Implementation Evaluation of the Nutrition North Canada Program

1.2.1 Background

NNC is a market-driven food subsidy program that seeks to improve access to perishable healthy food in eligible isolated northern communities.

The objective of the NNC is to make healthy foods more accessible and affordable to residents of isolated northern communities. By making nutritious food more accessible and more affordable, the program seeks to increase the consumption of nutritious foods and contribute to improving the overall health of the population, both Aboriginal and non-Aboriginal, living in the North.

NNC replaced the Food Mail Program, which was an airfreight transportation subsidy program operated by Canada Post since the late 1960s.

Population growth and increasing fuel prices were resulting in annual resource shortfalls, which required the program to seek additional funds from the fiscal framework each year. As a result, AANDC was directed by Cabinet to conduct an extensive review of the Food Mail Program and develop options to improve its efficiency in achieving its objectives, while maintaining financial sustainability and predictability.

In Budget 2010, the Government of Canada announced funding for a new program to improve access to affordable healthy food for Northerners. NNC was officially announced on May 21, 2010, as the replacement to the Food Mail Program, and the transition period began.

The NNC Program was launched on April 1st, 2011.

1.2.2 Program Objectives and Expected Outcomes

The NNC objectives are as follows, as per the program's Performance Measurement Strategy (September 2010):

• Make nutritious food more accessible and more affordable;
• Support the consumption of country foods; and
• Provide nutrition education on healthy foods choices and develop food preparation skills by targeted Health Canada initiatives (led by Health Canada).

The activities undertaken by AANDC and Health Canada are intended to result in the following immediate outcomes identified by the NNC's logic model (see Appendix A) as:

• Access to subsidized nutritious food in eligible communities (led by AANDC);
• Residents in eligible communities are informed about the program and subsidy levels (led by AANDC); and
• Residents in eligible communities have knowledge of healthy eating and skills to choose and prepare nutritious foods (led by Health Canada).

All three of these outcomes lead to the intermediate outcome identified by the NNC's logic model as consumption of nutritious food in eligible communities.

By making nutritious food more accessible and more affordable, the program seeks to increase its consumption and contribute to the ultimate outcome for NNC, which is Healthy Northerners living in eligible communities and ultimately improve the overall health of the population, both Aboriginal and non-Aboriginal, which is a key expected outcome of the Government's Northern Strategy.

1.2.3 Program Management, Key Stakeholders and Beneficiaries

Program Management
Two federal departments have specific responsibilities in implementing this new program: AANDC and Health Canada.

AANDC has overall responsibility for the NNC Program. AANDC is responsible for providing, monitoring and verifying the subsidy for eligible foods and promoting program awareness, outreach and engagement.^{Footnote 4} The Assistant Deputy Minister, Northern Affairs Organization and the Director General, Devolution and Territorial Relations are accountable, through the Deputy Minister, to the Minister for the implementation, management, monitoring and reporting of the food subsidy program. AANDC works with the Communications Branch to promote program awareness, outreach and engagement.

The program staff located at AANDC Headquarters administers the overall delivery of NNC. Their responsibilities include:

• Receiving and processing applications from potential program recipients;
• Managing funding agreements with recipients, including subsidy payments;
• Reviewing food price surveys;
• Identifying options for adjustments to the program's subsidy rates, the list of foods eligible for subsidy and/or the list of communities eligible under the program in order to ensure financial sustainability;
• Monitoring program delivery and outcomes to assess the performance of the program;
• Procuring a third-party Claims Processor and working with them to ensure validity of claim submissions and to process funding payments;
• Working with retailers to ensure visibility (via promotional materials) of the program and of subsidy rates to the consumer;
• Ongoing development and refining of program policy;
• Supporting governance bodies, including outreach activities like public meetings in eligible communities;
• Supporting program communication of the program, including compiling and posting data on the program website, responding to public and stakeholder inquiries and feedback; and
• Responding to information requests, including Access to Information and Privacy.

Health Canada, through its First Nations and Inuit Health Branch, funds complementary nutrition education initiatives in fully-eligible communities in order to support increased knowledge of healthy eating and development of the skills to choose and prepare nutritious foods. Outputs linked to Health Canada's component of the program are retail and community-based activities, such as: nutrition workshops, cooking classes, in-store demonstrations, educational materials, media, etc; and trained and supported community workers. The immediate outcome from Health Canada's activities and outputs is that residents in eligible communities have knowledge of healthy eating and skills to choose and prepare nutritious foods.

In addition to newly funded activities, Health Canada provides an advisory role to AANDC in the selection and approval of eligible food items, as well as providing general expert advice in the area of nutrition.

