2. HEALTHY PREGNANCY, BIRTH AND INFANCY

The Government of Canada invests in programs, services and information campaigns to promote healthy pregnancy, birth and infancy. Some of the programs described in this chapter are focused on helping pregnant women make healthier choices that will give their children a better start in life. Others provide information and support to help ensure healthy births and infancy.

Certain activities that have an impact on healthy pregnancy, birth and infancy are covered in other chapters. Examples include the Canada Prenatal Nutrition Program: First Nations and Inuit Component (Chapter 6), the Fetal Alcohol Spectrum Disorder Program: First Nations and Inuit Component (Chapter 6), and several of the research and information activities described in Chapter 7, such as the Canadian Perinatal Surveillance System.

ACTIVITIES AND EXPENDITURES

Human Resources and Social Development Canada

Employment Insurance: Maternity and Parental Benefits

Maternity and parental benefits provide temporary income replacement for working parents of newborn or newly adopted children. These benefits are intended to support parents in balancing the demands of work and family by providing the flexibility they need to stay home during their child’s first year of life.

Parents have the option to use these benefits as best suits their needs. Maternity benefits are available to mothers in the 15 weeks surrounding childbirth and parents can access 35 weeks of parental benefits, for a combined total of 50 weeks.

The Employment Insurance program is reviewed every year through a monitoring process to assess the impact on individuals, communities and the economy.

Website: www.hrsdc.gc.ca/en/home.shtml

Employment Insurance: Maternity Benefits

Expenditures		Sites	Children under 6 and their families
2000–2001	$752,000,000	Not applicable	176 000 children
2001–2002	$848,000,000	Not applicable	193 000 children
2002–2003	$845,000,000	Not applicable	191 000 children
2003–2004	$909,000,000	Not applicable	202 000 children
2004–2005	$925,000,000	Not applicable	199 000 children
2005–2006	$903,000,000	Not applicable	Not available at time of printing
Expenditures: The expenditures reflect the amounts paid to claimants and do not include operations and management costs or salaries. Children under 6 and their families: The estimated number of children is based on the number of new maternity claims filed each fiscal year. 2002–2003: These expenditures were revised from estimates to actuals in the 2003–2004 report. 2005–2006: EI maternity and parental benefits decreased from the previous year, further to Quebec’ s introduction of its own parental insurance plan as of January 1, 2006, replacing EI maternity and parental benefits. In provinces and territories other than Québec, benefits paid increased.

Employment Insurance: Parental Benefits

Expenditures		Sites	Children under 6 and their families
2000–2001	$502,000,000	Not applicable	177 000 children
2001–2002	$1,311,000,000	Not applicable	196 000 children
2002–2003	$1,880,000,000	Not applicable	193 000 children
2003–2004	$2,015,000,000	Not applicable	205 000 children
2004–2005	$2,112,000,000	Not applicable	202 000 children
2005-2006	$2,064,000,000	Not applicable	Not available at time of printing
Expenditures: The expenditures reflect the amounts paid out to claimants and do not include operations and management costs or salaries. Children under 6 and their families: The estimated number of children is based on the actual number of new claims filed for maternity and adoption benefits. The exact number of families that received these benefits is not known because sharing of parental benefits between parents can result in two claims per family instead of one. 2002–2003: These expenditures were revised from estimates to actuals in the 2003–2004 report. 2005–2006: EI maternity and parental benefits decreased from the previous year, further to Quebec’ s introduction of its own parental insurance plan as of January 1, 2006, replacing EI maternity and parental benefits. In provinces and territories other than Québec, benefits paid increased.

Public Health Agency of Canada

Canada Prenatal Nutrition Program

The Canada Prenatal Nutrition Program (CPNP) provides funding to community agencies and coalitions to increase access to health and social supports for women who face challenging circumstances that threaten their health and the development of their infants and to increase the availability of culturally appropriate prenatal services for Aboriginal women living apart from First Nations and Inuit communities.

The CPNP funds a comprehensive range of activities to attract potentially isolated pregnant women to prenatal care and support their connection to the broader community. These include provision of food supplements; counselling on nutrition and other health practices; education about breastfeeding, infant attachment and child development; social support and skill development; and referral on health and social issues.

In 2005-2006, an estimated 50 000 women participated in programs and services offered at 330 CPNP project sites across Canada.

Website: www.phac-aspc.gc.ca/dca-dea/programs-mes/cpnp_main_e.html.

