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Gaining ethical approval for qualitative health research and implementing all the planned research processes in a proposed study are not straightforward endeavours. The situation becomes more complex when qualitative research is conducted in a cross-national healthcare and academic context. Also, it is even exhausting when the study is student-based, as student researchers may be considered novices and inexperienced researchers, especially for field-based research. Our aim in this reflective paper is to present, reflect, and discuss the experiences of a doctoral researcher in dealing with two independent institutional review boards in Canada and Ghana during an interdisciplinary Ph.D. project and the ethical dilemmas encountered while collecting data in Ghana. Based on the researcher's experiences, it became apparent that consent and its documentation can have cultural implications in different settings; hence, institutional review boards must exercise reflexivity in their protocol review practice. Also, sharing research data with participants and institutional leaders while maintaining participant confidentiality and privacy in institutional ethnographic research requires sensitivity to bi-lateral ethical values. With the experiences shared in this paper, we advocate for a dialogic ethical review process in qualitative research where researchers and research ethics boards engage in ongoing dialogue rather than the usual prescriptive format research ethics reviews often assume. [ABSTRACT FROM AUTHOR]

Nursing is a self-regulating profession, and most professional nursing jurisdictions across Canada have undertaken the creation of Continuing Competence Programs (CCPs), with the goals of promoting good nursing practice, encouraging continuous learning, contributing to the quality of nursing practice, and optimizing client outcomes. Most CCPs call for a professional portfolio to collect, synthesize, and analyze professional experiences, including documentation of peer feedback and preparation of a learning plan. In the province of Saskatchewan, Canada, there is a self-reflective tool that enables registered nurses to self-rate their achievement of a set of foundational competencies. This article explores the perceptions that select registered nurses have about the CCP in Saskatchewan and how their view of the degree of professional control (as assessed through locus of control) that they have affects their perspective about the outcomes of the program. The study was designed to assess how perceived locus of control was related to how registered nurses view the implementation of the CCP in Saskatchewan. [ABSTRACT FROM AUTHOR]

Objective: To explore the impacts and implications of health reform/renewal for rural women in Saskatchewan and Manitoba, Canada. Design: The study was a multiple case study approach using mixed methods of focus groups, individual interviews, and trends/utilization analysis. Setting: Three rural communities – two in Saskatchewan; one in Manitoba. Participants: Rural women; non-health providers. Interventions: None. Outcome Measures: None. Results: This paper presents a four phase Integrated Community Policy Uptake Model which is derived from the experiences of rural women during the operationalizing of health reform policy. The model depicts a four phase integration of the health reform or renewal policy; specifically, ‘Taking In’, ‘Taking On’, ‘Taking Over’, and ‘Taking Beyond’. The Integrated Community Policy Uptake Model is firmly rooted in the perceptions and opinions of rural women, and is informed by their understanding of health policy. Conclusion: The involvement of rural women in the policy process is necessary. The model proposed potentially encourages women to become more directly engaged in future health policy making and planning. There is also significant potential for this model to inform decision makers of the perceptions, needs, and solutions offered by stakeholders such as rural women. [ABSTRACT FROM AUTHOR]

Continuing competence programs (CCPs) are becoming required in many nursing jurisdictions across Canada. CCPs have the common goal of ensuring nurses remain up to date and competent in their professional practice. They often incorporate reflective practice as a tool for nurses to critically explore their practice and professionalism on an ongoing basis. Feedback is one of the strategies within reflective practice which enables nurses to increase reflective capabilities and enhance professional performance through collegial exchange. Locus of control, a personality variable, is considered as a potential indicator of how receptive nurses may be toward CCPs. For CCPs to be optimally embraced by nurses, it is imperative that professional nursing bodies address nurses loci of control in developing, supporting, and strategizing for reflective practice, generally, and feedback,specifically. [ABSTRACT FROM AUTHOR]

