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Sex- and gender-based analysis plus

Table of contents

Section 1: Institutional SGBA Plus governance and capacity

Governance

Sex- and Gender-Based Analysis Plus (SGBA Plus) – used interchangeably with the Government of Canada's Gender-Based Analysis Plus (GBA Plus) – is an analytical, intersectional approach used by the Government of Canada's Health Portfolio to assess how determinants of health interact and intersect with each other and broader systems of power and oppression. Applying SGBA Plus enables the formulation of responsive and inclusive health research, policies, services, programs and other initiatives to promote greater health equity.

In 2025–26, PHAC's SGBA Plus Focal Point, alongside the SGBA Plus Champion and Executive-level SGBA Plus Branch Leads will renew the PHAC SGBA Plus Action Plan Framework and Implementation Strategy for 2025-26 to 2027-28 to advance its four priority areas:

The SGBA Plus Focal Point will continue to support the Agency's SGBA Plus communities to strengthen accountability and integration at the Centre/Directorate level. The Agency will also prioritize SGBA Plus and equity considerations at various governance committees and will demonstrate progress on its priorities through annual reporting to the Agency's Executive Committee.

Institutional Leadership

PHAC's SGBA Plus Focal Point will continue to strengthen SGBA Plus capacity across the Agency by:

PHAC's SGBA Plus Focal Point will deliver a robust challenge and support function by providing equity-informed advice and embedding inclusive and non-stigmatising language in all public health guidance, Cabinet documents, and other high visibility documents, as well as monitoring progress implementing the Health Portfolio SGBA Plus Policy.

Capacity

For 2025–26, the Agency's SGBA Plus Focal Point will enhance knowledge, awareness, and capacity by integrating SGBA Plus into the Agency's core functions through training, presentations, tools, and resources tailored to the public health context. The Focal Point is also committed to advancing equity-informed advice and evidence in domestic and international policies, frameworks, research, and reports.

Human resources (full-time equivalents) dedicated to SGBA Plus

In 2025–26 approximately seven Full-Time Equivalents (FTEs) will be dedicated to SGBA Plus implementation in the Agency:

Section 2: Gender and diversity impacts, by program

Core responsibility: Health Promotion and Chronic Disease Prevention

Program name: Health Promotion – Community Action Program for Children (CAPC) and Canada Prenatal Nutrition Program (CPNP)

Program goals: The CAPC and CPNP provide funding to community groups to support pregnant women and people, children aged 0 to 6 and their parents/caregivers who face challenges that may place their health at risk.

Funded projects provide stigma-free, culturally safe and inclusive environments, applying health equity and social determinants of health-based approaches to encourage healthy pregnancies, positive parenting and healthy child development in populations facing health equity barriers.

SGBA Plus data collection plan

The program plans to continue to collect CAPC and CPNP participant level data every five years. The next iteration of the survey will collect data on the demographic characteristics of the participants reached by the program and outcomes experienced. For CAPC, the program plans to disaggregate data related to the outcomes of the program by gender, income, and ethnicity and for CPNP by income and ethnicity.

Program name: Health Promotion – Dementia Community Investment (DCI)

Program goals: The DCI strives to reach populations that have a higher risk of developing dementia and/or face barriers to equitable care and to improve the effectiveness of interventions. Applicants to the DCI solicitation processes are asked to incorporate health equity, cultural sensitivity, and meaningful engagement considerations in their proposed projects.

SGBA Plus data collection plan

The DCI applies SGBA Plus and integrates health equity considerations (e.g., reporting on data disaggregated by sociodemographic and socioeconomic factors). Projects funded through the DCI are encouraged to provide the number of individuals reached by priority population (Indigenous Peoples, racialized communities, ethno-cultural minorities, newcomers to Canada, 2SLGBTQI+ communities, Official Language Minority Communities, people living in rural/remote communities, people living on low income and people living with disabilities), gender and geographic location. The DCI continues to work to improve disaggregated data collection at the project level by updating project reporting templates and instructions.

Program name: Health Promotion – Mental Health Promotion Innovation Fund (MHP-IF)

Program goals: The MHP-IF supports diverse community-based interventions that bolster protective factors for the mental health of young people in Canada, families and communities. The program actively seeks to remove barriers to health equity through strong partnerships, reflexive practice, learning, knowledge exchange and systems change.

