Submission ID 131124
| Issue/Objective | Canada invests significantly in global maternal and newborn health equity, yet a growing body of evidence reveals that Canada's own health system is reproducing the maternal health inequities it finances others to address elsewhere. Black women in Canada face disproportionate rates of preterm birth, higher likelihood of induction of labour, maternal transfusion, and ICU admission compared to White women. Canada's Black population currently represents approximately 4.3% of the national population and is projected to surpass 3 million by 2041, with a significant and growing proportion comprising recent African immigrants whose maternal health experiences straddle two health systems - those of their countries of origin and Canada's - in which they are structurally marginalised in both. |
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| Methodology/Approach | This paper draws on peer-reviewed evidence on Black maternal health disparities in Canada and real-world evidence from The Challenge Initiative (TCI) multi-country MNCH implementation from Africa and Asia. A cross-context analytical framework is applied to identify lessons, transferable principles, and adaptation pathways from TCI's programming model to Canada's emerging Black maternal health policy agenda. |
| Results | TCI's decade of RMNCH programming across communities where Black and Brown women face structural exclusion from quality care offers four transferable lessons for Canada. First, data disaggregation as an equity tool for Canada's critically needed race-based data infrastructure. Second, community health worker integration as trusted care navigators within formal health systems. Third, social and behaviour change communication that addresses structural power - engaging households, religious leaders, and male decision-makers. Fourth, accountability at the community level: TCI's self-reliance framework and community-level offer a model for the equity accountability structures that Canada's health systems currently lack for monitoring maternal outcomes by race and immigration status. |
| Discussion/Conclusion | Canada's aspiration to lead globally on health equity cannot be credible while Black, immigrant, and racialized women in Canadian cities experience preventable maternal harm within a universal health system that does not see them. TCI's decade of evidence in Africa and Asia - built precisely in contexts of structural exclusion, resource constraint, and community marginalisation - provides Canada with a tested, adaptable framework for advancing Black maternal health equity domestically. |
| Presenters and Affiliations | Victor Igharo Johns Hopkins University, W.H Gates Institute for Population and Reproductive Health Kojo Lokko Johns Hopkins University, W.H Gates Institute for Population and Reproductive Health Victor Igharo Johns Hopkins University, W.H Gates Institute for Population and Reproductive Health |
