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Integrating Learnings: Shaping a Better Future for Paediatric Care in Canada

  • Faiza Syed
  • Apr 2
  • 9 min read

As the introductory course to the Master of Health Studies (MHS) program, MHST 601 has provided a contemporary and inclusive overview of health in Canada, which has helped as a foundation for the rest of my MHS journey. The course focused on analyzing the factors influencing Canadians' health within the context of the healthcare system. It has highlighted an interprofessional approach, promoting collaboration and learning from peers with various professional backgrounds and from the professor. By engaging in discussions, reflective and partnering exercises, I gained a deeper appreciation for how health systems function, the challenges they face, and how various stakeholders such as government, healthcare providers, and communities play a role in shaping health outcomes.

Throughout the course, my focus area was paediatric neuromuscular diseases (NMDs). NMDs, which include a variety of conditions affecting children’s muscle and nerve function, are of particular significance within the Canadian healthcare context due to their complexity, higher cost of healthcare resource utilization and the long-term care needs they create (Amin et al. 2024). These diseases often require specialized, multidisciplinary care involving neurologists, respiratory therapists (RTs), and other healthcare providers to manage symptoms and improve the quality of life for affected children. Given the diversity and geography of Canada, accessing specialized care can be a challenge for families in remote or underserved areas which became quite apparent when I compared my province of Ontario (ON) to other provinces with more rural communities such as New Brunswick (NB) (Ontario Health, 2023). It also reinforced my interest in exploring how healthcare policies, access to resources, and interprofessional collaboration can improve outcomes for those living with NMDs. As a regulated RT (College of Respiratory Therapists of Ontario, n.d.), I have professional standards to adhere to in areas like patient care, interdisciplinary teamwork, and cultural competency, all of which were key focuses of this course.

            This course expanded my understanding of how the Canadian healthcare system addresses specialized conditions like NMDs, highlighting both strengths and gaps. This experience further sparked my interest for exploring how healthcare policies, resource access, and interprofessional collaboration can enhance outcomes for individuals with NMDs. As a regulated RT (College of Respiratory Therapists of Ontario, n.d.), I am committed to upholding professional standards in patient care, interdisciplinary teamwork, and cultural competency, principles that were central to this course and align with my core professional values (Syed, 2025). This has also shaped my vision for better supporting affected patients and their families in my field and enhancing the care pathway for NMDs in Canada. Below, I will review some key learnings from the course, including health determinants, interprofessional collaboration, a multidisciplinary approach to managing care, cultural competency for marginalized populations, and the future of healthcare in Canada, all of which I explored in my ePortfolio blogs and which you will find linked throughout this article.  A short case study will bring these elements together with a reflection on research opportunities in this area.

We began the course by defining health, which sparked a broader discussion. I shifted from the WHO’s definition of health as a "complete state" to embracing terms like “dynamic” and “adapting.” This exercise opened us to new perspectives. I then explored health determinants, needed for understanding outcomes for children with NMDs, and discovered well-curated resources that resonated with my professional experiences. One study, for example, by Amin et al. (2020) confirmed that these children often face delays in diagnosis and treatment due to limited access to specialized clinics, long wait times, and geographical barriers, especially in remote areas. Marginalized communities, such as Indigenous families, may also encounter cultural barriers and mistrust, further delaying care (D'Angelo et al., 2020). However, Canada's healthcare system does have growth opportunities through its interdisciplinary care models, progress in gene therapy studies, and growing use of virtual healthcare. Policy changes prioritizing health equity and cultural competence are needed for ensuring timely, effective care for all children.

The socio-ecological model helped illustrate how individuals with NMDs interact with their environments across various levels. By considering the individual, interpersonal, institutional, community, and policy levels, it provided a comprehensive view of how these factors influence health outcomes, including diagnosis, treatment, and management of paediatric NMDs (Shimamoto et al., 2022). Socioeconomic status affects access to care, with disadvantaged children facing delays due to financial barriers, lack of transportation, and limited healthcare, particularly in remote areas (Skinner & Slifkin, 2007). This topic was better understood through discussion and blog post with a class peer, particularly when contrasting remote communities in NB with an urban area in ON (Dekleva, 2025; Syed, 2025). Cultural factors, such as conflicts between traditional healing and conventional treatments, can create communication barriers and mistrust in healthcare. Social determinants such as poor housing, nutrition, and toxins can worsen respiratory conditions, while regional disparities often limit access to specialized care. Addressing these factors is key to improving outcomes and ensuring equitable, culturally competent care (Knoppers et al., 2024).

