Primary Health Care in Canada: Determinants, Factors, and Nursing

This report provides a detailed analysis of primary health care (PHC) in Canada, examining its structure, access, and key determinants. It highlights the dual function of PHC in Canada, emphasizing the provision of direct care and coordination of services to ensure continuity. The report delves into the key determinants of health, including social, economic, environmental, and personal factors, and their impact on health equity and inequalities within the Canadian population. Environmental determinants and their link to health are also discussed. Furthermore, the report explores the factors affecting PHC in Canada, such as fragmentation and patient information sharing, and the evolving role of nurses in addressing these challenges. The inclusion of person-centered care and evidence-based solutions in PHC is also considered, emphasizing the importance of collaborative approaches and patient empowerment to improve health outcomes and ensure equal access to healthcare services.

Running head: PRIMARY HEALTH CARE IN A GLOBAL CONTEXT
Assignment 2
Primary Health Care in a Global Context
Name of the student:
Name of the university:
Author note:

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Table of contents
Introduction:..............................................................................................................................2
Primary Health Care access in Canada......................................................................................2
Key determinants of health care in Canada...............................................................................5
Environmental determinants of health.......................................................................................6
Factors affecting primary health care in Canada and its effect on nursing practice..................7
The inclusion of person-centered care and evidenced-based solutions in primary health care.8
Conclusion.................................................................................................................................9
References..................................................................................................................................9

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Introduction
Primary health care has been the driving force in healthcare systems across the globe.
The values set by the WHO, principles, and approaches have informed the basis for improved
access to care and health fairness among the population. Primary health care model embeds on
the holistic view of health and disease in general. It focuses itself on the role of various root
causes of morbidity. Primary health care is oriented on individual, family, and community care.
Further its basis hinges on the preventive approach of care which is oriented to humankind and
environment. Primary health care approach follows a spectrum of services which lay a crucial
part in the healthcare system which include health promotion activities.
The focus of this paper is health care service equity in Canada. Canada’s health care
services have a broad spectrum of activities and services which address the health care. The
primary health services in Canada majorly focuses on providing first direct contact services
through avenues such as primary health care professionals in the service. The healthcare service
is coordinated as to ensure continuity and mobility across the various systems in place. Thus the
impact of health equity access for the Canadians, the key determinants underlying it,
environmental factors linked and contribution of health care provider’s nurses has been deeply
discussed.
Access of Primary Health Care in Canada
The aim of primary health care service in Canada serves a crucial dual function in the
health care system. They offer the provision of direct first care services through the usage of the

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various healthcare service providers in its disposal. Secondly, it offers coordination of health
care function so as to ensure that there is continuity of health care service. This means that care
for the Canadians remains open and serve the general population. The aim of the health access
equity in Canada is to provide responsive care of the needs of the population. In order to
facilitate this, it has offered a range of healthcare services which vary according to the
community needs. These primary health care services which ensure equity include prevention
and treatment, basic emergency services, health promotions, palliative care, healthy child
development among other health care services, (Aggarwal & Hutchison, 2012).
Previously, the health care system in Canada faced numerous challenges. The services
were delivered mainly through the physician and the general practitioners whom their key focus
was the treatment of illness and injury assessment. Various concerns were raised with this regard
which includes the lack of emphasis on health promotion and prevention of disease, problems
regarding access especially in the rural and far remote areas and providers relating to working
conditions, (Osborn et al, 2015).
With the raised concerns, primary health care reform took center stage. This brought
about to a shift towards a team of providers responsible for providing comprehensive care of
service to the citizens. This was initiated by the consensus that having better working conditions
among the health care team including the nurses, physician and other healthcare professional
team yielded better health outcomes leading to improved access to services, prudent usage of
health care resources in an equitable manner and offering the satisfaction of health care services
among providers and the patients. The shift in the team of providers ensured that health
promotion and improvement of chronic disease management, (Sweetman & Buckley, 2014).

