Public Health Governance Project

The aim of the Public Health Governance project is to better understand experiences and systemic fault lines of health system management and care in order to collaboratively develop a public health governance framework for Canada. This project engages with members of communities commonly sidelined in governance design, including allied healthcare workers, grassroots experts and marginalized groups, including newcomers, 2SLGBTQ+, low-income, and racialized individuals. The outcome, a national Public Health framework responsive to all communities, is being developed through national and international engagements and will address federal, provincial, territorial and municipal levels of government policy, programs and practices.

“Public health is a powerful tool to level the playing field, to bend the arc of [a] country away from distrust and disparities and back towards equity and justice.” —Leana S Wen, MD

See our posters presented at the 2025 Canadian Public Health Association Conference by clicking the links below:

Click a title below to view our posters:

1. A Canadian Population Health & Wellbeing Act and Department of Population Health 
   Presented by Dr. Shawn Harmon      
2. Triangulating Evidence for an Improved Public Health Governance Framework
   Presented by Dr. Christina Holmes
3. Public Health Governance: Emerging themes from community engagements across Canada
   Presented by Sarah Jervis

Project Overview

Funded by the Canadian Institutes of Health Research, the Public Health Governance for a Post-COVID Canada (PHG) project is being undertaken in collaboration with public health, social science, information science, and legal experts from across Canada. Our interdisciplinary team is pursuing a multi-stream research agenda, which includes:

1. Analysing existing and new data collected among marginalized communities, health service providers and legal and policy experts to gain insights from their knowledge and experiences during and since the pandemic.
2. Conducting a series of focus groups and deliberative engagements about public health across Canada.
3. Designing a public health governance framework to be developed into a Canada’s first Population Health & Wellbeing Act.

How are we defining public health?

Public health is concerned with the determinants of health and wellbeing as a whole. An effective framework must reflect how the multiple fields implicated by public health are governed and coordinated to better achieve equitable, healthy, and productive communities and improved opportunities and conditions for all. Canada's current public health system is a fragmented and incoherent framework, demonstrated in this poster.

Project Timeline

Phase 1 involves a literature review and jurisdictional scan focusing on public health governance, policies and practices and approaches to deliberative democracy along with innovative secondary analyses of empirical data collected in COVID-19-focused qualitative projects conducted by co-investigators across Canada.

Phase 2 involves holding pan-Canadian focus groups to gather insights from representatives of diverse communities and perspectives, with a focus on their lived experiences, capacities and capabilities. Each focus group with bring together 7-12 participants for a mediated conversation exploring their experiences during the pandemic, formal supports, strategies for resilience, experiences with healthcare infrastructures and users, as well as understandings and uses of current public health practices, processes, and programs.

Phase 3 involves two deliberative engagements. By bringing together people (15-20 people per engagement) of diverse backgrounds and positions to deliberate on the topic of health and well being (O’Doherty et al. 2021), adaptation of this method will facilitate the development of the public health framework and policy recommendations.

Deliberative Engagement #1 was a three-day structured deliberation among international experts in bioethics, epidemiology, public health, social sciences, and law at the Brocher Foundation (Geneva) in October 2024. The Working Group have expertise and experience in aspects of governance, delivery, and/or assessment of public health, the planetary/One Health concept, and the pursuit of health equity in the population setting. With expertise in public health structures in their own countries, we tested and challenged the governance challenges identified during Phase 1 and Phase 2 of the PHG project. 

Watch a video about our International Workshop at the Brocher Foundation below:

Deliberative Engagement #2 is a structured participant deliberation to be conducted with Canadian experts in bioethics, public health, social sciences, and law, as well as grassroots experts and diverse community representatives. It will explore questions related to the values and objectives, data and evidence, and structure and authority required for effective public health governance. 

View this powerpoint for an overview of preliminary results from our research activities to date!