Specific efforts to reduce mental health inequalities through action on determinants of health such as gender identity, geographic location and culture are mandatory requirements of funded projects. Funded initiatives must consider such inequalities and/or improve health equity at various stages of the intervention, including design and adaptation, implementation, scale and evaluation.

SGBA Plus data collection plan

The MHP-IF program applies equity analysis to core elements of program design and implementation. For example, the invitation to submit funding requests built specific equity and cultural safety considerations into the process in order to support priority audiences, including First Nations, Inuit and Métis, 2SLGBTQI+, and newcomers and refugees. The MHP-IF also requires that all funded projects make specific efforts to address systemic health inequities, based on a grounded understanding of the intersection of diverse experiences of marginalization (e.g., social and structural factors). The MHP-IF supports funded projects to apply intersectional analysis at various stages of the project; including design, adaptation, implementation, scaling, and evaluation, using health equity tools developed by the program. In addition, projects must complete annual reporting which includes the collection of basic information for the distribution of benefits of funded interventions by age group and by priority group, where appropriate (e.g., First Nations, Métis and Inuit, Newcomers, 2SLGBTQI+, Official language minorities and racialized communities).

Program name: Health Promotion – Pan-Canadian Suicide Prevention Service and 9-8-8 Suicide Crisis Helpline

Program goals: The goal of the 9-8-8 Suicide Crisis Helpline is to provide people across Canada with access to free, bilingual, 24/7 crisis support from trained responders, by phone call or text through an easy to remember three-digit number: 9-8-8. An Equity Working Group was created to help inform the implementation of 9-8-8.

SGBA Plus data collection plan

The 9-8-8: Suicide Crisis Helpline will collect data that is disaggregated by modality (call or text), official language, and province/territory.

Program name: Health Promotion – Preventing Family Violence

Program goals: The Preventing Family Violence program invests in the delivery and testing of health promotion programs and interventions that:

This program is designed to address gendered forms of violence that primarily affect women, girls, children and gender-diverse youth. Gender analysis is built into the design. In line with SGBA Plus best practices, solicitations are based on scoping research that include qualitative and quantitative disaggregated data and information as well as meaningful engagement with diverse stakeholders.

SGBA Plus data collection plan

SGBA Plus is applied to bolster this goal in two main ways: selection criteria for new projects, and reporting requirements for existing projects. In 2025–26, PHAC will fund projects to prevent youth dating violence and child maltreatment in priority groups that were identified in part through this analysis. Health equity is a core principle of the Preventing Family Violence program, and of underserved populations. With existing projects, PHAC will continue to encourage projects to collect data disaggregated by socio-demographic factors, where it is relevant, safe and feasible to do so, and to report on these data annually. Annual report templates further ask projects to report on efforts towards advancing cultural competency/humility in their organization, as well as reconciliation with Indigenous Peoples. The Program currently collects as much information as is safe and feasible.

Program name: Chronic Disease Prevention

Program goals: This Program seeks new solutions for the complex challenge of preventing chronic diseases in Canada. The program works across sectors to leverage partnerships and investments to design, implement and scale interventions that support healthy behaviours and create social and physical environments that enable and promote better health. The program addresses behavioural risk factors for chronic disease, namely physical inactivity, unhealthy eating and tobacco use, among people who face health inequalities and are at greater risk of developing poor health outcomes, including the main chronic diseases (e.g., diabetes, cardiovascular disease, cancer, etc.). The program also aims to improve the mental health of Black people in Canada and support collective action on the social determinants of health to reduce health inequities. Ultimately, the Program contributes to improving health equity and preventing chronic diseases through action on the social determinants of health and effective healthy living policies and interventions to advance health outcomes for all.

SGBA Plus data collection plan

Healthy Canadians and Communities Fund (HCCF)

Organizations funded through the HCCF are required to provide the number of individuals reached by priority populations (Indigenous People, newcomers to Canada, people with disabilities, 2SLGBTQI+ communities, people living on low incomes, and racialized communities), gender (female, male, or other gender), age groups (children and youth, adults, older adults), and geographical location (the first three digits of postal codes). Funded projects are also encouraged to disaggregate any outcome related to knowledge, skills, social environments, health behaviours, and health status according to gender and age groups. Disaggregated outcomes are reported upon availability of data and on a voluntary basis, as this was not a program requirement when most funded organizations started their projects. Since 2021–22, newly funded organizations must report this information in a more systemic manner and this reporting requirement is now embedded in contribution agreements.

