Prenatal care (PNC) is an essential health service that can reduce adverse health and social outcomes through prevention, detection and treatment of abnormalities of pregnancy. It offers an opportunity to mitigate the impact of the Social Determinants of Health (SDoH) on individual patients through advocacy and referral to social services. Despite a publicly funded health care system in Canada, disparities in access to PNC persist. Much is known about the barriers to PNC and client experiences of inadequate PNC (IPNC). Very little is known about care provider perspectives of IPNC, what should be done about it and are the barriers to doing it. The goal of this project was to address this gap in knowledge to inform the development of novel care delivery models that could reduce disparities in access to PNC in Hamilton. Using a Critical Theory lens, I conducted an interpretive descriptive study using individual interviews and focus groups with health and social service providers in Hamilton to explore their understandings of IPNC. Participants viewed IPNC as a small but important phenomenon disproportionately impacting people who are marginalized. The experience of IPNC is chaotic, worrisome and joyful for providers. An interdisciplinary, midwifery-led outreach PNC model would better meet the needs of the client population and providers alike. A Community Centred Care model of PNC embodies and enhances participant suggestions for addressing IPNC. Access to abortion, postpartum care and newborn apprehension require special attention. Peer participation and the impacts of patriarchy and racism must be addressed in the development of future PNC models. The ways in which participants described and proposed intervening in IPNC revealed an individualized understanding of the SDoH that is paralleled in existing research on IPNC. This conceptualization of the problem obscures the root causes of disparities in access and warrants future consideration. / Thesis / Master of Science (MSc) / Prenatal care (PNC) can help to reduce complications of pregnancy and birth and connect expecting families with other support services. Even though health care is free in Canada, people who are marginalized struggle to access enough PNC. We know the complexities of people’s lives and their negative experiences with the health care system prevent them from getting PNC. We know little about what PNC for people who don’t access it is like for the providers or why they can’t make their care easier to access. Mindful of systems of power, the goal of this research is to explore how health and social service providers understand inadequate PNC (IPNC), to inform accessible PNC models. Participants proposed an interdisciplinary outreach PNC model responsive to needs of the community. The Social Determinants of Health were an important part of how participants understood IPNC which shaped the way that they proposed to address it.

This thesis considers the relationship between practices, communities and continuity in intermittent organisational arrangements. Cultural festivals are argued to offer one such particularly rich and nuanced research context; within this study their potential to transcend intermittent enactment emerged as a significant avenue of enquiry. The engagement of organisation studies with theories of practice has produced a rich practice-based corpus, diverse in both theoretical concerns and empirical approaches to the study of practice. Nevertheless, continuity presents an, as yet, under-theorised aspect of this field. Thus, the central questions of this thesis concern: the practices that underpin the enactment of festivals; the themes emerging from these practices for further consideration; and relationships between festivals and the wider context within which they are enacted. These issues were explored empirically through a qualitative study of the enactment of a community-centred film festival. Following from the adoption of a ‘practice-lens approach', this study yielded forty-eight practices, through which to explore five themes emerging from analysis: Safeguarding, Legitimising, Gatekeeping, Connecting and Negotiating Boundaries. This study revealed an aspect of the wider field of practice that has not yet been fully examined by practice-based studies: the cementing or anchoring mechanisms that contribute to temporal continuity in intermittent, temporary or project-based organisations. The findings of this thesis suggest a processual model, which collectively reinforces an organisational memory that survives periods of latency and facilitates the re-emergence of practice, thus potentially enabling organisations to endure across intermittent enactment and, ultimately, transcend temporality and ephemerality. The themes examined and insights offered in this thesis seek to contribute to: practice-based studies and film-festival studies; forging a new path linking these two disciplines; and generating both theoretical and practical insights of interest to festival organisers and stakeholders of project-based, temporary or intermittent organisational arrangements.

The open debate launched through the ‘Design Research Agenda for Sustainability’ within the paradigmatic ‘Changing the Change’ conference held in Turin in 2008, defined design for sustainability as “Everything design can do to facilitate the social learning process towards a sustainable society. That is, to sustain promising social and technological innovations and to re-orient existing drivers of change towards sustainability” (Cipolla & Peruccio, 2008: 42).

The pillars on which this study is based (stands) could be compared with the observations of Ejiofor (1981: 4), who says the modern-and-African political models have not been sufficiently discovered, developed, and operated in African states. One thinks that the social and political behaviour of African people are in conflict with the present day political structures and institutions. Political and economic actors fail to harness the knowledge, attitudes, and responses with the indigenous values. Own to these reasons the present political dispensations in Africa are misconceived and ill-adapted to their reality. Hence, the call for detailed study of home-grown African values as a means to redress these imbalances has become inevitable. This study is based on Igbo cultural solidarity as a means to address and achieve rural development in Africa. Meanwhile, this study attempts to re-ignite and re-echo ‘people-based’ and understood ‘home-based’ models of achieving rural development as focused on Okigwe-Owerri-Orlu political divisions among the Igbo of South-eastern Nigeria. / Development Studies / M.A. (Development Studies)

The pillars on which this study is based (stands) could be compared with the observations of Ejiofor (1981: 4), who says the modern-and-African political models have not been sufficiently discovered, developed, and operated in African states. One thinks that the social and political behaviour of African people are in conflict with the present day political structures and institutions. Political and economic actors fail to harness the knowledge, attitudes, and responses with the indigenous values. Own to these reasons the present political dispensations in Africa are misconceived and ill-adapted to their reality. Hence, the call for detailed study of home-grown African values as a means to redress these imbalances has become inevitable. This study is based on Igbo cultural solidarity as a means to address and achieve rural development in Africa. Meanwhile, this study attempts to re-ignite and re-echo ‘people-based’ and understood ‘home-based’ models of achieving rural development as focused on Okigwe-Owerri-Orlu political divisions among the Igbo of South-eastern Nigeria. / Development Studies / M.A. (Development Studies)