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Various territories and provinces in Canada are putting forward plans which enhances
primary health care reforms in partnerships with the Transition fund in primary health care, body
initiated to oversee reforms in primary health. Various initiatives have emerged which enhances
health care equity access for all the service providers. These include creation of primary health
care teams which promote comprehensive care service for their clients, enhancing telephone line
services, improving on management of chronic services, putting emphasis on health promotion
and prevention, voluntary participation among health providers and enhancing capacity building
through evaluations to enhance quality of care, (Hutchitson & Glazier, 2013).
Through international health standards lenses, Canada is experiencing low ratios of
physician to the population , however, the rate of general practitioners is high and above average
compared to member states of OECD (Organization for Economic Cooperation and
development). Family physicians account for an estimate of about 51% of the total workforce of
physicians,(Canadian Institute of Health Information, 2010). An estimate of 91% of Canadians,
taste to normal care service delivery through a family physician, however, many residents still
argue difficulty to obtain primary care and referral services, (Canadian Institute of Health
Information, 2009) An estimate of 13% argue that there is difficulty in accessing health care
services and ongoing care and 33% reported that they had to experience a long waiting time to
access care services. Canadian citizens are however entitled to a free family physician, making
the physician services free at the health facilities.
It is interesting to note that Canada’s primary health care has entered into critical phase of
transformation. Various initiatives have been put forward for interprofessional healthcare teams,

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patient enrollment, group engagements, and patient intake with health care provider and
enhanced governance to support the changes for ensuring health access and equity for all.
Key determinants of health care in Canada
Preventive measures aiming at healthy food practices of healthy living have been rolled
out as a crucial aspect in Canada health care systems in challenging the rise of chronic diseases.
The rise in chronic disease and the epidemic proportions have raised the epidemic levels and
pose serious health issues towards health care sustainability in general through avenues of health
promotion.
Important underlying issues to this mentioned health characteristic in Canada lies in the
social and economic factors underlying health inequalities. Many factors have an impact on
influencing health. Health determinants are broad and often range from social, economic,
environmental and personal factors which are key determinants of population and individuals.
Major determinants underlying health are income, social status of the populations, working
conditions status, education levels, physical environment, health behavioral patterns, health
service access, gender, and cultural influences, (Mikkonen & Raphael, 2010).
Social determinants, on the other hand, entail certain aspect of social and economic
factors which have broader health significance. These have been shown to have an effect on the
societal position of an individual’s, education status, and employment and income opportunities.
Further discrimination of individual and trauma experiences has been shown to have an effect as
a health determinant of health, (Public Health Agency of Canada, 2011).

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In Canada, economic and wealth disparities are evident. Some of the Canadians citizens
have more wealthy possessions and have a more healthy life compared to other citizens. Those
pertaining health status have been contributing factor to health inequalities. The differences have
been observed due to the choices made. This means that social factors can be a factor as a
determinant of health. Health inequity and equity have been observed in the Canadian society.
Various approaches have been put forward to combat and reduce health inequalities. This
ensures that everyone gets the same opportunities for health, in wherever places they are in.
various avenues have been put forward by the Canadian government to reduce this social
determinant of health. Strengthening of evidence-based practice to inform decision making has
been practiced. This has been undertaken using health inequalities data tool which entails a data
set on health inequalities, created by the Canada public health agency. Another key tool being
used is the identification of key health inequalities illustrating the challenges existing, developed
through various stakeholder agencies. Data informatics on children about health and
developmental issues in the early years and effective childhood development programs and
interventions has been outlined. Engaging other none health sectors has been established across
the Canadian health system. This looks into beyond board in working with other sectors towards
improving and eliminating the social determinants affecting health and scaling equity of health
care, (GoC, 2018)
Environmental determinants of health
Research undertaken has shown a link between health and the environment. WHO states
environmental factors account for an estimate of 24% of the world burden of morbidity and 23%
all death causes. This tremendous costs it puts on human beings are higher in highly developed

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countries, Canada included. Data suggests that the greatest impacts are borne to the lowest
income category of people especially the aboriginal and marginalized groups. This phenomenon
is true with regard to the global context, where the developing countries are bearing the harmful
consequences of changing the climate, (RNAO online, 2018).
Protection of environment has not been only the matter of health, but also linked to social
equity and justice. Access to clean water and air, needs to be recognized as a human right due to
the seriousness of the threats it causes. Canada advocates for precautionary approaches towards
protecting the health of human beings and the environment in general.
The health costs related to the failure to act on environmental factors of health are a
record high. With illustrations of four commonly related environmental factors such as diabetes,
neural development, and Parkinson disease effects, their total health costs is estimated to be up to
US 10billion in Canada. This costs are high hence need for adequate actions by the various
health and none health actors to act, (RNAO online, 2018).
Factors affecting primary health care in Canada and its effect on nursing practice
There are various factors which play a crucial role in the health care delivery have been
attributed to various organizational gaps which include health care fragmentation, low
management levels and inability for successful follow-ups of to the vulnerable groups, limited
priority of health promotion practices, equality issues and patient information sharing. With
respect to these challenges, new models and innovations have been rolled out to meet these
challenges. Collaborative interdisciplinary approaches and quality improvement strategies have
been put forward, (Wong et al, 2010).