While additional identity factors such as employment status, education level, income range, immigration status, and sexual orientation are optional for HCCF projects, funded organizations are encouraged to also collect this information if relevant. This enhanced project results data allows for a better understanding of the project's impacts on participants who may experience health and social inequities. Since 2022–23, HCCF officials estimate project participants' income, education, and race by connecting first three digits of their postal code with socio-economic indicators derived from census data.

The HCCF will continue to work closely with funded projects to improve their capacity for collecting disaggregated data to support SGBA Plus and equity-informed analysis. In 2025-26 the HCCF will continue to share best practices and tools from previous research and through peer networking opportunities. The objective of this exercise will be to address challenges encountered in disaggregated data collection and use within organizations.

The Intersectoral Action Fund (ISAF)

Health equity is a guiding principle of the ISAF program. The ISAF prioritizes upstream action to address the root causes of poor health outcomes by targeting social, economic, institutional, legal, and political structures and norms. SGBA Plus considerations are embedded throughout the ISAF's solicitation process to encourage a systematic application of diversity and equity in applicants' project activities. Applicants are required, for example, to indicate if and how marginalized groups with lived experience will be engaged in their work. Organizations must subsequently report on the successful integration of these factors through a final report. This mandatory reporting will ensure that funded projects are more inclusive of the diverse populations in Canada, and ultimately lead to outcomes that address the diverse needs of communities.

The Invitation to Submit a Funding Request form and Final Report questionnaire constitute the two key tools for assessing project impacts by diversity and gender. By using various performance indicators, the ISAF program is able to evaluate the number of individuals or organizations that participated in the development of projects, and who were targeted and reached by demographic group or identity (e.g., age group, 2SLGBTQI+ community members, Indigenous and racialized communities), geography (e.g., official language minority communities, rural/urban), sector, and more. Additional indicators include the frequency and type of knowledge mobilization activities and the uptake of knowledge products across equity-denied communities and cross-sectoral stakeholders.

Promoting Health Equity: Mental Health of Black Canadians (MHBC) Fund

The MHBC Fund applies an equity lens and analysis to all elements of program design, implementation, and evaluation. All funded projects must describe how their project design, recruitment, and implementation consider health equity, and include equity-informed reporting as part of their project results.

Funding recipients must consider diverse needs and perspectives of diverse sub-groups to be able to adjust and tailor project activities. PHAC will use this information to reflect on the design and delivery of the program, lessons learned regarding approaches to addressing underlying health determinants, and potential implications for program delivery in other contexts.

Results from MHBC projects will help to inform program and policy decisions by documenting what interventions worked, for whom they worked, and in what context. This information will also help service providers and others to adapt activities to best meet the needs of diverse Black communities across Canada.

Program name: Evidence for Health Promotion, and Chronic Disease and Injury Prevention –Integrated Strategy for Healthy Living and Chronic Disease – Enhanced Surveillance for Chronic Disease

Program goals: The Enhanced Surveillance for Chronic Disease Program aims to build surveillance capacity and fill data gaps in priority areas. Under the terms of contribution agreements established, recipients will be responsible for submitting progress reports semi-annually, until they close.

SGBA Plus data collection plan

As part of the solicitation process, initiatives funded through this program are required to integrate SGBA Plus considerations into their proposals, which are assessed as part of the screening process. Further, projects are expected to report on these considerations in their progress and annual reporting to PHAC. Since the projects establish their own activities, each of them will report on different SGBA Plus indicators. Some examples of information being captured for analysis in this program include sex, gender, age, Indigenous status, disability, urban vs. rural status, level of education, employment status, general health status including diagnosed mental health conditions, race and immigration status.

Core responsibility: Infectious disease prevention and control

Program name: Laboratory Science Leadership and Services

Program goals: This program's objective is to provide people in Canada with the scientific readiness to respond to infectious disease threats. To that end, a governance mechanism was established to provide accountability on and oversight of SGBA Plus application.