1.2.4 Program Data

Documents reviewed show that the following key steps are undertaken in data collection:

• AANDC personnel monitor and verify the subsidy process by collecting and analyzing data on food prices, volumes and shipment content.
• Data is used to support funding forecasts, program and policy reviews and adjustments, including adjustments to the subsidy rates, the list of eligible food and communities, and implementation of cost containment strategies and framework.
• Verification of recipient claims to ensure that funding obligations are being met are carried out by a third party. Outputs resulting from these activities include payments to recipients, subsidized food available for sale in eligible communities, reports on the cost of the Revised Northern Food Basket, allocation of subsidy and detailed shipment information, weight and subsidy forecasts and program-led risk-based compliance reviews.

Further, a Performance Measurement Strategy was approved by Evaluation, Performance Measurement and Review Committee in September 2010.

In January 2011, AANDC developed a control framework to monitor the relationship with third parties (AANDC subsidy recipients and contractors) to ensure neutrality, objectivity and that appropriate controls are in place. Benchmark data was to be collected prior to the launch of the new program in April 2011.

To assist with monitoring and reporting, AANDC collects from its subsidy recipients detailed information on shipments of eligible products (e.g., weight by pre-determined categories, destination community, and for southern suppliers, customer type) and pricing (northern retailers are required to submit the price of items in the Revised Northern Food Basket by community on a monthly basis). These data are used for performance measurement as they translate directly into performance indicators (Tier 1 indicators) for the first stream of program activities, outputs and immediate outcome (i.e., to provide, monitor and verify subsidy for eligible foods so that eligible communities have access to subsidized, nutritious food and commercially produced country food). The quarterly reports on food pricing include the cost for the final month of the quarterly period (ie, June, September, December and March).

To this end, the program's management team created databases and spreadsheets to store data on:

• Food prices for each item in the food basket.
• Shipment volumes on a per-community-basis and per-category basis.
• Subsidies paid out per-period and per-community.

The data collected are used to prepare quarterly, semi-annual and/or annual reports on food basket costs, allocation of subsidy and detailed shipment information; to produce weight and subsidy forecasts; and to target program-led compliance reviews. Additionally, a survey to measure the awareness level and satisfaction level of consumers about the program was planned by AANDC but has not been undertaken. However, AANDC has commissioned a major study of food retailing in the North that is currently being conducted by eNRG research group and the Transport Institute at the University of Manitoba.

1.2.5 Program Resources

Nutrition North Canada has a fixed budget of $60 million in program funding. Of this, $53.9 million is allocated for the subsidy component through funding agreements for eligible recipients managed by AANDC. AANDC also receives another $3.4 million for program operations.

The remaining $2.9 million is for the Health Canada nutrition education initiatives component of the program.

Relevance

• Is there a continued need for the program? (Continued Need)
• To what extent are program objectives aligned with a) government-wide priorities; and b) are they linked to AANDC's strategic outcomes? (Alignment with government priorities and departmental objectives)
• To what extent are the objectives of the program aligned with the role and the responsibilities of the federal government? (Consistency with Federal Roles and Responsibilities)
• Is there duplication or overlap with other programs, policies or initiatives? (Consistency with Federal Roles and Responsibilities)

Performance – Effectiveness / Success

• To what extent has the NNC Program model created cost-effectiveness in terms of public money invested versus results (affordable food prices, etc.) compared to the former Food Mail Program?
• To what extent has access to subsidized nutritious food in eligible communities changed?
• To what extent are residents in eligible communities informed about the NNC Program and subsidy levels?
• To what extent are residents in eligible communities consuming subsidized nutritious food?
• What factors are facilitating or challenging the achievement of results?
• Has the NNC Program had any unexpected impacts, positive or negative?
• To what extent have the oversight committees and external advisory board been effective?
• To what extent do residents in eligible communities have knowledge about healthy eating and skills to choose and prepare nutritious foods?

Performance – Efficiency and Economy

• What modifications or alternatives might improve the efficiency and economy of the NNC Program?
• How can the NNC's efficiency be improved? Are there opportunities to identify cost saving measures?
• How has the NNC Program optimized its process and quality of services to achieve expected outcomes?
• How can the NNC's efficiency be improved?

Other Evaluation Issues

• Are there best practices and or lessons learned?

Design and Delivery

• To what extent does the program's design facilitate the achievement of results? (including AANDC and Health Canada complementarities of their activities to deliver the program in order to achieve results)
• Are AANDC's and Health Canada's roles and responsibilities in delivering the NNC clear?
• To what extent has the NNC been implemented as planned? (e.g. staffing, level of effort, use of external claims processer)?
• To what extent has the governance structure been implemented as planned?
• Are adequate data collection and reporting procedures in place for performance measurement?

