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Purpose: The purpose of this paper is twofold: to introduce scholars and practitioners of foresight to the emerging Canadian foresight ecosystem, and to provide lessons learned on developing policy foresight from the Government of Canada context. Design/methodology/approach: The paper provides a series of lessons based in part on informal and indirect observations and engagement with established Canadian foresight entities, including Policy Horizons Canada, and numerous newly established foresight initiatives at Global Affairs Canada, Standards Council of Canada and the Canadian Forest Service. Findings: The paper finds that Canada's newly emerging foresight units and initiatives face structural, institutional and organizational challenges to their long-term success, including in concretely measuring foresight outcome (rather than simply output) in policy making. Originality/value: The paper provides a unique and empirically driven perspective of the foresight ecosystem that has emerged within the Canadian federal public service since 2015. Lessons are culled from this emerging network of Canadian foresight practitioners for international application. [ABSTRACT FROM AUTHOR]

Purpose: In Canada, community engagement and accountability are a political imperative, resulting in an omnipresent program with varied opportunities for public participation. The purpose of this paper is to promote leadership and commitment for health system transformation that truly benefits communities. Design/methodology/approach: This paper is based on the author's experience with many engagement and accountability activities, applied in varied settings, for purposes such as evaluation, planning, policy making and system transformation. The specific context is generalized with international experiences and references. Findings: The "lessons learned" are based on practical considerations with relevance for both novice and experienced practitioners: clarifying principles, processes and purposes at the outset; using effective leadership to achieve the desired impact; using a variety of methods to engage communities; clarifying engagement and accountability roles precisely; measuring things that are meaningful; and consulting with internal as well as external communities. Also, community leaders should recognize effort as well as results. Research limitations/implications: Commitment to engagement and accountability is commendable – but is it enough? The paper concludes by looking beyond health system impacts to propose a broader systems perspective. If clinical governors want to use engagement and accountability to achieve "total value" for their communities, they will need to demonstrate as leaders that they are committed to long-term thinking and broad social goals. Originality/value: Too much focus on the process of care may mask accountability for reporting outcomes or systemic impact. The sustainable development goals highlight the need for systems thinking and public expectations include corporate social responsibility. As shown in the examples cited, a deeper commitment to engagement and accountability requires looking beyond care delivery to social determinants and to systemic impacts of the health care industry itself. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to examine the progress of the Mental Health Commission of Canada (MHCC) over the first five years of its existence toward stated goals while existing outside the constitutional framework of health care funding. Design/methodology/approach – The paper is a review of the outputs of the MHCC with emphasis on its first-ever mental health strategy for Canada, knowledge exchange network, anti-stigma initiatives, randomized controlled trial of housing-first initiatives for the homeless mentally ill, as well as other completed projects. Findings – Consultation and collaboration are essential aspects of working successfully with people with lived experience of mental illness, their families, health professionals, and governments. At the same time, when expectations are high, needs are great, and opinions are varied, disappointment and frustration are inevitable. Research limitations/implications – Although the MHCC initiatives include the largest single funded research project in mental health in Canadian history, and evaluation is built into other initiatives, the political dimension of its work does not lend itself to research evaluation. Practical implications – The creation of an organization outside the constitutional framework of health care funding may allow for a catalytic role in precipitating change. Social implications – The emphasis on anti-stigma campaigns targeted at defined populations (youth, health professionals, workforce, journalists) may combat the discrimination people with mental illnesses and their families experience. Originality/value – The paper shows that the Canadian experience is, to date, largely undescribed in the peer-reviewed literature and may influence other jurisdictions. One of its interventions is already being replicated internationally. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to explore 232 service providers' and policymakers' experiences of supporting children's well-being during the pandemic, across sectors, in 22 countries – including Kenya, the Philippines, South Africa, India, Scotland, Sweden, Canada and the USA, in the last quarter of 2020. Design/methodology/approach: A smartphone survey delivered via a custom-built app containing mostly open-ended questions was used. Respondents were recruited via professional networks, newsletters and social media. Qualitative content analysis was used. Findings: The findings reveal numerous system-level challenges to supporting children's well-being, particularly virus containment measures, resource deficiencies and inadequate governance and stakeholder coordination. Those challenges compounded preexisting inequalities and poorly affected the quality, effectiveness and reach of services. As a result, children's rights to an adequate standard of living; protection from violence; education; play; and right to be heard were impinged upon. Concurrently, the findings illustrate a range of adaptive and innovative practices in humanitarian and subsistence support; child protection; capacity-building; advocacy; digitalisation; and psychosocial and educational support. Respondents identified several priority areas – increasing service capacity and equity; expanding technology use; mobilising cross-sectoral partnerships; involving children in decision-making; and ensuring more effective child protection mechanisms. Practical implications: This study seeks to inform resilience-enabling policies and practices that foster equity, child and community empowerment and organisational resilience and innovation, particularly in anticipation of future crises. Originality/value: Using a novel approach to gather in-the-moment insights remotely, this study offers a unique international and multi-sectoral perspective, particularly from low- and middle-income countries. [ABSTRACT FROM AUTHOR]

This article starts from the theoretical assumption that successful multicultural integration of immigrants and ethnic minorities is critically dependent on providing them with opportunities to engage in public debate and in policy-making. Empowering cultural groups is important in particular to the traditionally vulnerable individuals in these groups, such as women. The argument is applied to Canada, a country whose turn to multicultural policies and an accompanying ethos of appreciating cultural diversity have created new opportunities for immigrant and minority groups to advocate for a pluri-cultural opening of the health care system. These opportunities can be found in state-monitored forms of community outreach and partial inclusion in the policy process, as well as in grassroots initiatives from immigrant or minority associations or professional networks. Promoting cultural diversity in the Canadian health care sector and empowering minorities in the system are depicted as challenging and, in spite of considerable progress over the last decade, successful primarily with respect to some exemplary practices and initiatives. Examples are drawn from the complex political fight of women with an immigrant or minority background for inclusion, diversity and social justice in the health care system. [ABSTRACT FROM AUTHOR]

To meet the management challenges of the 1990s, governments must fundamentally reexamine their approaches to administrative policy. In most governments, administrative policies, such as contracting, procurement, information technology, land and internal government services, are often dominated by management philosophies inherited from the 1960s and 1970s. Policies in these areas have often been shaped by a desire for detailed control, with little regard for the cost of these controls or their impact on service delivery or innovation. Governments today cannot afford administrative policies which do not balance the need for expenditure control with service delivery and innovation. The good news is that it can be done. Governments and businesses are under enormous pressures to reduce administrative costs, improve services, respond to the demands of an information society and to develop more innovative approaches to conducting business. As part of this transformation, the Federal Government in Canada found that its administrative policies were a major impediment to more efficient, service-oriented and innovative government. Recounts the story of how one organization in a central agency of the Government of Canada recognized the need for a dramatic change in its philosophy and approach to administrative policies, and accomplished those changes over a five-year period of phased implementation between 1988 and 1993. [ABSTRACT FROM AUTHOR]