Request for Proposals: Migration Health Workshop, Seminar or Conference (RFP 005)
I. Deadline
Full proposals must be received before February 1, 2002 (12:00pm
E.S.T.)
II. Funding and General Information
- The HPRP expects
to fund one proposal.
- Maximum funds available: $150,000
- Proposals with budgets that exceed $150,000, that do not meet
the three objectives noted below or that propose additional thematic
areas beyond the four described in the RFP will
be deemed ineligible, without exception.
- The event must include opportunities for Health Canada
officials to participate in a capacity which would (1) add to
the knowledge being considered; (2) ensure that relevant policy
issues are being considered; (3) increase the usefulness of the
results to Health Canada.
- Speakers/participants must be nationally representative.
Applicants will be expected to solicit papers from qualified
researchers/health policy experts in the four thematic areas
for presentation at the event. Health Canada is prepared to recommend
speakers for certain sessions.
- Funds cannot be used to commission research for the
event.
- Wherever possible, the event should coincide with another relevant
workshop/seminar/conference, in order to maximize efficiency
and effectiveness.
- Proposals must address all three objectives and all
four of the thematic areas described below in order to
be considered for funding.
III. Scope of Competition
Objectives
Health Canada is seeking to improve its understanding of migration
health policy issues. To achieve this goal, Health Canada is inviting
proposals for the development, organization and delivery of a workshop,
seminar or conference that meets the following three objectives:
- To develop, in collaboration with Health Canada, a Migration
Health Framework that identifies and clarifies the key issues
which require further research for eventual policy decision-making;
- To share existing research on the health of migrant populations
with respect to the four topic areas described below; and
- To achieve consensus on a Migration Health research strategy,
in support of possible future health policy options.
Context
Health Canada administers the Quarantine Act and acts as
health advisor to Citizenship and Immigration Canada (CIC) with
regard to certain provisions of the Immigration Act. These
two Acts, supplemented by other legislative and regulatory measures
(e.g., Health Canada's Human Importation of Pathogen Regulations)
are at the core of the means presently available to the federal
government to manage the entry of human diseases into Canada.
Embodied within both acts is the quarantine paradigm, which dates
to fourteenth century efforts to control the spread of the plague.
Traditionally, the emphasis has been on restricting entry or outright
exclusion; more recent iterations of the quarantine paradigm have
relied on medical examinations at or prior to entry. The approach
proved sound for several centuries, and throughout most of Canada's
history.
The closing decades of the twentieth century have witnessed the
emergence of a number of trends which point to the need to re-think
the quarantine paradigm. Key among these trends has been the advent
of affordable air travel, which has led to a greatly increased
volume of travel by migrants - immigrants, refugees, tourists,
business visitors, students and returning Canadians - and greatly
reduced transit times and an ever more integrated global economy.
The numbers alone tell the story of the limitations of public
health strategies which rely on exclusion, rather than inclusion.
Medical examination is a pre-condition of admissibility for immigrants
and some other long stay visitors, which means that the roughly
225,000 immigrants and Convention refugees each year have undergone
a medical assessment prior to landing. But, most of the 20,000
people who arrive each day from points overseas at Toronto's Pearson
airport have not undergone any medical assessment and neither have
the estimated 100 million persons who cross the Canada-US border
each year. If the public health challenge is too massive to manage
overseas or at ports of entry, it has to be managed inside Canada.
But how?
In addition to the public health challenge, there is a population
health challenge. Analyses of health service utilization patterns
show that, as a rule, immigrants use fewer services than the norm
over their first few years. But it also shows that this apparent
health advantage erodes over time. Why?
Topic Areas
1. Development of research strategies or methodologies to address
the incidence/prevalence attribution
A fundamental challenge for effective health risk management
lies in knowing where the risks are. In the migration health sphere,
this requires knowledge of the relative risks of infectious diseases
posed by discrete migrant populations including, but not restricted
to, Canadian tourists, foreign business visitors, Convention refugees,
refugee claimants, independent immigrants and family-class immigrants.
i) The experience of CIC with
respect to medical admissibility, and whether disease patterns
observed among immigration candidates and Convention refugees are
similar to, or different from, disease patterns in source countries
as a whole as reported by the World Health Organization, the Global
Public Health Intelligence Network or other authoritative sources;
ii) To explore and appraise competing methodologies of estimating
the risk of discrete migrant populations acquiring communicable
diseases outside of Canada, by comparing the experience of travel
medicine clinics, general practitioners, public health units, community
health centres, university departments of epidemiology, and preventive
medicine, and others; and iii) Strategies for linking or networking
academic health centres, public health units and travel medicine
clinics for the express purpose of improving insights into diseases
acquired outside of Canada by discrete migrant populations.
