Is our water as safe and as abundant as it appears to be? Karen Bakker aims to uncover the truth behind water governance in Canada.

This study aims to examine how the migration experience influences newcomer mothers’ young child feeding and care practices and their children’s overall health. The thesis comprises three separate manuscripts, each of which examines one of the three intermediate determinants of the nutritional status of young children (UNICEF 1990): access to healthcare, household food insecurity, and child feeding and care practices. The research was conducted in Toronto’s Jane-Finch neighbourhood, a suburban neighbourhood home to a high density of newcomers. Thirty-two participants (16 Sri Lankan Tamil and 16 Latin American) who had migrated to Canada within the past five years as refugee claimants or family sponsored immigrants participated in the study. Data collection consisted of semi-structured interviews with women from low-income households who had a child between the ages of 1 and 5 years. Spanish and Tamil speaking interviewers interviewed each participant two or three times. Data was analyzed using a mid-level approach in which broad analytical themes are determined prior to analysis and specific themes were then generated based on participants’ perspectives and are grounded in the data. The first manuscript examines newcomer mothers’ experiences accessing physicians for their children and identifies the major gaps between mothers’ expectations and their actual experiences that lead to barriers in communication and overall patient dissatisfaction. The second manuscript demonstrates that mothers’ past experiences with food insecurity affect two aspects of the construct of food insecurity: its managed aspect and its temporal nature. This finding has implications for the measurement of food insecurity in newcomer populations. The third manuscript reveals that newcomer mothers are exposed to several parallel and often conflicting systems of knowledge concerning health and nutrition for their children, and that their utilization of Canada’s Food Guide is impeded by its failure to acknowledge alternate parallel knowledge systems. These findings can be applied to the development of social and health policy aimed at improving cultural competency in healthcare and nutrition education and at ameliorating the income constraints leading to household food insecurity.

This study examined the annual C balance and its shifting trend in Canada’s managed forests from 1991 to 2006 using the Integrated Terrestrial Ecosystem C-budget (InTEC) model. During this period, Canada’s managed forests remained a moderate C sink of 58 Mt C yr¬¬¬-1 on average, but displayed an apparent trend of shifting towards a C source. The combined risk of climate change and increased disturbances are weakening the C sink in Canada’s managed forests. This study also compared the results from InTEC with those from CBM-CFS (Carbon Budget Model of the Canadian Forest Sector) at both national and regional levels. InTEC shows larger inter-annual variability and regional difference than CBM-CFS due to its incorporation of both disturbance and non-disturbance factors. In comparison, CBM-CFS3 has likely underestimated both the true C loss and the C sink potential of Canada’s managed forests, given that it does not account for the non-disturbance factors.

This study examined the annual C balance and its shifting trend in Canada’s managed forests from 1991 to 2006 using the Integrated Terrestrial Ecosystem C-budget (InTEC) model. During this period, Canada’s managed forests remained a moderate C sink of 58 Mt C yr¬¬¬-1 on average, but displayed an apparent trend of shifting towards a C source. The combined risk of climate change and increased disturbances are weakening the C sink in Canada’s managed forests. This study also compared the results from InTEC with those from CBM-CFS (Carbon Budget Model of the Canadian Forest Sector) at both national and regional levels. InTEC shows larger inter-annual variability and regional difference than CBM-CFS due to its incorporation of both disturbance and non-disturbance factors. In comparison, CBM-CFS3 has likely underestimated both the true C loss and the C sink potential of Canada’s managed forests, given that it does not account for the non-disturbance factors.