SGBA Plus data collection plan

In general, PHAC's laboratory services involve testing pathogen samples from clients, such as provincial and territorial partners, who do not submit patient information and metrics for privacy reasons in accordance with their respective legislative frameworks. The National Microbiology Laboratory Branch (NMLB) collects and receives data from provincial and territorial laboratories and based on that information, it can determine the general region and/or province or territory, but further disaggregated data on the specific locations is not shared or available in accordance with privacy legislation. As a result, NMLB is not in a position to collect and review disaggregated data.

However, to support the generation of SGBA Plus knowledge and evidence, NMLB encourages research activities to consider SGBA Plus implications on a project-by-project basis through its Science Planning Information Management System (SPIMS). SPIMS is a database that holds information of science planning and reporting value provided by NMLB program areas. When adding their research to the SPIMS database, all researchers must complete a dedicated section answering if there are any SGBA Plus considerations to their research. This requirement is a part of a broader branch-wide action plan to support SGBA Plus implementation across all activities. The plan seeks to enhance, strengthen, and expand the NMLB's application of SGBA Plus through strengthening SGBA Plus governance and accountability, including the generation of inclusive scientific knowledge and capacity and enhancing the Branch's internal capacity and expertise. Inclusive language tips are shared weekly to support NMLB staff in being more accommodating and inclusive in their interactions with different groups.

Examples of other specific activities will include enhancing SGBA Plus oversight and accountability within the Branch's governance structure and the co-development of a SGBA Plus science tool with the SGBA Plus Focal Point, to increase internal capacity and expertise on SGBA Plus application, as well as supporting its incorporation in NMLB's work. To further strengthen SGBA Plus governance and accountability, NMLB has established its Tier 2 Branch Oversight Committee as the lead governance table to provide accountability and oversight to NMLB's SGBA Plus Framework.

For greater understanding and synthesis of NMLB efforts in SGBA Plus advancement, NMLB is maintaining an internal repository of the Branch's SGBA Plus-related activities.

Program name: Communicable Disease and Infection Control

Program goals: The purpose of the program is to prevent and control the spread of infectious diseases in communities and healthcare settings. The program is striving to achieve this goal through collaboration with domestic and international stakeholders to share knowledge, tools and resources to support public health front-line efforts, including tailored community-based interventions, to prevent, control and reduce community and healthcare-associated infections. It promotes and coordinates a pan-Canadian approach to disaggregated data collection, including health equity data to support SGBA Plus analyses, to help identify key populations and locations to provide evidence-informed public health measures guidance, address barriers to healthcare services related to sexually transmitted blood borne disease (STBBI) and harm reduction and reduce stigma and discrimination toward diverse populations disproportionally affected by STBBI, including people living with HIV or hepatitis C.

SGBA Plus data collection plan

A continuous improvement approach is applied in the areas of surveillance and data collection. To better reflect the impacts of its programs on gender and diversity, the program is in the process of developing an SGBA Plus data collection commitment to facilitate and streamline collection of data. Additionally, plans are in place to update collection and reporting on data disaggregated by socio-demographic and socio-economic factors to support equity-informed analysis. The related identity factors include gender, sex, age, race, ethnicity, income, geographic location, employment status, and level of education.

Program name: Vaccination

Program goals: Several surveillance systems collect SGBA Plus factors, such as age, biological sex, and measure of geographical location while others collect enhanced SGBA factors such as ethnicity, Indigeneity, and socio/behavioural risk factors. These include the International Circumpolar Surveillance program, National Enhanced Invasive Group A Streptococcus (iGAS) Surveillance System, and Sentinel Pediatric Hospital-based Surveillance. Collecting equity-related variables improves data quality and advances Canada's progress towards objectives outlined in the National Immunization Strategy, which is currently under renewal for 2025-2030, such as reaching and maintaining vaccine preventable disease reduction targets. Further, this strengthens the quality of information and allows for an intersectoral analysis applied across various data products, such as dashboards, and better informs the National Advisory Committee on Immunization in making its evidence-based recommendations on the optimal use of vaccines authorized for use in Canada.

The purpose of the Immunization Partnership Fund (IPF) is to support confidence and uptake of vaccines among people in Canada across the life course, particularly among those from disproportionately impacted communities or populations who experience vaccine hesitancy and face barriers accessing vaccination or vaccine education and experience persistent gaps in vaccine coverage. The program achieves this through funding initiatives that are evidence-informed and equity promoting, engaging in culturally-sensitive, supportive services and education, and tailoring outreach to reflect the historic and present-day drivers of vaccine hesitancy.