2. Development of research strategies or methodologies to address
tuberculosis (TB) reactivation
There are two key issues. The first bears on TB itself
and the extent to which travel abroad explains the incidence of TB in
Canada among non-aboriginal, non-immigrant populations. The second
issue bears on the potential significance of TB reactivation
as a sentinel condition, indicative of declining standards of living.
Different studies have revealed varying latency periods, but it
appears that about half of the TB cases
among the foreign-born are diagnosed within five to seven years
following immigration.
While the literature on the etiology of TB is
clear on the role played by socio-economic factors, it is less
clear in other areas. Workshop participants should develop, and
obtain consensus on, research strategies or methodologies capable
of capturing the information described below:
i) How the TB experience
may vary between discrete immigrant populations (e.g., independent,
family class, Convention refugee, etc.); and
ii) The extent to which TB incidence
might be explained by reference to;
- settlement/integration programming
- access to public health services
- breakdown in sponsors' undertakings
- workforce exploitation
3. Development of research strategies or methodologies to address
health services access during the first 90 days following arrival
in Canada
The Canada Health Act allows provinces to impose a qualifying
period on immigrants before they can become "insured persons". CIC, for its part, has an Interim Federal
Health Program (IFHP),
to cover needy immigrants during this period. Workshop participants
should develop, and obtain consensus on research strategies or
methodologies capable of capturing the information described below:
i) factors affecting service non-utilization or under-utilization
during the first 90 days (e.g., provincial qualifying periods,
non-awareness of the IFHP,
cultural factors which may mitigate against seeking services, etc.);
and
ii) estimates of the health consequences of service non- or under-
utilization.
4. Development of research strategies or methodologies to address
the extent to which "place matters"
Studies of the health status of immigrants have generally been
confined to a single locale or jurisdiction. Thus, findings reported
by investigators working independently do not always tell the same
story. Workshop participants should develop, and obtain consensus
on, research strategies or methodologies capable of capturing the
information described below:
i) settlement and integration factors affecting the health status
of immigrants including,
- number of community members of the same ethnicity/nationality
as the immigrant already in the locale/jurisdiction
- level of acceptance of host community of immigrants
- ability of health and social authorities in specific locales/jurisdictions
to anticipate and meet the health needs of immigrants
- comparisons between locales/jurisdictions with established,
although different, approaches to settlement and integration
programs
- comparisons between locales/jurisdictions which are popular
immigrant destinations and those which are not.
IV. Policy Contact
When developing the proposal, policy inquiries should be directed
to:
Mark Wheeler
Assistant Director, Policy Division
Policy, Planning and Priorities Directorate
Health Policy and Communications Branch
Health Canada
Telephone: (613) 952-8553
Fax: (613) 947-1204
Email: Mark_Wheeler@hc-sc.gc.ca
The policy contact is responsible for ongoing interaction with
researchers to provide contextual guidance and advice to researchers
when developing their proposal. We encourage all applicants to
consult with the policy contact prior to preparing a proposal.
The policy contact is to be consulted on the policy issues and
proposal content only. Formatting, eligibility/ineligibility, and
other administrative questions (such as time frames, budgets, etc.)
should be directed to the HPRP Program
Officer. As the policy contact will not provide letters
of support, applicants must outline their interaction(s)
with Health Canada staff in the body of the proposal.
Do not forward proposals (draft or otherwise) to the policy
contact for their review at any time. Preliminary review of a proposal
by a policy contact will be deemed a conflict of interest and may
result in the disqualification of your proposal.
V. How to Apply
Full proposals must be received before 12:00 pm (E.S.T) on February
1, 2002.
Researchers are strongly encouraged to consult the Health Policy Research Program Guide before preparing a proposal. If you
are interested in submitting a proposal in relation to this RFP,
please refer to the Application for workshop, seminar, conference
funds and Instructions for completing the application form for
workshop, seminar, conference funds.
When developing a proposal, please direct inquiries regarding
eligibility, the proposal preparation and review process, and terms
and conditions of the HPRP to:
Elizabeth Maddocks
Senior Program Officer
Health Policy Research Program
Research Management & Dissemination Division
Health Canada
Telephone: (613) 954-8557
Fax: (613) 954-7363
Email: Elizabeth_Maddocks@hc-sc.gc.ca
Sherrill MacDonald
A/ Senior Program Officer
Health Policy Research Program
Research Management & Dissemination Division
Health Canada
Telephone: (613) 954-0830
Fax: (613) 954-7363
Email: Sherrill_MacDonald@hc-sc.gc.ca
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