Recommendations for Canadian public health policy after H1N1
Comprehensive study of decision-making during H1N1 in Canada is now published
Toronto, March 1, 2013 – A comprehensive study of how decision-makers set public health policy during the pandemic H1N1 in Canada has been published in the journal Social Science and Medicine. “A policy analysis of the use of evidence in developing public health policies for pandemic H1N1 in Canada” by Rosella et al. offers an important and critical look at decision-making during this fast-changing public health event.
“We wanted to examine the Canadian public health care system response to the 2009 H1N1 pandemic,” said Dr. Laura Rosella, scientist, Public Health Ontario, and lead author of the study. “We analyzed the pandemic decision-making process and identified the factors that influenced the uptake and application of research-based scientific evidence for public health policy decisions during pH1N1. We hope that the lessons and recommendations that result from this analysis will have direct and positive implications on the function of public health in Canada.”
As Canada and the world faced the first pandemic in 40 years, public health officials had to quickly assess evidence and make decisions to protect the public. Understanding what factors affected their decisions – and the context in which those decisions were made – was central to this study. Lessons learned from earlier crises, such as Walkerton in 2000 and SARS in 2003, emphasized the need for better surveillance, better communications and strengthened capacity and expertise to deal with emerging issues. While these lessons came to fruition during pH1N1, the study authors found other opportunities to continue to strengthen the public health system.
The study is based on interviews with Canadian public health officials and scientific advisors, and reviews of pandemic policy documents. Participants recognized the challenge in considering scientific evidence for decision-making in emerging and potentially uncertain situations. The authors hope that identifying barriers and modifiable influences will help improve the response to future emergencies.
Some of the study recommendations include:
- Clarification of roles within Canada's public health system and building on existing structures and relationships to avoid duplication and maintain credibility
- A more transparent and iterative approach to incorporating evidence into public health decision-making that reflects the realities of the external pressures present during a public health emergency
- Creation and use of pandemic plans to accommodate dynamic responses in emerging situations
- More rigorous use of formalized Incident Management Systems to improve processes and ensure better information flows and documentation
“A policy analysis of the use of evidence in developing public health policies for pandemic H1N1 in Canada,” by Rosella, L.C., Wilson, K., Crowcroft, N.C, Chu, A., Upshur, R., Willison, D., Deeks, S., Schwartz, B., Tustin, J., Sider, D., Goel, V. is available here.
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