Request for Letters of Intent for a Workshop (RFP 009)

The Development of a First Nations and Inuit Health
Policy Research Framework: Phase I

I. Deadline

Full proposals must be received before June 10, 2002 (12:00 noon E.S.T.)

II. Funding and General Information

• Maximum funds available for this competition: $150,000 (Please see budget allocations below).
• Planning for 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; and (3) increase the usefulness of the results to Health Canada.
• Speakers and participants must be nationally representative. Health Canada is prepared to recommend participants for certain sessions. Applicants must include a list of potential invitees to the workshop.
• Funds cannot be used to commission research for the event.
• If possible, the event should coincide with another relevant workshop/seminar, in order to maximize efficiency and effectiveness.
• Researchers are strongly encouraged to consult the Health Policy Research Program Guide before preparing a proposal, particularly to familiarize themselves with the eligibility and review criteria.

III. Scope of Competition

Objective

Health Canada is currently in need of a policy research framework that will inform policy development on First Nations and Inuit (FN/I) health issues. To achieve this goal, Health Canada is inviting proposals for the development, organization and delivery of (a) workshop(s) that meet(s) the following objectives:

1. To outline the current knowledge available across four broad health domain areas and four cross-cutting themes (described below);
2. To identify the knowledge gaps across these health domain areas;
3. To develop research questions that would address these knowledge gaps;
4. To develop appropriate methodologies for addressing the research questions.

Research questions should identify research priorities that are of importance to Health Canada policy-decision makers in the medium to long term (2 to 5 years).

Context

Health Canada is proposing to develop the policy research framework in three phases. This RFP is meant to address Phase 1 only. Phases 2 and 3 will only proceed if funding can be obtained and they are not part of this RFP.

Phase 1 (current RFP):

Identify research questions across health domains of importance to public policy for FN/I and to develop appropriate methodologies for addressing the research questions in a manner that will inform the policy decision-making process;

Phase 2 (future work):

Develop a strategy to implement the research, including the identification of necessary partners/stakeholders and their respective roles and responsibilities, time frames for completion of the research, research transfer/uptake methods to inform policy decision-makers, etc..

Phase 3 (future work):

Conduct the research, working in close consultation/collaboration with Health Canada and other partners/stakeholders.

Health Domains and Cross-Cutting Themes

There are many issues and challenges facing the health and well-being of FN/I in Canada. For example, compared with non-FN/I peoples, FN/I groups experience significantly higher poverty rates (e.g., 43% of on-reserve housing is inadequate¹), shorter life expectancy¹, higher morbidity rates², higher infant mortality rates², higher rates of injuries and violence², and higher rates of chronic diseases (e.g., self reported diabetes prevalence is three times higher for males and 5 times higher for females³⁾ and infectious diseases (e.g., rates of tuberculosis are 8 times higher⁴). Forty per cent of FN/I are under 20 years of age and the entire FN/I population is expected to grow at 2 per cent per year over the next 10 years¹. Suicide mortality in First Nations females, aged 15-24 was eight times higher than the general Canadian rate of females aged 15-24². Similarly, the male First Nations suicide rate was five times higher. FN/I peoples are also affected by encroaching urbanization and economic development that have brought on the destruction of natural environments - affecting drinking water, traditional hunting grounds, and access to traditional foods.

These issues and others that affect the quality of life of FN/I peoples in Canada are a priority not only for Health Canada but for the government of Canada as a whole, as evidenced in the January 2001 Speech from the Throne, and the September 2000 Health Accord in which First Ministers agreed to work in collaboration with Aboriginal people, their organizations and governments, to improve their health and well-being.

Health Canada has identified three broad health domains that would provide the base components of a broader FN/I health policy research framework:

1. Health Systems Management;
2. Broad Determinants of Health;
3. Health Promotion and Wellness.

A fourth, 'Open' category is available to allow for the possibility of applicants suggesting additional health domains. Applicants must obtain approval for any open category topics from the policy contact.

In identifying knowledge gaps across these health domains, the research and data available in Canada and other countries must be considered. Once knowledge gaps have been identified, research questions should be developed to address them. It is important that research questions consider the policy implications for governments and FN/I peoples.

