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AbstractTemporary farm labour migration schemes in Canada have been justified on the premise that they bolster food security for Canadians by addressing agricultural labour shortages, while tempering food insecurity in the Global South via remittances. Such appeals hinge on an ideology defining migrants as racialized outsiders to Canada. Drawing on qualitative interviews and participant observation in Mexico, Jamaica and Canada, we critically analyse how Canada's Seasonal Agricultural Worker Program is tied to ideological claims about national food security and agrarianism, and how it purports to address migrant workers' own food insecurity. We argue remittances only partially, temporarily mitigate food insecurity and fail to strengthen migrant food sovereignty. Data from our clinical encounters with farm workers illustrate structural barriers to healthy food access and negative health consequences. We propose an agenda for further research, along with policies to advance food security and food sovereignty for both migrants and residents of Canada.

In workplace health interventions, engaging management and union decision makers is considered important for the success of the project, yet little research has described the process of making this happen. A case study of a knowledge-transfer process is presented to describe the practices and processes adopted by a knowledge broker who engaged workplace parties in discussions on research on physical and psychosocial factors important for employee health. The process included one-on-one interactions between the knowledge broker and individuals to explain the research, to build trust and credibility, and to explore the applicability of the research to their work (sense making). It also included facilitated group sessions, where the groups explored how the research could solve problems within the workplace (social construction of knowledge). The workplace context offered multiple opportunities that helped and hindered the flow of research. Nevertheless, this intense, sustained, knowledge-transfer intervention noted conceptual, structural, and political knowledge use.

BACKGROUND: Since its founding in 1970, Canada's International Development Research Centre (IDRC) has supported research by concerned Latin American researchers on environments and human health relationships. Framing of such relationships has changed through different periods. METHODS: Participant observation, bibliographic searches, document review, and interviews with key IDRC staff. FINDINGS: From the early years of multiple different projects, IDRC developed more focussed interest in tropical diseases, pesticides, agriculture and human health in the 1980s. The United Nations Conference on Sustainable Development in the early 1990s gave impetus to examination of links between ecosystems and human health or "EcoHealth". Projects in Latin America built on earlier work but extended it in methods (transdisciplinarity, community participation, gendered approach) and scope (broader land use and development paradigm issues tackled). A key IDRC-funded activity in Latin America was "EcoSalud", an Ecuadorian effort, which has worked with farming communities, agricultural researchers, health practitioners and local politicians to advance integrated pest management, better recognize and treat poisonings and improve pesticide-related policies. ONGOING CHALLENGES INCLUDE: mobilizing sufficient resources for the primary prevention focus of EcoHealth activities when primary care infrastructure remains stretched, promoting micro-level change in diverse communities and ecosystems, and addressing power structures at the global level that profoundly affect environmental change.

Background National health research for development (R4D) platforms in lower income countries (LICs) are few. The Health Research Capacity Strengthening Initiative (HRCSI, 2008–2013) was a national systems-strengthening programme in Malawi involved in national priority setting, decision-making on funding, and health research actor mobilization. Methods We adopted a retrospective mixed-methods evaluation approach, starting with information gleaned from reports (HRCSI and Malawian) and databases (HRCSI). A framework of a health research system (actors and components) guided report review and interview guide development. From a list of 173 individuals involved in HRCSI, 30 interviewees were selected within categories of stakeholders. Interviews were conducted face-to-face or via telephone/Skype over 1 month, documented with extensive notes. Analysis of emerging themes was iterative among co-evaluators, with synthesis according to the implementation stage. Results Major HRCSI outputs included (1) National research priority-setting: through the production of themed background papers by Malawian health researchers and broad consultation, HRCSI led the development of a National Health Research Agenda (2012–2016), widely regarded as one of HRCSI's foremost achievements. (2) Institutional research capacity: there was an overwhelming view that HRCSI had produced a step-change in the number of high calibre scientists in Malawi and in fostering research interest among young Malawians, providing support for around 56 MSc and PhD students, and over 400 undergraduate health-related projects. (3) Knowledge sharing: HRCSI supported research dissemination through national and institutional meetings by sponsoring attendance at conferences and through close relationships with individuals in the print media for disseminating information. (4) Sustainability: From 2011–2013, HRCSI significantly improved research systems, processes and leadership in Malawi, but further strengthening was needed for HRCSI to be effectively integrated into government structures and sustained long-term. Overall, HRCSI carried out many components relevant to a national health research system coordinating platform, and became competent at managing over half of 12 areas of performance for research councils. Debate about its location and challenges to sustainability remain open questions. Conclusions More experimentation in the setting-up of national health R4D platforms to promote country 'ownership' is needed, accompanied by evaluation processes that facilitate learning and knowledge exchange of better practices among key actors in health R4D systems.

