A Failure of Access?: The Birth Evacuation Policy in Canada’s North
Bibliographic record
Abstract
The Birth Evacuation Policy in Canada's NorthThe primary policy objective of the Canada Health Act is to maintain and improve the health of Canadians [1].Under this Act all residents are entitled to reasonable and equitable access to all medically necessary hospital and physician care, free at the point of service.In practice, however, universal and equal health care access is challenged in Canada by a variety of factors, including di culties in sta ng availability and providing cost-e↵ective services in rural and remote areas.Maternity care is one such medically necessary service that is not always reasonably and equally accessible.In the current health care delivery model, patients in remote areas of Canada often need to travel long-distances between communities or go south to access both specialized and standard maternity care.Since the 1980s, pregnant women in most Inuit communities, regardless of health risk, are flown to southern cities such as Iqaluit, Winnipeg, Ottawa, and Yellowknife to deliver approximately four to six weeks prior to their due date [2,3].The costs of this obstetric evacuation policy are high in terms of the emotional, social and cultural costs to mothers and their communities.The costs of air travel to these remote regions mean that pregnant women usually travel alone, separated from their support system while they wait to deliver their child.For women who travel to Manitoba, Ontario or Quebec to deliver, there is the added stress of adapting to a di↵erent culture and language.Women have reported isolation, anxiety, stress, sadness and loneliness associated with this policy [4,5].Reported instances of women hiding their pregnancies, lying about due dates, refusing to leave the community and deciding to give birth on their own, demonstrate a preference for delivering within the community.Furthermore, although this policy certainly improved outcomes for high-risk pregnancies, no conclusive evaluation of the e↵ects of this policy exists for non-high-risk pregnancies.Although there is some evidence that there have been improvements in pregnancy outcomes associated with the policy, its implementation coincided with the provision Ask an Expert: Future Health & Society
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.023 | 0.008 |
| Scholarly communication | 0.008 | 0.003 |
| Open science | 0.003 | 0.004 |
| Research integrity | 0.005 | 0.006 |
| Insufficient payload (model declined to judge) | 0.009 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".