2.3.1. Planning and Development of Methodology

2.3.3 Data Collection and Analysis Phase

Data collection and analysis was conducted between January 2013 and August 2013, with visits to four communities currently eligible for the NNC Program.

The evaluation used multiple lines of evidence to respond to the evaluation issues and questions. A detailed explanation of the methods is provided below:

2.4.1 Strengths

2.4.2 Limitations

4.1.1 Supply-chain model

Evidence suggests that the NNC Program supply-chain model is well-suited to achieving program objectives of making food more accessible, largely in part because it enables retailers to organize their own shipping routes and secure competitive freight rates. Evidence from interviews and documents reviewed indicate that the supply chain design allows retailers the flexibility to make more economic choices and that the supply chain structure could result in the establishment of more efficient delivery routes.^{Footnote 32}

Further, documents reviewed suggested the devolution of transportation responsibilities to retailers is meant to contribute to both cost-savings and capacity development.^{Footnote 33} Program documents outline the potential benefits, such as carrier systems under NNC having the capacity to lower the transportation costs per net kilo.^{Footnote 34} Thus, community stores are better able to influence airline schedules, allowing them to better marry trucking schedules, where they are available. A few key informants have acknowledged this fact as a factor to facilitate the achievement of results.

4.1.2. Program Eligibility Criteria

Program documentation indicates that in 2011-2012, under NNC, 82 communities were eligible for a full subsidy and 21 for a partial subsidy^{Footnote 35} and in 2012-13, 84 communities were eligible for a full subsidy and 19 for a partial subsidy.

To be initially eligible for Nutrition North Canada, a community must:^{Footnote 36}

• Lack year-round surface transportation (i.e. no permanent road, rail) and marine transportation link to southern centres; and
• Have used Food Mail, the Department's previous northern transportation subsidy program. Communities that did not use the previous Food Mail Program are deemed ineligible for the subsidy under NNC.

Communities eligible for a full subsidy used the Food Mail Program extensively, which was defined as communities that received over 15,000 kg (annualized) of perishable food shipments or more than $4 per month per resident in transportation subsidies, between April 1, 2009, and March 31, 2010. Communities deemed eligible for a partial subsidy were those that made very little use of the Food Mail Program with between 100 and 14,999 kg (annualized) of perishable food shipments and less than $4 per month per resident in transportation subsidies during the same time period.

About half of the respondents interviewed indicated that the community eligibility criteria are an issue. Some key informants have questioned the terms of eligibility, explaining that there are many remote, fly-in communities that would greatly benefit from a food subsidy program, but are ineligible as a result of not utilizing the former Food Mail Program. Further, some communities have limited access to affordable healthy foods and would benefit from the subsidy, but do not meet the fly-in community criteria, despite being difficult to access by road. Although a few key informants recognized that including more communities would limit the amount of funding available given the funding cap of $53.9 million that is currently in place, they explained that there was an under-addressed need in some communities.

According to the document review, AANDC was expected to re-assess community eligibility in 2012-2013^{Footnote 37} to see whether any of the 19 communities currently on a partial subsidy should be on the full subsidy. AANDC will also consider whether any of the 30 fly-in communities currently not eligible should be eligible. According to interviews, a community eligibility assessment has not been completed at this time.

4.1.3 Food Eligibility List

From October 3, 2010, until the end of the Food Mail Program on March 31, 2011, non-food items, most non-perishable foods and some perishable foods of little nutritional value were deemed not eligible for subsidized airlift to eligible communities with access to seasonal marine transportation.^{Footnote 38}

This change was announced on May 21, 2010, in conjunction with the Government announcing its plan to replace Food Mail with NNC. However, from the launch of NNC on April 1, 2011, to September 30, 2012, the list of items eligible^{Footnote 39} for the Nutrition North Canada subsidy was expanded to include all food, as well as most non-food items that were eligible under the Food Mail Program.

The decision to adopt an expanded list of eligible products for this 18-month period was taken to help ensure a smooth transition to Nutrition North Canada and to allow for two more sealift and one more winter road cycles.

On October 1, 2012, the program implemented a list of foods eligible for subsidy focused on perishable, nutritious choices. This list was expected to be reviewed annually and changes made if necessary. It was expected that feedback from Northerners on these lists would be provided. The program expected this feedback to come through the Advisory Board and through a survey that the program was to have conducted.

Some of the interview respondents indicated that they were dissatisfied with the change in eligible food items under NNC to exclude non-food items and some dry non-perishable food items. It was pointed out that many community members relied on non-food items such as snow mobile parts and diapers, which have become more expensive without the subsidy. It was additionally noted that high arctic communities receive infrequent shipments of Level-1 foods, and are often left with canned items that are no longer subsidized since they are mainly shipped via sealift or winter roads.