The practice of chlorine disinfection of drinking water to reduce microbial risks provides substantial benefits to public health. However, increasing concern around potential risks of cancer associated with exposure to chlorinated disinfection byproducts confuses this issue. This article examines the science agenda regarding chlorinated disinfection byproducts (CDBP) and cancer in Canada and the United States, focusing on the social construction of scientific knowledge claims and evidence. Data for this analysis were obtained from published documents as well as from in‐depth interviews with epidemiologists and toxicologists centrally involved with the issue in both countries. Results of the analysis suggest that toxicological scientists want to close the door on the "chloroform issue" due to increasing evidence that chloroform is safe at low doses, because epidemiological scientists can no longer move forward the cancer science until significant improvements can be made in assessing human exposures, and because the scientific foci of research on DBP have shifted accordingly. Further, a distinction emerges in terms of how scientific uncertainties are interpreted when they cross‐cut disciplines in the context of human health risk assessment. We suggest this tension reflects a balance of how uncertainty and authorities are managed in a mandated science‐policy domain. Sufficient evidence was provided to keep the DBP issue on the regulatory agenda and to generate additional research, yet authorities and concomitant interpretations of uncertainty were contested. Such science generation and contestation inevitably influences complex risk assessment processes with respect to what water‐related health risks are addressed and how.

This paper describes a multi‐stakeholder process designed to assess thepotential health risks associated with adverse air quality in an urban industrial neighborhood. The paper briefly describes the quantitative health risk assessment conducted by scientific experts, with input by a grassroots community group concerned about the impacts of adverse air quality on theirhealth and quality of life. In this case, rather than accept the views of the scientific experts, the community used their powers of perception toadvantage by successfully advocating for a professionally conducted community health survey. This survey was designed to document, systematically and rigorously, the health risk perceptions community members associated with exposure to adverse air quality in their neighborhood. This paper describes theinstitutional and community contexts within which the research is situated as well as the design, administration, analysis, and results of the community health survey administered to 402 households living in an urban industrial neighborhood in Hamilton, Ontario, Canada. These survey results served tolegitimate the community's concerns about air quality and tohelp broaden operational definitions of 'health.' In addition, the resultsof both healthrisk assessment exercises served to keep issues of air quality on the localpolitical agenda. Implications of these findings for our understanding of theenvironmental justice process as well as the ability of communitiesto influence environmental health policy are discussed.

