organizations that work with the key populations   Seven of these ACAP projects are integrated with hepatitis C funding to prevent the spread of HIV/AIDS and hepatitis C by targeting people who use injection drugs.

Name of Transfer Payment Program: National Collaborating Centres for Public Health (NCCPH)

Start Date: 2004-05

End Date: Ongoing

Description: Contribution to persons and agencies to support health promotion projects in the area of community health, resource development training and skill development and research. The National Collaborating Centres (NCCs) focus on improving the use of scientific and other knowledge to enhance the effectiveness and strengthen the capacity of Canada’s public health system. The NCCs make useful research available to and foster linkages among public health practitioners, researchers, and others within the public health community. They promote the sharing of knowledge across this network to strengthen public health practice across Canada.

Strategic Outcomes: Healthier Canadians and a stronger public health capacity

Results Achieved: All six NCCs have been created. They have undertaken environmental scans of their stakeholder communities to identify gaps and priorities, conducted Knowledge-synthesis, Translation and Exchange (KSTE) activities and created products to assist the public health community in Canada.

Name of Transfer Payment Program: Healthy Living Fund

Start Date: June 2005

End Date: Ongoing

Description: Contribution funding to support and engage the voluntary sector and to build partnerships and collaborative action between governments, non-governmental organizations and other agencies. The Fund supports healthy living actions with community, regional, national and international impact.

Strategic Outcome: Healthier Canadians and a stronger public health capacity

Results Achieved: Funding through the Healthy Living Fund will build public health capacity. By developing evidence on Canadian initiatives, projects helped to strengthen the evidence-base and contributed to the knowledge development and exchange component, informing health promotion activities.

The Healthy Living Fund (national stream) solicited, received and signed Contribution Agreements with ten (10) organizations (11 projects in total) in 2007-08.

Bilateral agreements (the regional stream of the Healthy Living Fund) were signed with 8 provinces/territories (P/Ts), and 5 Healthy Living projects received Ministerial approval for funding. Through collaboration with P/Ts, joint priorities on healthy living were established between the federal and provincial/territorial governments, with agreement to match funding in support of these priorities.

Name of Transfer Payment Program: Canadian Diabetes Strategy (CDS) (non-Aboriginal)

Start Date: 2005-06

End Date: Ongoing

Description: The Agency provides leadership on the non-Aboriginal elements of the Canadian Diabetes Strategy (CDS), which has been in effect since 1999. Under the Agency’s Healthy Living and Chronic Disease Initiative, the Diabetes Strategy will undergo a change of direction, targeting information to Canadians who are at higher risk (e.g., family history, high blood pressure, high cholesterol in blood) especially those who are overweight, obese or pre-diabetic; and the prevention of complications among those with diabetes.

Strategic Outcome: Healthier Canadians and a stronger public health capacity

Results Achieved: Results included increased collaborations with provincial and territorial partners, increased engagement with high risk populations, and increased collaboration with the broad diabetes NGO community. In 2007-08, a total of 65 national and regional projects (24 new projects) were supported for a total of $3.6 million. Of the new projects, 19 targeted Canadians at risk, including youth and ethno-cultural communities. 

Additional results include: increased knowledge among planners, policy-makers and practitioners of diabetes-related determinants; risk and protective factors; at-risk populations; effective interventions and promising community-based practices; increased awareness, knowledge and skills among individual Canadians to prevent diabetes and its complications, and healthier behaviours among individual Canadians to prevent diabetes and its complications.

All projects collected evaluation data based on a common data collection tool. Results will be used to inform Treasury Board commitments.

Name of Transfer Payment Program: Cancer

Start Date: 2005-06

End Date: Ongoing

Description: The Agency is working with the new Canadian Partnership Against Cancer Corporation (CPACC), announced in November 2006, to implement the Canadian Strategy on Cancer Control (CSCC). The CPACC will manage the CSCC’s knowledge translation platform and coordinate communities of practice to reduce the number of new cases of cancer, improve the quality of life of those living with cancer, and reduce the number of deaths from cancer. The CSCC’s strategic priorities (primary prevention; screening/early detection, standards, clinical practice guidelines; rebalancing the focus; health human resources; research; and surveillance and analysis) will provide the overarching framework for cancer control.

Strategic Outcome: Healthier Canadians and a stronger public health capacity

Results Achieved: Results included enhanced partnership with CPACC through the Agency’s representation on most of CPACC’s Action Groups, and a key seat on CPACC’s Advisory Council and continued partnership with CPACC, stakeholders, provinces and territories to enhance the national cancer surveillance system. Under the Healthy Living and Chronic Disease initiative grants were provided to organizations involved in work relating to seniors and cancer. The program funded the Canadian Breast Cancer Initiative (CBCI) for research, care and treatment, professional education, early detection programs, and access to information. Also, on behalf of the CBCI, the Canadian Breast Cancer Screening database was managed and maintained. It monitored and evaluated organized breast cancer screening programs across Canada, and published the associated bi-annual national performance report.