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Nutrition 3701


Nutrition 3701-lecture 33

29 November 2010



Health and Nutrition Care Delivery Strategies


Canada has a predominantly publicly-financed, privately-delivered health care system known to Canadians as Medicare. It provides access to universal, comprehensive coverage for medically necessary hospital, in-patient and out-patient physician services. Most doctors are private practitioners who work in independent or group practices, enjoy a high degree of autonomy, and are generally paid on a fee-for-service basis.

The federal government is responsible for:

The provincial and territorial governments are responsible for:

Federal Nutrition

Canada’s food guide

The mission of the Food Program is to protect and improve the health of the people of Canada through science-based policies and programs related to safe and nutritious food.

The Food Program provides information related to food safety and regulation such as:

Nova Scotia Health


Nova Scotia health care delivery

Community-based, family-focused, and person-centred.
This means that:

Everyone in the community (individuals, families, primary health care providers, community groups, service delivery organizations and government) works together to identify and build upon community strengths and capacities, and to define community health needs and the best ways to meet them.

The uniqueness and diversity of individuals, families and communities are valued and responded to appropriately

Individual, family and community capacities to improve health status and to participate in health services planning are increased.

All Nova Scotians have an ongoing relationship with a primary health care provider through whom they can access health care services.


This means that:

The many factors that influence health are considered in primary health care planning and delivery, including but not limited to income, social status, education, employment, healthy child development, genetic endowment, gender, culture, spirituality and race.

The primary health care system provides a balance between activities that promote health and provide health care services.

A wide range of services is offered by the primary health care system, including but not limited to primary care, continuing care (long term and home care), rehabilitative care, public health, emergency care, community mental health, addictions, nutrition services, palliative care and pharmaceutical services.

Activities that promote health are supported by the primary health care system and include but are not limited to community capacity building to promote health, individual health education, disease and injury prevention and advocacy for healthy public policy.


Responsive and flexible.
This means that:

Communities are supported in gathering and accessing reliable information to help identify changing capacities, needs and issues.

The changing capacities and needs of individuals, families and communities are recognized and responded to in a timely manner.

Primary health care services are offered in ways that value and respond to the cultural, racial, and spiritual experiences of individuals, families and communities.


This means that:

Primary health care services are accessible to all Nova Scotians, as close as possible to where they live, work, or go to school.

Nova Scotians can choose a primary care provider and have access to a defined range of primary health care services, including access to urgent care 24 hours a day.

There is equity of access for those who have historically faced barriers, including but not limited to barriers related to illness, disability, poverty, culture, race, ethnicity, language, geography and gender.

Access to other primary, secondary and tertiary health care services is coordinated, and linkages are made with services outside the health care system including programs and services offered at the community level by a variety of providers and organizations.

Activities that promote health are supported in all communities across the province.

Specific mechanisms are in place to ensure that where both federal and provincial jurisdictions have responsibilities for service delivery (e.g. to First Nations), access is assured and coordinated.


Integrated, collaborative and innovative.
This means that:

Health care services are coordinated and integrated in a way that ensures care is provided to individuals and families in the optimal setting, and assists individuals and families in navigating with ease through the system.

Linkages are made and maintained with organizations, agencies and government departments whose contribution is essential to the improvement of individual, family and community health status.

Collaboration within and outside the primary health care system results in creative, innovative and effective approaches to the delivery of health care services and to the implementation of activities that promote health.

Collaboration among primary health care professionals, other care providers, community organizations, individuals and families is supported by structures that foster trust, support for shared decision-making and respect for professional autonomy.


This means that:

Those who receive and provide care as well as those who govern the health system and work on behalf of communities have clearly defined and specific areas of accountability.

Health information and data are available and accessible so that individual, family, community, health professional and government decision-making is based on sound evidence.

There is ongoing evaluation of the primary health care system related to needs, standards, efficiency and effectiveness.

Communities participate in identifying and supporting methods used to promote health and to deliver primary health care services.


This means that:

Those who govern the health system and work on behalf of communities ensure the delivery of quality activities to promote health and health care services that are efficient, effective, affordable, and acceptable to the community.

Duplication and waste are identified and eliminated.

Standards and best practices are widely adopted in the effort to sustain equitable, quality care across the province.

Ongoing education and resources are available to support primary health care professionals in both their delivery of services and in collaborating with others.





Nova Scotia nutritional policies are directed at all ages from pre-birth to old age and mimic federal guidelines

Objectives of Health Care and  Nutrition care Strategies 

            Best possible population health for the lowest possible cost

Lowest possible cost to society

-financial-the cost of keeping people healthy(prevention), returning people to health and  keeping them healthy or partially cured once they are in a state of improved health


-productivity-fewer missed work days and more productive when society is on the job-when many in the population are off work or are not productive when at work then the economy suffers leaving potentially less money for health care which then causes greater illness


-enjoyment-productivity leads to societal enjoyment (better societal income,  societal education and services) and in turn enjoyment leads to a better level of societal productivity which allows more tax dollars to be spent on societal health


Lowest possible cost to individual

-financial-more money to spend on nutritious food and to meet the concepts of adequacy, balance, energy control, nutrient density moderation and variety


-productivity-if person is better fed and is meeting all nutrient intake requirements via the concepts of adequacy, balance, energy control, nutrient density moderation and variety one is less likely to be ill or ill for longer periods of time


-enjoyment-a more productive person is clearly less prone to depression and is therefore less likely to incur both financial and productivity costs associated with depression



            Research- new approaches in medicine including nutrition:

-assessment of current and new approaches in terms of cost of delivery and their effectiveness in terms of reducing both short and long term costs

-cost/benefit ratios –ideally theses should be as low as possible so as to get the biggest benefit per dollar

-benefits- fewer visits to physicians, nurses, dieticians

              -shorter illnesses and less severe illnesses

               -shorter hospital stays

               -longer life before serious illness sets in

-requirements for less expensive drugs and nutritional interventions