Objectives Research is key to achieving global development goals. Our objectives were to develop and test an evidence-informed process for assessing health research management and support systems (RMSS) in four African universities and for tracking interventions to address capacity gaps. Setting Four African universities. Participants 83 university staff and students from 11 cadres. Intervention/methods A literature-informed 'benchmark' was developed and used to itemise all components of a university's health RMSS. Data on all components were collected during site visits to four African universities using interview guides, document reviews and facilities observation guides. Gaps in RMSS capacity were identified against the benchmark and institutional action plans developed to remedy gaps. Progress against indicators was tracked over 15 months and common challenges and successes identified. Results Common gaps in operational health research capacity included no accessible research strategy, a lack of research e-tracking capability and inadequate quality checks for proposal submissions and contracts. Feedback indicated that the capacity assessment was comprehensive and generated practical actions, several of which were no-cost. Regular follow-up helped to maintain focus on activities to strengthen health research capacity in the face of challenges. Conclusions Identification of each institutions' strengths and weaknesses against an evidence-informed benchmark enabled them to identify gaps in in their operational health research systems, to develop prioritised action plans, to justify resource requests to fulfil the plans and to track progress in strengthening RMSS. Use of a standard benchmark, approach and tools enabled comparisons across institutions which has accelerated production of evidence about the science of research capacity strengthening. The tools could be used by institutions seeking to understand their strengths and to address gaps in research capacity. Research capacity gaps that were common to several institutions could be a 'smart' investment for governments and health research funders.

In May 2010, Grand Challenges Canada (GCC) was launched with the mandate to identify global challenges in health that could be supported through the Government of Canada's Development Innovations Fund (DIF: $225 million over five years). The GCC offers a potentially excellent mechanism for taking Canada's participation in global health challenges "to a higher level". Recent GCC announcements raise new questions about the emphasis being placed on technological discovery or "catalytic" research. Missing so far are opportunities that the Fund could offer in order to support innovative research addressing i) health systems strengthening, ii) more effective delivery of existing interventions, and iii) policies and programs that address broader social determinants of health. The Canadian Grand Challenges announced to date risk pushing to the sidelines good translational and implementation science and early career-stage scientists addressing important social, environmental and political conditions that affect disease prevalence, progress and treatment; and the many unresolved challenges faced in bringing to scale proven interventions within resource-constrained health systems. We wish to register our concern at the apparent prioritization of biotechnical innovation research and the subordination of the social, environmental, economic and political context in which human health is either protected or eroded.

Background Chamas for Change (Chamas) is a group-based health education and microfinance program for pregnant and postpartum women that aims to address inequities contributing to high rates of maternal and infant mortality in rural western Kenya. In this prospective matched cohort study, we evaluated the association between Chamas participation and facility-based delivery. We additionally explored the effect of participation on promoting other positive maternal, newborn and child health (MNCH) behaviors. Methods We prospectively compared outcomes between a cohort of Chamas participants and controls matched for age, parity, and prenatal care location. Between October–December 2012, government-sponsored community health volunteers (CHV) recruited pregnant women attending their first antenatal care (ANC) visits at rural health facilities in Busia County to participate in Chamas. Women enrolled in Chamas agreed to attend group-based health education and microfinance sessions for one year; controls received the standard of care. We used descriptive analyses, multivariable logistic regression models, and random effect models to compare outcomes across cohorts 12 months following enrollment, with α set to 0.05. Results Compared to controls (n = 115), a significantly higher proportion of Chamas participants (n = 211) delivered in a health facility (84.4% vs. 50.4%, p < 0.001), attended at least four ANC visits (64.0% vs. 37.4%, p < 0·001), exclusively breastfed to six months (82.0% vs. 47.0%, p < 0·001), and received a CHV home visit within 48 h postpartum (75.8% vs. 38.3%, p < 0·001). In multivariable models, Chamas participants were over five times as likely as controls to deliver in a health facility (OR 5.49, 95% CI 3.12–9.64, p < 0.001). Though not significant, Chamas participants experienced a lower proportion of stillbirths (0.9% vs. 5.2%), miscarriages (5.2% vs. 7.8%), infant deaths (2.8% vs. 3.4%), and maternal deaths (0.9% vs. 1.7%) compared to controls. Conclusions Chamas participation was associated with increased odds of facility-based delivery compared to the standard of care in rural western Kenya. Larger proportions of program participants also practiced other positive MNCH behaviors. Our findings demonstrate Chamas' potential to achieve population-level MNCH benefits; however, a larger study is needed to validate this observed effect.