4.1.4 Country Foods

Documents reviewed indicate that the harvesting of country foods can have significant costs, and only those with sufficient income can afford to do it.^{Footnote 40}The case studies additionally indicate that access to country foods is also limited by not only high cost, but additionally a lack of distribution and food handling capacity, and declining local food sources.

In addition to the nutritional benefits, case studies and the literature review reported overwhelmingly on the benefits of country food to First Nations, Inuit and Northerners, including: cultural expression and tradition, social benefits associated with the practice of sharing, cooperation, and generosity, the relative affordability of traditional food compared with store-bought food and physical activity.^{Footnote 41}

Some key informant respondents confirmed findings of the document review, that a subsidy such as the one offered by NNC for processed traditional food would facilitate the shipment of local traditional foods, but both the shipping costs and the distance with which food would have to travel makes a sharing network for traditional food less feasible.^{Footnote 42} Concerns were also raised about a lack of commercial facilities in communities for processing traditional food in the North.

5.1.1 Access

Nutrition North Canada provided $54.1 million in subsidies during its first year in operation. More than 26 million kg of nutritious perishable and non-perishable food as well as certain non-food items were subsidized in 2011-2012. According to data reviewed, twelve nutritious perishable foods accounted for more than half of the annual subsidy amount, including: bread; frozen meat; fresh 2% milk; fresh meat; frozen potato products; eggs; yogurt; fresh potatoes; bananas; frozen poultry; unsweetened juice (in containers of 250 ml or less); and oranges.^{Footnote 48}

With respect to the achievement of the immediate outcome of access to nutritious perishable foods, the clearest indicator is the amount of food subsidized (in kilograms).

Although, it is too early to identify trends with only two years of data, an analysis of average kilograms per capita, by community, for 2011-12 and 2012-13, indicate that milk and country food categories experienced an increase in shipments.

Meanwhile according to the data review, meat, poultry and fish; bread and bread products, cereals, crackers, flour and plain fresh and frozen pasta; cheese, yogurt and other dairy products; fruit and vegetables (fresh and frozen); eggs and egg substitutes; nuts, seeds, peanut butter and other nut butters, tofu and other meat alternatives; and non-prescription drugs all experienced little or no change.

A decline was found for the following: cooking oils, margarine, lard, shortening, butter, mayonnaise and salad dressing; infant formula and foods prepared specifically for infants; unsweetened juice; and combination foods (fresh and frozen).

On the issue of country food, an increase was found in the total kilograms of country food shipped through the NNC Program, including the number of communities that had country food transactions rising from four in 2011-12 to thirteen in 2012-13. This could be due to the fact that country food processors were not registered for much of the first year. Additionally, case study evidence suggests that, even with the increase of country food shipments through NNC, it has not yet had an impact on accessibility to country foods in most communities.

Finally, case study evidence from interviews conducted in four communities indicated that, in Iqaluit especially, and to a lesser extent in Aklavik, Cape Dorset and Poplar River, healthy food from the South is now more accessible than it was prior to NNC. Also, the quality of nutritious food was found to be better overall since NNC, although the variety of food items, such as fruits and vegetables and fresh meat, were still seen as limited in some communities.

5.1.2 Affordability

With respect to access from a cost or affordability perspective, program documentation and media reports from retailers suggest that prices of some subsidized food items have decreased since the implementation of NNC.

North West Company issued a statement indicating that NNC has lowered prices of healthy basket items by an average of 15 percent,^{Footnote 49} claiming a 21.6 percent jump in net earnings in their second quarter, with sales up by 1.7 percent overall in Canada. They claim that the NNC Program has allowed for a revamped shipping model to lead to savings that will be passed on to consumer through price reductions of 15 percent on key products.^{Footnote 50} Meanwhile, Stanton Group says they have seen savings of up to 35 percent on certain perishable foods and have reports to show the subsidy being passed on to consumers.^{Footnote 51}

Additionally, the program's performance is monitored using the estimated weight of eligible food purchased per capita. On a monthly basis, AANDC collects detailed information on shipments of eligible products and collects monthly price reports from registered northern retailers in order to calculate the cost of the Revised Northern Food Basket by community on a quarterly basis.

