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Research Highlights
Research Highlights
Do children go underfed because families can't afford food or because they lack guidance on children's nutritional requirements?
Do children go underfed because families can't afford food or because they lack guidance on children's nutritional requirements?
This study in Public Health Nutrition (Cambridge, 2013) examines whether inadequate infant and young child feeding (IYCF) practices in India are driven by information constraints or household economic capacity, using the National Family Health Survey (NFHS-3) and logistic regression across 9,241 children aged 6–18 months. Nutritional counselling by frontline community health workers is a strong, consistent predictor of WHO-compliant feeding practices across all wealth quintiles. For infants aged 6–8 months, household wealth is not statistically significant; early feeding behaviour is shaped more by knowledge than income. Yet compliance remains low even among higher-income households, and mass media exposure independently improves outcomes, reinforcing behaviour change communication (BCC) as a scalable intervention. The findings position child malnutrition not only as a resource problem but as a health literacy and behaviour change challenge with direct implications for IYCF program design across LMICs.
Malhotra (2013) finds that nutritional counselling by frontline community health workers predicts WHO-compliant IYCF practices across all wealth quintiles in India, with household wealth not significant for infants aged 6–8 months, positioning child malnutrition as much a health literacy challenge as an affordability problem.
Cite: Malhotra, N. (2013). Inadequate feeding of infant and young children in India: lack of nutritional information or food affordability? Public Health Nutrition, 16(10), 1723–1731. https://doi.org/10.1017/S1368980012004065
Weight stigma, anti-Indigenous racism, and racial discrimination each leave independent marks on perinatal care experiences in Canada.
Weight stigma, anti-Indigenous racism, and racial discrimination each leave independent marks on perinatal care experiences in Canada.
This study in BMC Pregnancy and Childbirth (Springer Nature, 2024) provides the first large-scale quantitative examination of weight-based disparities in respectful perinatal care across Canada, using the RESPCCT (Research Examining Stories of Pregnancy and Childbearing in Canada Today) pan-Canadian cross-sectional survey among 3,280 childbearing people with a BMI ≥18.5, measuring autonomy, respect, and mistreatment with three validated patient-reported experience measures (PREMs) directly relevant to CIHI's mandate for pan-Canadian health system performance reporting.
As BMI increased, so did the odds of reduced autonomy, disrespect, and mistreatment. Childbearing people with BMI ≥35 had 45% higher adjusted odds of reduced autonomy (AOR 1.45), declining respect scores across BMI categories (ORs 1.34, 1.51, 2.04; p<.01), and mistreatment (AOR 1.95). All significant after controlling for race, income, and education.
Indigenous Peoples in Canada and racialized childbearing people faced independently elevated mistreatment odds (AOR 2.26 and 1.33, respectively), evidence that directly informs Health Canada's 2024–25 priority of addressing anti-Indigenous racism in health systems. For CAHSPR and CIHR agendas, these findings provide patient-oriented, pan-Canadian evidence that weight stigma, racism experienced by racialized non-Indigenous people and Indigenous Peoples in Canada, each independently contribute to measurable deficits in respectful maternity care.
Malhotra, Jevitt, et al. (2024) provide the first pan-Canadian quantitative evidence that BMI, Indigenous identity, and racialized identity independently influence mistreatment and reduced autonomy in perinatal care, even after adjusting for each other and for income and education. Specifically, Indigenous Peoples in Canada face 2.26 times higher odds of mistreatment, non-Indigenous racialized childbearing people 1.33 times higher odds, and those with BMI ≥35 an adjusted odds ratio of 1.95. All effects are mutually adjusted, demonstrating that weight stigma, anti-Indigenous racism, and racial discrimination operate as distinct barriers to respectful perinatal care in Canada.
Cite: Malhotra, N., Jevitt, C. M., Stoll, K., Phillips-Beck, W., Vedam, S., & the RESPCCT Study Team. (2024). Weight-based disparities in perinatal care: quantitative findings of respect, autonomy, mistreatment, and body mass index in a national Canadian survey. BMC Pregnancy and Childbirth, 24, 737. https://doi.org/10.1186/s12884-024-06928-8
Current Projects
Current Projects
PRIMARY HEALTH CARE IN CANADA
PRIMARY HEALTH CARE IN CANADA
Which province gives you the best chance of having a regular doctor & which leaves you most at risk?
Which province gives you the best chance of having a regular doctor & which leaves you most at risk?
This chart tracks the percentage of the population with a regular primary health care provider across five Canadian provinces from 2015 to 2022, using data aligned with CIHI's pan-Canadian shared health priority indicators for primary care access.
Ontario consistently leads, holding above 90% throughout — a benchmark against which other provinces can be measured. Alberta shows the greatest improvement, rising from 80.5% to 89% by 2022. British Columbia held steady between 81–84% with little system-level progress. Quebec shows the most concerning pattern — starting at the lowest level, 72.5%, in 2015 and remaining well below all other provinces throughout the period, reaching only 79% by 2022.
The persistent 10+ percentage-point gap between Quebec and Ontario raises direct questions about Health Canada's equitable access mandate, PHAC's community health programming, and CIHR's IHSPR Quadruple Aim priorities. For CAHSPR's health services research community, these provincial trajectories provide a baseline for evaluating the impact of primary care reform policy on population attachment to care.
How long does it take to see a health care provider in Canada — and which province gets you there fastest?
How long does it take to see a health care provider in Canada — and which province gets you there fastest?
This chart draws on the Canadian Community Health Survey (CCHS) public use microdata files (PUMF) to show the distribution of waiting times to see a provider across six provinces — data directly relevant to CIHI's pan-Canadian indicators on timely primary care access.
Alberta and Saskatchewan lead on same-day access (30.0% and 29.4%), with Ontario close behind (27.1%). Quebec performs the weakest — lowest same-day rate (18.5%) and the highest share of waits over one month (11.5%), nearly four times Alberta's 2.0%. Combining same-day and next-day access, Alberta (48.9%) and Ontario (46.4%) substantially outperform Quebec (34.6%) and Manitoba (40.0%).
These provincial gaps speak directly to Health Canada's equitable access mandate, PHAC's health promotion programming, and CIHR's IHSPR Quadruple Aim priorities. For CAHSPR's health services research community, the CCHS-derived data provide actionable evidence for primary care workforce planning and health system redesign across Canada
Waiting Time to See a Provider
Waiting Time to See a Provider
#CCHS #CanadianCommunityHealthSurvey #PrimaryHealthCare #TimelyCare #WaitTimes #CIHI #PanCanadian #HealthEquityCanada #HealthPolicy #PatientAccess #PHAC #CAHSPR #CIHR #HealthSystemPerformance #CanadianHealthcare #PrimaryCareReform #SDG3
PREM Measures CIHI
PREM Measures CIHI
PATIENT EXPERIENCE IN CANADIAN HOSPITALS 2022
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