In addition, four cross-cutting themes for horizontal analysis of the health domains have been identified. For each domain addressed, workshop participants must submit a report which identifies research that has been consulted, research questions of importance to public policy for FN/I and describes appropriate methodologies for addressing the research questions in a manner that will inform the policy decision-making process. All health domains (including any additional domains proposed under the Open category) must address all of the cross-cutting themes identified below, where appropriate.

1. Rural and Remote:
   In Canada 77% of FN/I communities in Canada have less than 1,000 people and 34% of FN/I communities are semi-isolated, isolated or remote. The geographic location as well as the socio-economic and demographic profile of rural and remote areas may impact health outcomes for FN/I in terms of types of health care required, access to health services and availability of medical professionals.
2. Community Stability:
   Housing, training, justice, economic development, health, social services and income support are all issues that impact on the stability of any community. In FN/I communities in Canada, the challenges in addressing some of these issues are more pronounced.
3. Multiple Jurisdictions:
   FN/I people receive essential components of Primary Health Care from federal and provincial/territorial governments and FN/I organizations. The involvement of these multiple jurisdictions create significant policy challenges for the FN/I health care systems. This category includes coordinating and integrating systems of health care across FN/I, federal, provincial and territorial jurisdictions.
4. Cultural:
   There is ample evidence of profound cultural differences both between the Canadian population as a whole and FN/I as well as between the numerous FN/I groups in Canada. Cultural values, practices and traditions can have a significant impact on all aspects of health care provision and utilization and will help to shape and define what are culturally appropriate services.

A chart has been attached to illustrate the relationship between the health domains and themes.

Budget Allocations

All proposals must address one of the following:

• All three health domains, excluding Open category (maximum $150,000 budget);
• Two of the three health domains, excluding Open category (maximum $100,000 budget);
• One of the three health domains, excluding Open category (maximum $50,000 budget);
• Open category + one health domain (maximum $100,000 budget);
• Open category + two health domains (maximum $150,000 budget).

IV. Policy Contact

When developing a proposal, policy inquiries (i.e., non-administrative questions) should be directed to:

Tracey Spack, PhD
Policy Advisor
Strategic Policy
First Nations and Inuit Health Branch
Health Canada
Tel: (613) 954-1737 or (613) 957-3442
Email: Tracey_Spack@hc-sc.gc.ca

The policy contact is responsible for providing contextual guidance and advice. All applicants should consult with the policy contact prior to preparing a proposal, to ensure that applicants have a clear understanding as to the requirements of this RFP.

The policy contact is to be consulted on the policy issues and proposal content only. 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.

Please do not forward proposals (draft or otherwise) to the policy contact for review at any time. Preliminary review of a proposal by the 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 noon (E.S.T.) on
June 10, 2002.

Researchers are required to register with the HPRP Program Officer before submitting an application. When you contact the officer, you will be given an application form and a registration number which must be quoted on the application form.

When developing a proposal, please direct inquiries regarding eligibility, time frames, budgets, the proposal preparation and review process, and terms and conditions of the HPRP to the HPRP Program Officer:

Inger Abrams
Senior Program Officer
Health Policy Research Program
Research Management & Dissemination Division
Health Canada
Room 1532, Jeanne Mance Building
Postal Locator 1915A
Tunney's Pasture
Ottawa, Ontario
K1A 0K9
Tel: (613) 952-8112
Fax: (613) 954-7363
Email: Inger_Abrams@hc-sc.gc.ca

VI. References

¹ Department of Indian Affairs and Northern Development. Basic Departmental Data - 1999. Departmental Statistics Section, Information Quality and Research Directorate, Information Management Branch. February 2000.

² First Nations and Inuit Health Branch, Health Canada. Internal Data, 1994.

³ First Nations and Inuit Regional Health Survey National Steering Committee. First Nations and Inuit Regional Health Survey : National Report 1999. St. Regis, Quebec: Assembly of First Nations, 1999.

⁴ Health Canada. Tuberculosis in First Nations Communities, 1999. Ottawa: Minister of Public Works and Government Services, 2001