In this article, a consideration of the role and meaning of the rural hospital is contextualised within the health reform environment in Saskatchewan (Canada). Individual and community perceptions of the impact of the conversion/closure of a rural hospital are often unheard and more often unheeded. Some researchers suggest hospital conversion/closure is a devastating event in the life of rural communities, yielding long-lasting medical, economic and psychological consequences. This article examines the concept of critical incidents with the intent of proposing a working definition of the concept. Lazarus and Folkman's (1984) construct of appraisal provides the framework for discussion and re-conceptualisation of critical incidents. The recommendation is to consider the adoption of an alternate definition of critical incident shifting away from professional or external delineation of an event's meaning. The proposed definition states that a critical incident is any external event that alters an individual's or community's life from the perspective of that individual or community. Finally, the conversion/closure of a rural hospital is considered within this re-conceptualised ‘critical incident’ definition. [ABSTRACT FROM AUTHOR]

The article discusses how the Canadian government can help reduce health disparities. Five recommendations are presented. They include establishing a national population health framework, an integrated population health-information infrastructure, and a plan to assess population health initiatives. Education and training that help implement strategies for societal action on the determinants of health are also recommended. The availability of data sources for tracking health status is addressed. The need for further assessment and research is mentioned. The authors believe national action along with recommendations from the World Health Organization Commission on the Social Determinants of Health will reduce health inequalities.

Background: Adverse health outcomes are higher among Maasai children in the Ngorongoro Conservation Area compared to other co-located ethnic groups and regions of Tanzania. The Mama Kwanza Socioeconomic Health Initiative, a Canadian-Tanzanian partnership delivering healthcare at clinics in this region, gathered perceptions of mothers regarding breastfeeding and infant nutrition in order to inform culturally sensitive, realistic, and effective health promotion efforts., Methods: A qualitative description approach was used in interviewing 30 Maasai mothers of infants zero to six months of age to explore their infant feeding practices, beliefs, knowledge, and recommendations to support breastfeeding. A local research team was trained to conduct and transcribe the interviews and assist with data interpretation. Qualitative content analysis was used in analyzing the interview transcripts., Results: Lactation is universal in this culture with all the mothers planning to breastfeed for at least one year and most having initiated breastfeeding within one hour of birth. Lactation skills and knowledge are passed down intergenerationally from the elder women. None of the infants less than six months were exclusively breastfed, with a variety of liquid and semi-solid supplements given. Mothers perceived their milk alone was nutritionally insufficient with maternal dietary deficiencies cited as a factor., Conclusions: While there is a strong breastfeeding culture among the Maasai in Ngorongoro, intersectoral efforts are required to provide culturally respectful health education on the benefits of exclusive breastfeeding and to ensure the maternal dietary adequacy required to achieve this goal. The findings reinforce the importance of international health projects adapting health promotion initiatives to local realities and beliefs in efforts to improve maternal child health.

Background Health-care environments influence service delivery; approaches need to be more wholistic and culturally competent requiring effective interagency collaboration to bridge traditional Indigenous and mainstream health services. Despite considerable research on collaboration, the concept remains misunderstood, at worst, and formative, at best. Within the nexus of these two diverse health services, there is limited information on how collaborations could be created and sustained effectively. Purpose To explore the perspectives/experiences of collaboration of select Saskatchewan health professionals practicing across these diverse services to understand the concept from their perspectives. Methods This qualitative study explored collaboration through observation and interviews to elicit perspectives (two-eyed seeing) of health professionals working within the context of a traditional-mainstream health services partnership. Results Individual- and system-level factors and accountabilities are needed for successful cross-cultural collaboration and can be enabled by embedding the virtues of Indigenous and values of mainstream health services along with building and maintaining relationships, valuing difference, creating supportive environments and wholistic approaches, having the right people at the table, and making a change for impactful outcomes. Conclusion Findings support the need for implementing contextually relevant collaborative practice models for productive, wholistic health services. Two-eyed seeing provides the ability to capture and catalyze the tremendous value and strengths of both worlds, potentiating complementary aspects to meet the needs of clients and communities.