Canada Prenatal Nutrition Program

Expenditures		Sites	Children under 6 and their families
2000–2001	$27,366,000	301 projects	34 000 women
2001–2002	$31,000,000	325 projects	45 600 women
2002–2003	$31,000,000	320 projects	44 000 women
2003–2004	$29,544,353	330 projects	>47 000 women
2004–2005	$31,729,121	338 projects	50 000 women
2005-2006	$30,700,819	330 projects	50 000 women
Expenditures from 2000–2003 are allocations and include grants and contributions, operations and management costs, and salaries. The CPNP programs serve pregnant women and women with infants up to one year of age. 2003–2004: Expenditures include grants and contributions (actuals), operations and management costs (allocations), and salaries (allocations). The reduction in expenditures is due to a decrease in actual grants and contributions in response to departmental budgetary pressures. 2004–2005: Expenditures include grants and contributions (actuals), operations and management costs (allocations), and salaries (allocations). 2005-2006: Expenditures include grants and contributions (actuals), operations and management costs (allocations), and salaries (allocations).

Family-Centred Maternity and Newborn Care National Guidelines

These national guidelines were widely distributed in 2000 to health professionals and programs offering maternal and newborn care to Canadians. The objective of the guidelines is to ensure a healthy and satisfying pregnancy, birth and postpartum experience for all mothers, babies and families. The guidelines are based on research evidence and represent the “gold standard” for family-centred maternal and newborn care.

Website: www.phac-aspc.gc.ca/dca-dea/publications/fcmc00_e.html.

Family-Centred Maternity and Newborn Care: National Guidelines

Expenditures		Delivery Agent	The activity reaches
2000–2001	$15,000	Public Health Agency of Canada Web site	Health professionals, health care facilities, public health and other planning, implemental and evaluating maternal and newborn care programs and services
2001–2002	NA
2002–2003	NA
2003–2004	NA
2004–2005	NA
2005-2006	NA
While no new funds were committed to the guidelines after 2000–2001, copies of the report continue to be distributed and are available online.

Healthy Pregnancy Strategy

The Healthy Pregnancy Strategy is a collaborative effort of the Public Health Agency and Health Canada to raise awareness of the major factors in a healthy pregnancy. Components of the strategy include the following:

Folic Acid Awareness Campaign

Folic acid is essential to the normal development of a baby’s spine, brain and skull, especially during the first four weeks of pregnancy. To reduce the risk of neural tube defects, it is important for women to start taking folic acid before getting pregnant. This awareness campaign delivers the message that all women who could become pregnant should be taking folic acid daily.

Website: http://www.phac-aspc.gc.ca/fa-af/index.html

Folic Acid Awareness Campaign

Expenditures		Delivery Agent	The activity reaches
2000–2001	NA	Family physicians, neonatologists, obstetricians, midwives, hospitals, pharmacists, dieticians, geneticists, nursing schools and public health units	Health professionals
2001–2002	$600,000
2002–2003	$85,000
2003–2004	NA
2004–2005	NA
2005-2006	NA
Expenditures above include operations and management costs, and salaries. 2002–2003: No new materials were produced, resulting in a decrease in expenditures. 2003–2004: There were no expenditures due to financial constraints, but copies of information materials continued to be distributed. 2004–2005: The Folic Acid Awareness Campaign is now included in the Healthy Pregnancy Social Marketing Campaign.

Healthy Pregnancy Social Marketing Campaign

The objective of this campaign is to raise awareness of key healthy pregnancy issues and encourage women to explore the new Government of Canada portal on healthy pregnancy.

In 2005-2006 several creative concepts and key messages were developed as the next step towards launching an advertising campaign.

The key issues highlighted as part of the Healthy Pregnancy campaign are:

alcohol (Fetal Alcohol Spectrum Disorder)
folic acid
tobacco
nutrition
physical activity
mental health
oral health

Website: www.healthycanadians.ca

Healthy Pregnancy Social Marketing Campaign

Expenditures		Delivery Agent	The activity reaches
2000–2001	NA	Advertising campaign.	Women aged 18 to 29 who are pregnant or planning a pregnancy
2001–2002	$12,000
2002–2003	$125,000
2003–2004	$51,765
2004–2005	$121,171
2005-2006	$17,125
Expenditures above include operations and management costs only. 2002–2003: The increase in expenditure was the result of an agreement with programs to pursue needed research. 2003–2004: Due to fiscal restraints, programs were unable to contribute as much as in the previous year. However, marketing pursued further research of the target audience and health professionals in preparation for a future campaign launch. 2004–2005: The increase in expenditures is due to the Healthy Pregnancy Social Marketing Campaign receiving Treasury Board approval as an advertising initiative. The expenditures were made on behalf of the seven programs involved in the Healthy Pregnancy Strategy in preparation for a future advertising campaign. 2005-2006: Plans to launch the campaign did not occur due to federal election.

National Fetal Alcohol Spectrum Disorder Social Marketing Campaign

The social marketing campaign related to Fetal Alcohol Spectrum Disorder (FASD) raises awareness about preventing FASD, emphasizing that there is no safe amount of alcohol during pregnancy.