The social determinants of health such as socioeconomic disparities, limited access to healthcare and reliable health information, historical mistrust in medical institutions, language barriers, and lower health literacy contribute to lower vaccine acceptance and uptake. IPF acknowledges that these factors do not exist in isolation, instead, they intersect, resulting in challenges and barriers that are uniquely experienced across groups. The IPF responds to the intersectional needs of underserved and disproportionately impacted communities by encouraging funding recipients to meaningfully include members of priority population communities in the planning and implementation of their initiatives.

SGBA Plus data collection plan

Funding recipients are required to consider health equity by incorporating SGBA Plus in their project workplans. Recipients are required to focus their projects to reach at least one priority population, which IPF has identified, for the purposes of the program, as:

In formulating and implementing their projects, IPF recipients consider how diverse population groups access and experience activities differently, as a result of intersecting and overlapping social and structural determinants of health and how they can tailor their projects to reduce barriers. This is monitored and assessed through the life cycle of the project through reporting requirements. Annual performance measurement data collection tools will continue to be refined to gather demographic information, where feasible, to inform the interpretation and application of program results. Additionally, monitoring and reporting tools will be refined to better describe the intersectionality of the priority populations IPF projects reach and capture the variety of low-barrier and barrier reducing methods used to reach them.

As a continuation of the efforts to expand PHAC's capacities to report on impacts by gender and diversity, the program will enhance capacity within Canada to monitor vaccine safety and coverage, particularly among communities or populations experiencing or facing inequities and deemed as priority populations. PHAC incorporates SGBA Plus considerations by conducting epidemiological vaccine safety investigations to better understand the gender-based differential risk of adverse events following immunization. The program will continue to integrate SGBA Plus where possible in the testing, design, methods and analysis, and interpretation of findings.

Program name: Foodborne and Zoonotic Disease

Program goals: The Infectious Disease and Climate Change (IDCC) Program and Fund focuses on preparing and protecting people living in Canada from climate-sensitive infectious diseases that are zoonotic, food-borne and water-borne. The program and fund incorporate SGBA Plus considerations into program implementation, roll-out and design. For example, SGBA Plus considerations were integrated into new solicitation documents (e.g., funding application form, application guide, evaluation forms, etc.) as well as the integration of SGBA Plus metrics into new project reporting templates. Updated funding application questions require organizations to describe how they will incorporate SGBA Plus into the planning, implementation, and evaluation of the project. This includes how project activities will be tailored to address the needs of the project audiences/beneficiaries (e.g., culture, geographic area, Indigeneity, sex, gender, language, socio-economic status).

The incorporation of additional SGBA Plus considerations will allow the IDCCF to improve its understanding of the intersecting determinants of health, the different issues and barriers that exist and which populations are disproportionately impacted by climate-sensitive infectious diseases. As a result, applying SGBA Plus enables the IDCCF to target critical gap areas and priority populations through the development of funding objectives and activities (note Program is scheduled to sunset in 2028).

SGBA Plus data collection plan

In 2025–26, the IDCC Program will continue to improve and integrate SGBA Plus considerations into the next cycle of solicitation documents, including the funding application form and application guide. The application guide provides applicants with an overview of SGBA Plus requirements and outlines the considerations that must be given to gender, as well as other identity factors such as age, education, language, geographic location, culture and income.

As of 2023-24, organizations funded through the IDCCF are required to identify which priority population is the focus of their project (children, teenagers and youth, pregnant people, women, older adults, immigrants and newcomers, 2SLGBTQI+ community, Black people, Indigenous Peoples, linguistic minority communities, religious minority communities, racialized people in Canada, people with disabilities, people who use drugs, homeless/underhoused (those facing housing insecurity), as well as the geographic location (urban, rural, remote, mix of urban and rural).

Additionally, updated reporting templates now include questions to solicit quantitative information regarding key priority populations (e.g., children, women, older adults, newcomers, Indigenous Peoples, etc.) as well as a new section to solicit qualitative information. These questions ask how projects identified and reduced systemic barriers to health equity related to infectious diseases, climate change and the impact on human health, as well as what methods/approaches were used to reduce barriers associated with engaging, raising awareness or conducting workplan activities and, in promoting health equity, how organizations connected with people in their preferred language (products and services).