North West Company suggests that since the launch of NNC, across all 67 stores that are supported through NNC, prices were down an average of 22.3 percent on a basket of healthy food products, and that average consumption was up 11 percent for dairy, 8.6 percent for meat, and 25 percent for produce.^{Footnote 52}

Additionally, according to program documents, analysis of food prices provided by retailers indicates that in communities eligible for a full subsidy, the cost of feeding a family of four a healthy diet for one week was on average lower by $34.16 or eight percent in March 2012 than in March 2011.^{Footnote 53} Evidence of certain price decreases is also supported by the preliminary results of a Laval University consumer price survey that indicated the cost of fruit and vegetables dropped 36 percent; dairy has dropped 30 percent; but that the cost of frozen food, non-perishables and other household products have risen. The report went on to note that what costs $100 to buy in Quebec City, costs $183 in Nunavik.^{Footnote 54}

Overall, the majority of key informants all agreed that food in stores is more affordable and accessible, despite retailer transparency concerns, but that these gains were still only in relative terms. Of these, a few specifically mentioned that prices had gone down and also, that availability of nutritious food had increased.

Nevertheless, evidence on this issue is somewhat contradictory. Program documents indicated that while Advisory Board members were told that supply chain efficiencies will allow prices to continue to drop in certain communities, they also heard that in Labrador, prices were unchanged and food quality was spotty. The Advisory Board was questioned by community members about suppliers' accountability for passing on savings (on direct orders). Complaints were also received that some invoices do not clearly demonstrate how and where the subsidy was applied.^{Footnote 55} Reports from the media also indicate that there are some who believe that food prices have actually increased. There have been many editorials and protests regarding the cost of food in the North overall. This is supported by a few key informants who felt that prices had not decreased as a result of the program. These key informants further mentioned that people in communities felt that the degree to which overall food prices went down was minimal.

On the issue of how design contributes to the achievement of objectives, about half of the key informant respondents indicated that the program design leads to more affordable and accessible nutritious foods, but that the improved accessibility and affordability are only relative and that food prices remain high. It was discussed by about half of respondents that food prices remain high in the North due largely to capacity and infrastructure issues, and that the NNC subsidy program is not and should not be considered the only solution to reduce food insecurity experienced by low-income families.

5.1.3 Consumption of nutritious food in eligible communities

With respect to the achievement of the intermediate outcome, consumption of nutritious food in eligible communities, while the program data was able to provide information on access in communities based on kilograms shipped, it was not able to directly inform and support findings regarding consumption of food.

However, the indicator, weight/subsidized foodto the communities can serve as a proxy for consumption, the assumption being that the majority of the food being shipped is being consumed, with only minimal amounts ending up as spoilage.

In the media, North West Company claims that the consumption of dairy, meat and produce in Nunavut has increased 14-19 percent since NNC started.^{Footnote 56} They also indicated that consumption of dairy went up 14 percent, meat was up 18 percent and produce went up 19 percent in 67 stores.^{Footnote 57}

Case study analysis suggests that reported overall increases in consumption are more varied. According to those interviewed during case studies, consumption of fruits and vegetables appears to be low, but is starting to grow because of education and practical nutrition and cooking programs. The readily available easy-to-prepare food options, which are less nutritious, seem to be favoured by families used to traditional meat-based meals. Younger children, who were introduced to healthy eating habits in school, were more likely to try new fruits and vegetables, although it is unclear on the extent to which it is part of their regular dietary choices.

Case studies and key informant interviews showed that the consumption of country foods varies widely across communities, with some eating country foods a couple of days a week, and others barely eating it at all. For example, in Iqaluit, country food is difficult to procure and is, thus, eaten less often while in Cape Dorset, country food reportedly comprises at least 50 percent of the local diet. However, in most cases, residents' consumption of country foods is limited to what friends and family bring home and share, or what might be available through various regional food distribution initiatives, rather than through NNC and the local grocery store.

5.2.1 Communication Activities

The document review indicates the development of communication tools, protocols and products designed to raise program awareness, enhance clarity around goals and objectives, and provide the public with the means to interact with program officials. Some of the products include an NNC Facebook moderator guide^{Footnote 58}, social media engagement approach^{Footnote 59}, Food Mail Program-NNC transition communications strategy and work plan^{Footnote 60}, communications strategies^{Footnote 61 Footnote 62}, and an advertising plan^{Footnote 63}.

Many respondents within the key informant interviews identified the existence of various communications products for the program, including: radio ads, radio interviews, posters, letters to the editor, social media pages, the NNC website, and a program Facebook page (which was brought up most frequently and by the majority of the respondents).

Several concerns identified by respondents about program communications were that communications messages were generic and did not address questions and concerns about the program; some confusion exists between NNC materials and the materials of other similar programs and initiatives; and a disconnect exists from the program staff, given that the program Facebook page is being managed by the Communications Branch. Additional concerns were that the NNC website is not easy to navigate and information about NNC was not being communicated in appropriate Aboriginal languages and writing formats.