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Primary health care symposium held in 2016 in McGill discussed collectively on the
challenges health care system was facing. This forum put into shape the role nurses played in
healthcare practice. In the current arena, the role of the nurses has always been undermined
contrary to many successful models where nurses have played a crucial role. Nurses play a
crucial role in health promotion, illness prevention, caring for the ill, dying and the disable
persons. Further, advocacy roles, safe environmental area, engaging in research, and the shaping
of health policy forms key areas of focus for nurses, (Bartz, 2010).
The Canadian Nurses associations have put forward key roles of the nurse as impacting
positivism in the patient, being a provider and achievement of organizational outcomes. The
nurses play a crucial role in shaping current and future professional nursing decorum, (Canada
Nurses Association online, 2018).
The inclusion of person-centered care and evidenced-based solutions in primary
health care
The Canadian healthcare continues to evolve; the prevalence of chronic disease continues
to rise. This has brought into focus health professionals. The concept of patient-centered care has
been advanced in various surveys done, (Montaque et al, 2017). Patient-centered care has been
structured around healthcare user and enhancing empowerment. Various platforms have been
initiated such as personal electronic health records packaged with effective interoperability
functionality has been put in place. A person-centered approach has initiated positive working
relations among health care workers, promoting wellness and involving all parties with the
overall agenda of promoting equal health access for all, (Canadian Association of Person Centred
health, online, 2018).

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Towards the promotion of evidence-based solutions in nursing practice, nurses play a key
role in nursing research. This addresses key focus areas of knowledge and personal enhancement
desires. The critical tasks in coming up with evidence-based recommendations entail performing
laboratory experiments and utilizing analytical skills. Nurse’s role is diverse and calls for
assertiveness, high clinical practice and commitment. This portrays the critical phase the nurses
are in Canada in promoting primary health care and ensuring evidence-based care practices,
(Gibbs & Lowton, 2012).
Conclusion
Canadian primary health care is undergoing a tremendous transformation, through the
implementation of key initiatives which promote interprofessional health approaches, healthcare
networking, patient, and financial incentives all geared towards ensuring that there is an easy
access to health care for all. Canada's changes have shown that primary health care can be made
equal and accessible to all. Acting on the various factors affecting health care and the critical role
of nurses plays a fundamental aspect in healthcare delivery.

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References
Aggarwal, M., & Hutchison, B. (2012). Toward a primary care strategy for Canada. Ottawa, ON:
Canadian Foundation for Healthcare Improvement.
Bartz CC. International Council of Nurses and person-centered care. International Journal of
Integrated Care. 2010;10(5). DOI: http://doi.org/10.5334/ijic.480
Canada Nurses association [Internet]. Effectiveness of Registered Nurses and Nurse Practitioners
in Supporting Chronic Disease Self- Management: A Public Health Agency of Canada
Funded Project; 2012. Available from: https://www.cna-aiic.ca/. viewed at 09/09/2018
Canadaian Association of Person Centred health, What is Person-Centred Healthcare? Accessed
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Canadian Institute for Health Information. Experiences with Primary Care in Canada. Ottawa:
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Gibbs CL, Lowton K. The role of the clinical research nurse. Nursing Standard. Date of
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Hutchison, B., & Glazier, R. (2013). Ontario’s primary care reforms have transformed the local
care landscape, but a plan is needed for ongoing improvement. Health affairs, 32(4),
695-703.
Mikkonen, J., & Raphael, D. (2010). Social Determinants of Health: The Canadian Facts, York
University School of Health Policy and Management, Toronto.
Montague, T., Gogovor, A., Aylen, J., Ashley, L., Ahmed, S., Martin, L., ... & Nemis-White, J.
(2017). Patient-Centred Care in Canada: Key Components and the Path Forward.
Healthcare quarterly (Toronto, Ont.), 20(1), 50-56.

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Osborn, R., Moulds, D., Schneider, E. C., Doty, M. M., Squires, D., & Sarnak, D. O. (2015).
Primary care physicians in ten countries report challenges caring for patients with
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Sweetman, A., & Buckley, G. (2014). Ontario's experiment with primary care reform.
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