Delivering equitable care: comparing preventive services in Manitoba.

OBJECTIVES

This study examined preventive care delivered in Manitoba during the 1990s by 3 different methods -childhood immunizations (by physicians and public health nurses under a government program), screening mammography (through a government program introduced in 1995), and cervical cancer screening (no program).

METHODS

Longitudinal administrative data, an immunization monitoring system, and Canadian census databases were used.

RESULTS

Cervical cancer screening rates remained static and showed strong socioeconomic differences; childhood immunization rates remained high with small socioeconomic gradients. The introduction of the Manitoba Breast Screening Program resulted in rising rates of screening and vanishing socioeconomic gradients.

CONCLUSIONS

Manitoba government programs in childhood immunization and screening mammography actively helped the provision of preventive care. Organized programs that target population groups, recognize barriers to access, and facilitate self-evaluation are critical for equitable delivery.