Retailers, however, have reported in-store signage making a positive difference in consumption habits^{Footnote 64}. As part of the requirements for retailer recipients, retailers must agree to make the program visible through in-store signage and displays, and the subsidy transparent via on-receipt messages. It is noted within the documents, however, that recipients are not forced to install or distribute promotional material that promotes provisions of the program that are not in the recipients' business interests. Evidence from the case studies suggests that retailers are not systematically using available signage and other promotional materials for the program. In other words, some retail stores do have labels and posters promoting the program and/or the subsidy rates or savings while others do not. This is supported by evidence from key informants, case studies, and compliance reviews that indicate inconsistent use of promotional materials across retailers within the program.

5.2.2 Consumer Awareness

Some evidence suggests a change in public discussion around NNC, indicating improved awareness of the program.

With respect to key informants, many respondents indicated that program presence or the awareness of the existence of the program is high and that there has been a lot of publicity, (including adverse publicity mentioned by a couple respondents) on the NNC. Further, a few interview respondents indicated greater awareness of NNC due to communication efforts and expressed a comprehensive knowledge, and ability to identify differences between Food Mail and NNC. Program documents indicate that analysis of the public environment suggests that there has been a change in the public discussion around NNC such that there seems to be a greater understanding of the limited role of the program and how the program itself works^{Footnote 65}.

Additionally, documents state that public education of the facts on NNC has been successful- determined based on more balanced mainstream and social media coverage^{Footnote 66}. Facebook engagement has been strong following the rise of Feeding my Family, and NNC has leveraged this to highlight positive aspects of the program and encourage interactions between people. Evidence suggests that the NNC Facebook page resulted in an increase of 73 percent more time spent by viewers exploring the NNC website, and a 21 percent increase in the number of pages viewed^{Footnote 67}. The use of social media is highlighted in the case studies as well, where outlets such as Facebook were favoured by community members as a way to express their concern about high food costs and a lack of government action.

At the same time, overall awareness of the NNC is inconsistent, with the program more familiar among retailers, while most case study respondents do not understand the program and continue to confuse NNC with the pre-existing Food Mail Program. Case studies showed that readily available information about the NNC is very limited, both around the communities and in-store. It has been indicated to the Advisory Board that communication challenges and inadequacies still exist between the program and consumers.

Both key informants and case studies suggest that the average resident in the communities is unlikely to know about the program. Some interviewees commented on the lack of apparent public knowledge of NNC. Conversations with case study respondents pointed to a limited knowledge of actual government action to address the high cost of food and a lack of awareness of the details of NNC. It was reported that to some extent, suspicion of retailers passing on the subsidy remains, and many Northerners want the subsidy to be higher.

Media analysis corroborates the notion that residents still may not understand the program and don't trust that the businesses are treating people fairly^{Footnote 68}. Based on media review and case studies, the public's awareness of NNC focused primarily on sensitivities to high food costs. They are concerned about high prices and are not convinced that the subsidy is being passed on to them^{Footnote 69}.

Document review also indicates that despite audit/verification in place, perception persists that subsidy is not being passed on due to higher-than-expected prices, and questions remain in terms of how to access subsidy and what to do. It was noted that the subsidy and influence of other cost-drivers need to be explained to consumers^{Footnote 70}. With the information provided, shoppers felt it was difficult to calculate actual individual savings resulting from the NNC subsidies.

Interest from Non NNC Communities

Multiple lines of evidence, including approximately 50 percent of interviewees noted that the increase in public awareness of the NNC Program has resulted in further requests from fly-in communities that are currently ineligible for NNC to join. However, approximately the same amount of key informants said that with a capped budget, NNC does not lend itself well to growth. This has the potential to add pressure on the program's limited resources.^{Footnote 75}

Impact on Retailers

Multiple lines of evidence suggest that some of the smaller retailers have had trouble competing with larger chain stores in northern communities because they have less capacity or power to negotiate with airlines or suppliers compared to larger stores. Some concern has been raised on how this may negatively affect competition in communities with multiple stores.^{Footnote 76} Evidence of smaller retailers regrouping, through the Arctic Co-op for example, has shown to increase the efficiencies for some of these smaller retailers.

A few key informants also indicated the general administrative burden of paperwork and reporting associated with the program. With the change in reporting requirements under NNC, the data available has changed to supplier and retailer-based information. This has particularly impacted smaller retail stores that are independent of large chains, who have noted having more difficulty with the NNC-related reporting requirements due to a lack of technological capacity. The amount of paperwork was seen as especially burdensome in light of the amount of money they receive in subsidy returns, though a few suppliers/retailers also noted that the new system has improved their business processes. Other suppliers, however, are calling for a more efficient reporting system.

