Equitable access to primary healthcare in British Columbia and Norway: an exploration of policy and practice options

This is a mix method study that will include (1) policy and document analysis, (2) interviews with policy-makers and service providers; and (3) interviews and/or focus groups with representative of populations considered vulnerable, indigenous and those w ith documented inequalities. Norway is recognized internationally as a leader in health equity. The WHO 2000 Health System report ranked Norway 11th and Canada 30th in terms of overall performance. Based on a composite indicator of health (DALY), responsi veness, and fairness in financial contribution, Norway ranked 3rd in the world. Canada was ranked 7th. While comparing such different countries has limited utility, Canada and Norway are both northern countries with significant populations living in small rural and remote communities. Both countries are ethnically diverse. Some commonalities thus exist. At the same time, indigenous peoples in Canada are considered among the most vulnerable and marginalized, as a result of former and current colonial polic ies and a general resistance among the Canadian public to give credence to indigenous peoples claims that their marginalization is linked to systemic issues, rather than their own failure. These debates are particularly present in BC. I note that this is not the case in Norway. This contrast may result in meaningful insights. The expected outcomes will be: an international comparative analysis of the policy options in place to meet the PHC needs of vulnerable population, indigenous peoples and those expe riencing health inequalities in Norway and British Columbia; an analysis of the context in which these policies emerged; and an analysis of the range of options in place in PHC to address inequalities, their acceptability and performance.