Canada established its National DNA Data Bank (NDDB) in 2000. Since that time, the NDDB has assisted in the solving of numerous criminal investigations. The NDDB has two indexes: the convicted offender index, which holds the identifiable DNA of persons convicted of designated crimes, and the anonymous crime scene index, which holds anonymous DNA collected from crime scenes. A match to a crime scene profile provides criminal investigators with extremely valuable evidence linking a suspect to a crime scene and the NDDB has been used to identify perpetrators in thousands of crimes in Canada. By limiting the identifiable DNA in the NDDB to convicted offenders, Canada has aimed to balance the crime-solving benefits of the data bank with competing rights issues, particularly the individual right to privacy. Some have encouraged expansions to the NDDB scheme in order to increase the number of crimes that can be resolved through the use of DNA evidence. One possible expansion is to introduce familial searching, a technique in DNA analysis that enables suspect identification based on the existence of a partial match between an identifiable DNA profile and an anonymous profile retrieved from the scene of a crime. Where closely matching profiles indicate that a close genetic relationship likely exists between the identifiable offender and an anonymous perpetrator, police will have a useful lead for follow-up and may be able to locate a suspect by testing the DNA of the identified offender’s close relatives. The use of familial searching is controversial. As a crime-solving tool, it has helped solve crimes in other jurisdictions in which it is currently used. At the same time, it introduces legal and ethical questions that have not been fully explored in Canada. One of the crucial questions is whether and to what extent familial searching may discriminate against Canada’s Aboriginal peoples, who suffer the effects of systemic bias in the criminal justice system generally and who are likely to be overrepresented in the NDDB. Applied in an inherently unequal system, familial searching would disproportionately impact Aboriginal peoples and perpetuate or possibly worsen this existing inequality. To help inform Canada’s decision about the use of familial searching as part of NDDB operations, this dissertation examines the issue from a Critical Race Theory perspective. It outlines the various ways in which familial searching would disproportionately impact Aboriginal peoples. The dissertation further examines international approaches to familial searching and evaluates the extent to which these policies protect against racial inequality concerns relating to the use of familial searching in each jurisdiction considered. It argues that Canada should prohibit familial searching of NDDB data in order to avoid a situation in which the technique would perpetuate or worsen systemic bias against Aboriginal peoples in the Canadian criminal justice system.

Ongoing global health inequities have been amplified since the 2020 COVID-19 pandemic and subsequent social movements. Such inequities have resulted in increased literature critiquing the historical roots and current practices in global health. From this literature, questions have emerged about the future of global health and Canada’s role in this future. However, there is little research consolidating existing critiques and, based on these critiques, exploring adolescent sexual and reproductive health (ASRH) research and the role of Canadian funding for ASRH. The aim of this dissertation is to consolidate contemporary critiques of global health to develop a conceptual framework for one potential imagined future for global health. It then explores the conceptual framework for an imagined future through an example of global health research, policy, and practice, as it relates to ASRH in Eastern sub-Saharan Africa, to consider the opportunities and challenges of achieving this new potential vision. In this dissertation, I present four unique contributions. The first article presents the conceptual framework for an imagined future that will be used to explore ASRH research, policy, and practice. The second article presents findings from a scoping review on adolescent engagement in ASRH research. The third article presents a review of Canada’s Feminist International Assistance Policy (FIAP) and examines the development of the policy in relation to an imagined future. The fourth article presents a qualitative description of stakeholder perspectives who are implementing ASRH projects with Canadian funding and discusses these perspectives in relation to an imagined future. Conclusions suggest that language to support changes towards an imagined future in global health exists although there is continued opportunity to operationalize the changes. Further research is encouraged to engage local actors and consider practical ways to shift towards equity and justice in Canadian funding for ASRH. / Dissertation / Doctor of Philosophy (PhD) / There is growing controversy in the field of global health and it is not yet clear how the field will respond and evolve. As the number of critiques grow, responding with new ideas for the future of global health becomes more urgent and yet more difficult. This thesis aimed to address this challenge by examining what an imagined future for global health research, policy, and practice might be, and how it might be achieved. This research focuses on the future of global health and Canada’s role in it, particularly regarding adolescent sexual and reproductive health (ASRH) in Eastern sub-Saharan Africa. By reviewing documents and conducting qualitative interviews, this study explores adolescent involvement in ASRH research, Canada’s Feminist International Assistance Policy (FIAP) and stakeholder experiences implementing ASRH projects with Canadian funding. Findings emphasize the need for concrete actions to implement the changes proposed by scholars. Further research is encouraged to engage local actors and consider practical ways forward for shifts towards equity and justice in Canadian funding.

As of fairly recently, migrant workers from South East Asia are migrating to Canada for work in the agricultural industry. Little research has been conducted on migration routes and recruitment patterns of these migrant workers. Interviews with 13 workers and three support workers were conducted between May and July 2011 to learn about this process; specifically with how these individuals are getting to Canada, and how they maintain (or do not maintain) relationships with the private intermediaries and employment agencies that facilitate this movement. This research will fill a gap in the literature by describing the recruitment processes of ‘low-skilled’ workers into Canada and, more importantly, it will provide a much-needed space for South East Asian migrants to share their experiences about working in Canada.