Storage and Infrastructure

As mentioned previously, one of the impacts of the transition to NNC is the increased need for storage capacity, such as freezers and warehouses, to store large quantities of food in northern communities. Under Food Mail Program, policies regarding provincial shipping rates made it more advantageous to fly in non-perishable products than to invest in warehouses. With the revised food list, in order to keep costs down, retailers have increased their bulk purchases, particularly via sealift, to bring up items that are no longer eligible to be flown in using the subsidy rate. This in turn requires advanced planning during the months when there is no freeze-up on water passages and a greater need for storage space to stock the full year supply of items that arrive by barge. There is some concern by a few key informants that the state of infrastructure currently in place in many communities is insufficient to meet the increased storage needs, particularly around refrigeration.

Additionally, in some cases, having to order some items so far in advance, as well as lacking proper storage infrastructure, has led to some products passing their expiry dates and spoilage, which add to food costs.^{Footnote 77}

Public Perception

Another unintended impact of the program revolves around the varied and widespread public opinion about the program. A few key informants noted that the program is quite unpopular among the public and has not been good for the Department's reputation due to public criticism and a lack of consumer support. Most of these key informants believe that this is due to the lack of knowledge around the previous Food Mail Program. As a result, NNC has had to address a number of the issues facing the previous program, including program reach and transparency.

Additionally, almost half of key informants raised the point that community members were not aware of the full details of the Food Mail subsidy program and its shift towards NNC. There was the perception that a program was being taken away only to be replaced by one with fewer eligible items. The case studies suggest that many community members are unfamiliar with the specifics of the program and do not know how much money they are saving on their purchases.

A few key informants further noted that they felt the program was oversold on what it would be able to achieve, and this created an unrealistic expectation around the impact on prices that AANDC is still trying to correct. The mission of NNC was not clear to a lot of people for a long time. A few key informants felt that the communications for NNC did not adequately reflect the purpose and objectives of the program to community members.

Perceptions on Prices

The evaluation found significant evidence of a perception by many northern consumers that the subsidy is not being passed on to them. Despite recipient attestation and compliance reviews by third party auditors to ensure accountability and passing on of the subsidy, perception persists that subsidy is not being passed on fully. This perception is exacerbated by reports that North West Company's stocks and profit margins continue to rise. NNC transparency is weak because consumers do not know the cost of transportation and of operating stores in isolated communities, before or after the subsidy.^{Footnote 78} Decreased transparency leads to decreased trust in retailers, some feel retailers are taking advantage of customers. It is reported that many want a regulatory process put in place to regulate food prices consistently in stores.^{Footnote 79}

6.2.1 Alternatives

The communities visited for the case study portion of the evaluation (Cape Dorset, Aklavik, Iqaluit and Poplar River) offered nutrition or health education to their community members. Residents mentioned that more education could be beneficial in increasing the consumption of nutritious foods, which could subsequently increase retailer demand. Community members also noted that it is difficult for lower-income families to plan ahead when they do not own credit cards that are required for personal or direct orders. Because of infrastructural and capacity issues prevalent in northern communities, lower income families may not be fully benefiting from the program if more education on shopping and food planning is not offered.

Key informant interviews corroborate the case studies, noting that increasing the nutrition education component of NNC would lead to a better understanding of healthy eating within communities. Two key informants found the dedicated funding for Health Canada's nutrition education initiatives to be a very positive part of NNC.

When raising the question of food security in northern communities, many sources have pointed to the importance of active community participation to overcome scarcity of nutritious foods. Community-led initiatives have been proposed to supplement NNC. A few key informants mentioned the possibility of increased greenhouse use in northern communities to grow nutritious fruits and vegetables in the communities. The high cost of energy sources has deterred communities from relying on this alternative further. Alternatives such as greenhouses have the potential to alleviate food needs, possibly without spending limited subsidy funding.

The media scan has highlighted the importance of country foods to developing community involvement and engagement. Country foods can be seen as a community initiative. Some key informants interviewed have found the country foods subsidy difficult to access, explaining that the food has to come from a processing plant.

Documents reviewed and some key informant interviews noted the significance of long-term programming, concerned that a lack of long-term food development policy might create further problems. Community-led alternatives such as the greenhouses to grow fresh local produce were identified as a possible alternative. Although benefits from such initiatives will not be evident in the coming few years, they have the potential to supplement existing programs, such as NNC.

According to key informant interviews, most respondents stated that the NNC Program was addressing one or more of the food security issues. Some specifically mentioned that food security is a broader issue that NNC cannot address independently as other factors contribute to food insecurity in the North.