The course emphasized the importance of interprofessional collaboration, which I applied to NMD care, where specialists like neurologists, physiotherapists, genetic counselors, and social workers work together to manage the disease and support families. However, access to such diverse professionals is not always available in all regions, leading to care inequities. Some classmates shared experiences where they had to take on roles outside their scope due to shortages, highlighting the impact of government policies, funding, and public health collaboratives on healthcare access. Additionally, this course has greatly enhanced my ability to collaborate with various professionals, showing me the value of understanding perspectives from different fields and across different healthcare landscapes in Canada. By incorporating their curated resources and site links into the resources section of my e-portfolio, I am better equipped to explore how these diverse perspectives can influence care, policy, and support systems.

This course highlighted how healthcare inequities, driven by social, economic, and cultural factors, impact marginalized groups like Indigenous and immigrant children with NMDs. These groups face barriers to specialized care, delayed diagnoses, and cultural misunderstandings. Indigenous children, particularly in remote areas, struggle with accessing neuromuscular specialists and diagnostic services, worsened by geographic isolation and limited resources (Umaefulam, Kleissen, & Barnabe, 2022). While the Indigenous Non-Insured Health Benefits (NIHB) program helps with medical travel, leaving their communities for care presents additional challenges. Cultural mistrust and language barriers further complicate care. Similarly, immigrant children face language barriers, unfamiliarity with the healthcare system, and limited access to culturally competent care (Dada et al., 2024). Addressing these disparities requires improving access to culturally safe care, enhancing communication, and addressing social determinants like housing and transportation.

I also learned that cultural competence training is essential for providing effective care in Canada, especially for children with NMDs in diverse communities (Alghazali & Ahmed, 2024). Healthcare professionals must respect the cultural values of families, for example in Indigenous and immigrant communities, as traditional healing practices may conflict with medical treatments, leading to mistrust and communication barriers (Achan et al., 2021). Achan and colleagues (2021) emphasize that providers should practice cultural humility, listen attentively, and incorporate relevant practices when possible. Language support, like interpreters, is crucial for clear communication. Cultural competence training should be mandatory to address trauma-informed care, language barriers, and discrimination faced by these populations.

A patient’s case reminded me of the importance of applying course concepts to identify system shortcomings and the need for improvement. Several years ago, I worked with “Dakotah”, a 6-year-old Indigenous child from a remote northern Ontario community diagnosed with spinal muscular atrophy (SMA). Her family faced significant challenges, including limited healthcare access, socioeconomic strain, and difficulty obtaining medical supplies, despite support from the Non-Insured Health Benefits (NIHB) program (Indigenous Services Canada, n.d.). Dakotah was referred to our facility later than expected, complicating her care. When Dakotah developed pneumonia and was admitted to the ICU, her father requested a smudging ceremony, a traditional Indigenous practice. This led to confusion and resistance from hospital staff, who viewed the smoke as unsafe with oxygen around, resulting in its refusal. Her father, feeling cultural disconnect expressed "I just wanted to honor my daughter's culture and give her some peace in her final moments, but it felt like no one understood. It was hard to see how much of our tradition was being dismissed in a time when we needed the most support." This situation highlighted the importance of cultural sensitivity in healthcare. Sadly, Dakotah passed away from pneumonia complications, with only her father by her side. This case reinforced the need for timely, culturally sensitive care, and emphasized interdisciplinary collaboration to address medical, emotional, and social needs. It also brought forward key course concepts like health equity, social determinants of health, and culturally competent care, highlighting the importance of advocating for better healthcare access and integrating cultural respect into patient care. The organization has now made strides in supporting Indigenous health through a dedicated navigator, cultural competence training, and safe integration of traditional practices like smudging (SickKids, n.d.), with ongoing efforts to improve cultural sensitivity.

The future of healthcare for marginalized children and their family caregivers should focus on virtual care and immersive healthcare education for caregivers, especially for those in remote or underserved communities. Virtual care through telemedicine eliminates the need for long-distance travel, reducing delays in diagnosis and treatment, while enabling continuous monitoring and follow-up. Immersive education can help close knowledge gaps by training caregivers in the child's home and community, enhancing the quality of care and enabling families to make informed decisions.