Website: www.publichealth.gc.ca/healthypregnancy

National Fetal Alcohol Spectrum Disorder Social Marketing Campaign

Expenditures		Delivery Agent	The activity reaches
2000–2001	NA	Not applicable	Not applicable
2001–2002	$240,000
2002–2003	$120,000
2003–2004	NA
2004–2005	NA
2005-2006	NA
Expenditures above include operations and management costs only. 2002–2003: Health Canada’s role changed from supporting implementation and monitoring to providing resource materials to the program, resulting in a decrease in expenditures. 2003–2004: There was no budget for public education (marketing) in 2003–2004. 2004–2006: The National Fetal Alcohol Spectrum Disorder Social Marketing Campaign was included in the Healthy Pregnancy Social Marketing Campaign.

National Fetal Alcohol Spectrum Disorder Initiative

The National Fetal Alcohol Spectrum Disorder (FASD) Initiative provides a focal point to coordinate work to prevent future births affected by alcohol, and improve outcomes for those affected by prenatal alcohol exposure. The initiative supports prevention, public and professional education and training, capacity building, the development of practical tools and resources, and national leadership/coordination. It does not provide direct services to children and families affected by FASD.

Website: http://www.phac-aspc.gc.ca/fasd-etcaf/index.html

National Fetal Alcohol Spectrum Disorder Initiative

Expenditures		Delivery Agent	The activity reaches
2000–2001	$912,600	Community-based program workers, health professionals, vintners, brewers, other government departments and other levels of government	Stakeholders who serve families and children
2001–2002	$1,421,100
2002–2003	$1,853,000
2003–2004	$1,901,600
2004–2005	$2,669,204
2005-2006	$1,204,002
All expenditures above include grants and contributions, operations and management costs, and salaries. Amounts from 2000–2001 to 2002–2003 were revised in the 2003-2004 report to reflect actual expenditures. 2004-2005: The increase in expenditures is due to funding through Canada’s Drug Strategy to assist with the publication and dissemination of the diagnostic guidelines, which were published in March 2005 as a peer-reviewed supplement to the Canadian Medical Association Journal. 2005-2006: Decrease in expenditures is due to budget reallocations.

Postpartum Parent Support Program

In this community-based program, hospital and community health nurses educate families of newborns on the postpartum period. Program resources include information sheets for parents that cover a range of topics such as Breastfeeding, Home Safety and Postpartum Adjustment Blues and Depression.

Website: www.fedpubs.com/subject/health/postpartum.htm

Postpartum Parent Support Program

Expenditures		Delivery Agent	The activity reaches
2000–2001	$100,000	Hospitals, public/community health centres and health agencies	Health professionals, parents
2001–2002	$35,000
2002–2003	$5,500
2003–2004	$3,000
2004–2005	NA
2005-2006	NA
Expenditures above include operations and management costs only. 2001–2002: While financial support for national-level activities (e.g., program maintenance) had declined, a study of hospital and community health sites was conducted to assess the status of the program in these implementing sites and to gain information that would help in setting future directions for the program. 2002–2003: Health Canada’s role changed from supporting implementation and monitoring to providing resource materials to the program, resulting in a decrease in expenditures. 2003–2004: Amount related to publishing costs. 2004–2005: No expenditures—publishing of the master sets completed in 2003–2004. 2005-2006: No expenditures. Master sets continue to be sold by Canadian Government Publishing on behalf of the Public Health Agency of Canada.

Reducing the Risk of Sudden Infant Death Syndrome

The objective of this activity is to give parents of newborns practical information about ways to reduce the risk of Sudden Infant Death Syndrome (SIDS). The ultimate goal is to reduce the number of SIDS deaths in Canada.

The program’s primary resource is Back to Sleep, a brochure that advises parents how to reduce the risk of SIDS.

Website: www.phac-aspc.gc.ca/dca-dea/prenatal/sids_e.html

Reducing the Risk of Sudden Infant Death Syndrome

Expenditures		Delivery Agent	The activity reaches
2000–2001	$40,000	Health professionals, nurses, midwives, physicians, hospitals and public/community health centres	Parents of newborn children
2001–2002	$50,000
2002–2003	$5,000
2003–2004	$20,000
2004–2005	$23,631
2005-2006	$17,350
Expenditures above include operations and management costs only. 2000–2001: This is based on the quantities of resources disseminated. Potentially, parents of all newborn infants will receive this information. 2001–2002: $10,000 for resource dissemination and $40,000 for tracking survey. 2002–2003: Health Canada continued to disseminate materials; however, no new materials were developed in 2002–2003, resulting in a decrease in expenditures. 2003–2004: Funds to reprint resources for continued distribution. 2004–2005: Funds to host a workshop and reprint resources. There is no specific allocation of funding for this activity. 2005-2006: Funds to reprint resources for continued distribution.