The IDCCF will work closely with experts to improve the integration of SGBA Plus metrics into project reporting tools and templates. An information session will be held with funding recipients to help them strengthen SGBA Plus considerations in the implementation of projects.

Core responsibility: Health Security

Program name: Emergency Preparedness and Response

Program goals: This program is responsible for strengthening Canada's capacity to prevent, mitigate, prepare for and respond to public health events and emergencies. The program recognises that disasters, events and emergencies have the potential to exacerbate health inequities and disproportionately impact some population groups more than others. The program exists for all people in Canada. However, where possible, considerations of the various sectors of the population (i.e., men and women, older adults, Indigenous Peoples and individuals living in vulnerable situations) have been considered and built into the service delivery to ensure that equity has been integrated into this program.

SGBA Plus data collection plan

Though the collection of disaggregated data on impacts is limited due to the nature and scope of work, the program will continue to incorporate SGBA Plus and health equity considerations in its activities, including emergency response planning, training activities and medical asset procurement. For example, its training programs will continue to build competencies to understand and apply principles of SGBA Plus during applied public health response; NESS will continue to consider the availability of alternative products if certain population groups (e.g., pregnant or immunocompromised individuals) have contraindications to certain vaccines and therapeutics or considerations for medical equipment and supplies (e.g., face size and shape for respirators, skin tone for biomedical measurement equipment, etc.).

Program name: Biosecurity

Program goals: The Biosecurity program administers and enforces the Human Pathogens and Toxins Act and Regulations (HPTA/R) and select sections of the Health of Animals Act and Regulations (HAA/R). The program and regulatory framework are designed to prevent accidents and incidents with pathogens and biological toxins, as well as deter the development of biological weapons.

SGBA Plus data collection plan

Though the collection of disaggregated SGBA Plus data on impacts is limited at this time, PHAC is exploring opportunities to collect this data to inform the design and prioritization of tools, guidelines and outreach activities. In the interim, as part of the legislative renewal of the Human Pathogens and Toxins Regulations, PHAC will incorporate SGBA Plus in assessing relevant influential socio-demographic factors for facilities and organizations handling human pathogens and toxins and incorporate these considerations into the regulatory amendment package as it moves forward. Finally, PHAC will incorporate SGBA Plus considerations when conducting pathogen and toxin risk assessments and in the development of Pathogen Safety Data Sheets. As part of the pathogen and toxin risk assessment process, certain subgroups are routinely considered (e.g., pregnant women and people, older adults) to determine whether biological susceptibility or sex-specific differences (at birth) might exist and whether additional precautions may be necessary when working with these agents. This information is then used in the development of pathogen safety data sheets, which are technical documents published by PHAC that describe the hazardous properties of a human pathogen and provide guidance on how to work safely with these agents in a laboratory setting.

Program name: Border and Travel Health

Program goals: This program protects the travelling public by informing travellers how to protect themselves from travel-related public health risks, working with the conveyance industry to protect against risks associated with water, food and sanitation, and working with border partners to limit the spread of public health risks to protect Canada's health care system and meet International Health Regulation requirements. In general, the program's service delivery approach is aimed at the whole population, and where possible, adapted to specific groups such as women, older adults and children, to mitigate disparate impacts.

SGBA Plus data collection plan

With respect to health policy advice developed that is related to borders and with respect to travel health advice, there continues to be significant reliance on publicly available disaggregated data and information, such as from Statistics Canada and other credible sources.

The program has started using online intercept surveys to collect disaggregated data (e.g., gender, age, geographic distribution, and identification as a member of a racialized community) from visitors to the Government of Canada's Travel and Tourism site (travel.gc.ca) who seek travel health advice. Lessons from use of these online intercept surveys will inform ongoing assessment and evolution of the program.

Certain clients for border and travel health services – including Yellow Fever Vaccination Centre Designation and Ship Sanitation Inspections – are corporate entities and disaggregated data collection is therefore not applicable. Where feasible and in compliance with Privacy Act requirements, the program will continue to explore ways to collect disaggregated data at the individual level through the development of case management data systems.

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2025-06-17