PubMed · 8498269
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1993. Educational programs for deaf students.. https://doi.org/10.1353/aad.2012.0644
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BACKGROUND: Health systems worldwide face persistent health workers challenges including nursing shortages, workforce strain, and inequities. In Canada, these challenges have prompted renewed national and provincial reforms to strengthen recruitment, retention, leadership, and sustainability. This paper compares nursing workforce policy directions across Canada, and international jurisdictions to inform policy and planning. METHODS: A cross-country comparative analysis of policies building on a comprehensive national funded review that included an umbrella review of 69 systematic reviews, a comparative policy review of nursing workforce strategies in five jurisdictions, and validation through national horizon-scanning and policy dialogues (n >100). Evidence was analyzed across system, organizational, and individual levels. RESULTS: At the system level, international jurisdictions demonstrate comprehensive, legislated approaches integrating data, governance, and multi-year funding have advanced key nursing strategies. In Canada, the advances show the importance of strategies to have national and provincial/territorial alignment emphasizing leadership, flexibility, and inclusion as key levers. Organizational and individual-level reforms such as mentorship, leadership development, and wellness initiatives are expanding but remain variably evaluated. Experts identified national workforce data strategies and policy integration with embedded evaluation as key enablers to inform scalability and sustainability of implemented strategies. CONCLUSIONS: Canada's nursing workforce reforms are advancing toward coordinated, equity-driven, and evidence-informed strategies. Continued investment in evaluation, leadership, and national integrated data systems along with integrating nursing workforce planning within broader intersectoral planning will consolidate these gains and position Canada as an international leader in sustainable nursing workforce policy.
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OBJECTIVE: To ascertain whether the increase in the crude infant mortality rate in Canada in 1993 was due to a recent increase in the registration of newborns weighing less than 500 g as live births. DESIGN: Ecological study, with Poisson regression analysis. SETTING: Canada. SUBJECTS: All live births and infant deaths in Canada between 1987 and 1993, as reported by Statistics Canada. Data from Newfoundland were excluded because they were incomplete for 4 years. OUTCOME MEASURES: Proportion of live births by low-birth-weight category; and annual crude and adjusted infant mortality rates. RESULTS: Over the study period the proportion of newborns weighing less than 500 g registered as live births increased significantly (chi 2 for trend = 71.26, p < 0.01). This trend was an isolated phenomenon rather than a general increase in all low-birth-weight categories (chi 2 for trend in the proportion of newborns weighing 500 to 2400 g registered as live births = 1.14, p = 0.28). The crude infant mortality rate per 1000 live births decreased from 6.4 in 1991 to 6.1 in 1992 and then increased to 6.3 in 1993. Poisson regression analysis revealed that the apparent increase in the infant mortality rate was caused by the increased registration of infants weighing less than 500 g as live births. The adjusted infant mortality estimate for 1993 was lower than that for 1992. CONCLUSIONS: The increased infant mortality rate in Canada in 1993 appears to be due to increased registration of infants weighing less than 500 g as live births. Comparisons of infant mortality rates by place and time should be adjusted for the proportion of such live births, especially if the comparisons involve recent years.