This course has highlighted key research areas in pediatric NMDs, particularly improving diagnostic accuracy and treatment options. There is a need for early screening tools, genetic testing for underserved populations and better access to personalized medicine. Research into telemedicine, mobile healthcare, and multidisciplinary care models is also needed. The course enhanced my understanding of healthcare disparities, particularly for Indigenous children, and highlighted how social determinants like income, housing, and transportation affect diagnosis and treatment. I am now specifically interested in exploring ways to improve availability of specialized respiratory equipment, and address inequities. I am also keen to investigate the future of healthcare education through innovative, immersive approaches to better prepare professionals to tackle these challenges, which could transform care for children with NMDs and create a more inclusive healthcare system.



References

Achan, G. K., Eni, R., Kinew, K. A., Phillips-Beck, W., Lavoie, J. G., & Katz, A. (2021). The

two great healing traditions: Issues, opportunities, and recommendations for an integrated First Nations healthcare system in Canada. Health Systems and Reform, 7(1), e1943814. https://doi.org/10.1080/23288604.2021.1943814

Alghazali, I. S., & Ahmed, R. (2024). The role of cultural competence in health care to improve

communication between immigrant patients and health-care providers in Ottawa, Canada. International Journal of Migration, Health and Social Care, 21(1),  132–148 https://www.emerald.com/insight/content/doi/10.1108/ijmhsc-09-2023-0091/full/html

Amin, R., Verma, R., Bai, Y. Q., Guttmann, A., Cohen, E., Gershon, A. S., Katz, S. L., Lim, A.,

& Rose, L. (2024). Healthcare use and costs in children receiving home mechanical Ventilation in Ontario: A 14-year cohort study. Annals of the American Thoracic Society, 21(10), 1421-1431. https://doi.org/10.1513/AnnalsATS.202401-105OC

College of Respiratory Therapists of Ontario. (n.d.). Home. College of Respiratory Therapists of

Ontario. Retrieved from https://www.crto.on.ca

Dada, S., Khan, N., & Dewji, N. (2024). Left behind: Newcomer children with disabilities and their

families. Frontiers in Public Health, 12, 1332403. https://doi.org/10.3389/fpubh.2024.1332403

D'Angelo, C. S., Hermes, A., McMaster, C. R., Prichep, E., Richer, É., van der Westhuizen, F. H.,

Repetto, G. M., Mengchun, G., Malherbe, H., Reichardt, J. K. V., Arbour, L., Hudson, M., du Plessis, K., Haendel, M., Wilcox, P., Lynch, S. A., Rind, S., Easteal, S., Estivill, X., Thomas, Y., & Baynam, G. (2020). Barriers and considerations for diagnosing rare diseases in Indigenous populations. Frontiers in Pediatrics, 8, 579924. https://doi.org/10.3389/fped.2020.579924

Dekleva, C. (2025, Feb 23). Comparing Health Determinants New Brunswick vs. Ontario. Retrieved

Indigenous Services Canada. (n.d.). Indigenous health supports and services in Canada. Government

Knoppers, T., Haley, C. E., Patrinos, D., & Zawati, M. H. (2024). “Protection for the public, better use

of resources and clearer lines”: Interviews with genetic counselors and  their colleagues on the need for regulation in Quebec. Journal of Genetic Counseling, 34(2), e1960. https://doi.org/10.1002/jgc4.1960

Ontario Health. (2023). Indigenous services and resources. Ontario Health.

Shimamoto, T., Ishizaka, M., Ozato, N., & Yamaji, T. (2022). Application of a social-ecological model

to study the factors associated with sarcopenia. Journal of Clinical Medicine, 11(3), 1234. https://doi.org/10.3390/jcm11031234

SickKids. (n.d.). Indigenous health. The Hospital for Sick Children. https://www.sickkids.ca/en/care-

Skinner, A. C., & Slifkin, R. T. (2007). Rural/urban differences in barriers to and burden of care for

children with special health care needs. Journal of Rural Health, 23(2), 150– 157. https://doi.org/10.1111/j.1748-0361.2007.00082.x

Syed, F. (2025, March 27). Exploring Canada and Ontario’s determinants of health. Critical

Syed, F. (2025). The RT profession: Governance. Faiza Syed's e-Portfolio for MHST 601. Retrieved from

Umaefulam, V., Kleissen, T., & Barnabe, C. (2022). The representation of Indigenous peoples in

chronic disease clinical trials in Australia, Canada, New Zealand, and the United States. The Society for Clinical Trials, 19(1). https://doi.org/10.1177/1740774521106915

Wilton-Clark, H., Al-aghbari, A., Yang, J., & Yokota, T. (2023). Advancing epidemiology and

genetic approaches for the treatment of spinal and bulbar muscular atrophy (SBMA):

Focus on prevalence in the Indigenous population of Western Canada. Preprints.org.

 
 
 

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