The purpose of this qualitative narrative inquiry was to describe the teachers' perceptions of pedagogy and examine their cross-cultural strategies regarding culturally responsive teaching of K-12 students. Indigenous students of the Northwest Territories (NWT) face academic challenges in a Eurocentric educational system. Tribal critical race theory and Eurocentric diffusionism provided the conceptual framework in this study. Six participants were interviewed and their narratives were triangulated by a 5-member focus group. The research questions focused on the teachers' strategies for building bridges between the Eurocentric and Native ways. Participants were interviewed and their responses created individual stories, which added to the meaning making. Fifteen themes were identified using open and axial coding. The findings showed a teacher proclivity for pedagogy infused with Indigenous thought, and an understanding that residential schooling was intrusive to Indigenous life. Participants presented an anti-Eurocentric diffusionist stance, advocating for schooling that matches Indigenous life and is devoted to a dynamic home-school culture directed at closing the achievement gap with the rest of Canada. This study contributes to social change by providing supporting evidence for the need to involve Indigenous students in the development of their education.

Decisions to reform pharmaceutical policy often involve trade-offs between competing social and commercial goals. Canada's Access to Medicines Regime (CAMR), a reform that permits compulsory licensing for the production and export of medicines to developing countries, aimed to reconcile these goals. Since it was passed in 2004, only one order of antiretroviral drugs, enough for 21,000 HIV/AIDS patients in Rwanda for one year, has been exported. Future use of the regime appears unlikely. This research aimed to examine the politics underlying the formation of CAMR. Parliamentary committee hearing transcripts from CAMR's legislative development (2004) and from CAMR's legislative review (2007) were analyzed using a content analysis technique to identify how stakeholders who participated in the debates framed the issues. These findings were subsequently analyzed using a framework of framing, institutions and interests to determine how these three dimensions shaped CAMR's final policy design. In 2004, policy debates were dominated by two themes: intellectual property rights and TRIPS compliance. Promoting human rights and the impact of CAMR on innovation were hardly discussed. With the Departments of Industry Canada and International Trade as the lead institutions, the goals of protecting intellectual property and ensuring good trade relations with the United States appear to have taken priority over encouraging generic competition to achieve drug affordability. The result was a more limited interpretation of patent flexibilities under the WTO Paragraph 6 Decision. The most striking finding is the minimal discussion over the potential barriers developing country beneficiaries might face when attempting to use compulsory licensing, including their reluctance to use TRIPS flexibilities, their desire to pursue technological development and the constraints inherent in the WTO Paragraph 6 Decision. Instead, these issues were raised in 2007, which can be partly accounted for by a greater representation of the interests of potential beneficiary country governments. While the Government attempted to strike a balance between drug affordability and intellectual property protection, it designed CAMR as a last resort measure. Increased input from the developing country beneficiaries and shifting to institutions where the right to health gets prioritized may lead to policies that better achieves affordable drug access.

Decisions to reform pharmaceutical policy often involve trade-offs between competing social and commercial goals. Canada's Access to Medicines Regime (CAMR), a reform that permits compulsory licensing for the production and export of medicines to developing countries, aimed to reconcile these goals. Since it was passed in 2004, only one order of antiretroviral drugs, enough for 21,000 HIV/AIDS patients in Rwanda for one year, has been exported. Future use of the regime appears unlikely. This research aimed to examine the politics underlying the formation of CAMR. Parliamentary committee hearing transcripts from CAMR's legislative development (2004) and from CAMR's legislative review (2007) were analyzed using a content analysis technique to identify how stakeholders who participated in the debates framed the issues. These findings were subsequently analyzed using a framework of framing, institutions and interests to determine how these three dimensions shaped CAMR's final policy design. In 2004, policy debates were dominated by two themes: intellectual property rights and TRIPS compliance. Promoting human rights and the impact of CAMR on innovation were hardly discussed. With the Departments of Industry Canada and International Trade as the lead institutions, the goals of protecting intellectual property and ensuring good trade relations with the United States appear to have taken priority over encouraging generic competition to achieve drug affordability. The result was a more limited interpretation of patent flexibilities under the WTO Paragraph 6 Decision. The most striking finding is the minimal discussion over the potential barriers developing country beneficiaries might face when attempting to use compulsory licensing, including their reluctance to use TRIPS flexibilities, their desire to pursue technological development and the constraints inherent in the WTO Paragraph 6 Decision. Instead, these issues were raised in 2007, which can be partly accounted for by a greater representation of the interests of potential beneficiary country governments. While the Government attempted to strike a balance between drug affordability and intellectual property protection, it designed CAMR as a last resort measure. Increased input from the developing country beneficiaries and shifting to institutions where the right to health gets prioritized may lead to policies that better achieves affordable drug access.