6.2.2 Capacity

During the transition period, between April 1, 2010, and March 31, 2011, AANDC had three main objectives: 1) to begin the transition towards a new northern healthy food subsidy program; 2) to operate the last year of the Food Mail Program; and 3) to terminate the Agreement between the AANDC and the Canada Post Corporation.

Although NNC replaced the former Food Mail Program, NNC was launched on April 1, 2011, as an entirely new program. During the introductory phase of NNC, program management noted that significant time and attention was required by NNC Program management and staff to develop new practices and processes while also managing and responding to increased public and media inquiries on the new program.

Given the NNC is a market-driven program, predicting consumer demand was challenging and there was limited data or similar programs from which to draw experiences or lessons learned.

Despite structural support, community members during the case studies explained that local infrastructural capacity made it difficult to transport fresh produce and to guarantee quality. As part of the funding for the transition from Food Mail to NNC, $1.15 million was allotted to CanNor to support infrastructural upgrade projects in the territories.^{Footnote 83} Half of the key informants interviewed about capacity believe that the program could use additional resources to undertake all the necessary activities. One informant explained that NNC's administrative costs are now higher, since the partnership with Canada Post no longer exists. Some key informants have commented on the technological barriers to receiving certain claims documents.

Adjust subsidy rates

The rates are established at levels that take into account recipients' shipment forecasts and the program's subsidy budget of $53.9 million. Recipients update their forecasts periodically because Northerners' demand for eligible products changes over time. The program expects to analyze and adjust if necessary the subsidy rates twice each year – on April 1 and on October 1. Rates were adjusted in October 2011 and have since remained unchanged.

Streamline eligibility lists

The program is also able to change the list of eligible communities and items in order to contain over or under spending by increasing or decreasing eligibility accordingly.

According to documentation from the Oversight Committee, the body involved in monitoring the NNC budget, funding shortfalls were expected to occur as of February 2013. Documents reviewed indicated that the cost-containment strategy led to a plan to decrease level-one subsidy rates by $0.45/kg by July 1^st, 2012 to reach a $0.2 million surplus or a $0.65/kg by October 1^st, 2012, to break even. However, there is limited evidence that shows the cost-containment strategy is being fully implemented.

7.1.1 Community Freezers

Community freezers were widely noted in case studies, key informant interviews and the literature review as important to supporting community food harvesting and the integral cultural practice of sharing for communities.^{Footnote 84} Some communities have programs with local hunter-trapper organizations that donate food or pay for hunters to provide food to freezers that can be accessed by community members in need. Challenges noted by case studies to keep community freezers running include funding, leadership and administration. Community freezer programs are supported by Nunavut Tunngavik Inc, Nunavik Kativik Government, the Province of Manitoba, and individual community governments.

7.1.2 Community Gardens and Greenhouses

According to case studies, literature review, and advisory committee meetings, community and household gardens have been promoted as a sustainable source of fruits and vegetables. They help food security needs by putting food in people's backyards and helping reconnect community members with traditional practices.^{Footnote 85} They also contribute to social interacting and community sharing.^{Footnote 86}

A variety of communities in Nunatsiavut, Northern Ontario, Northern Manitoba, and New Brunswick, have undertaken initiatives to support the production of local food. Initiatives included culturally appropriate learning guides, providing gardening tools and gardening workshops, woodland garden harvesting and a salmon restoration project.

Inuvik, Northwest Territories has successfully established a community greenhouse in operation since 1998-1999. According to case studies, challenges in creating gardens in northern regions include poor soil quality, a short growing season, and limited knowledge of gardening. According to case studies and key informant interviews, community engagement and input were integral to the success of both freezer and garden programs.

The Province of Manitoba has partnered with First Nation and Inuit Health Branch, tribal councils, communities, private businesses and non-government organizations to support the Northern Healthy Foods Initiative. The Northern Healthy Foods Initiative supports local food self-sufficiency activities including gardening and greenhouse initiatives, community food programs, and food business developing. Successful projects include the Cross Lake Chicken Club, Gods Lake Narrows Gardens, and the Revolving Loan Freezer Purchase Program.

7.1.3. Store Management Leadership

Literature review sources and case studies found that store management can influence food choices available in the community and healthy eating.

The capacity, practices, and beliefs of store managers with regards to stocking healthy foods in isolated communities contributes to healthy shopping and eating habits.^{Footnote 87} One particular store manager in a case study was noted by many respondents as being responsive to community requests and promoting healthy options. The manager was active in promoting food label reading, inviting cooking classes, healthy food sampling, and donating healthy food to community events.

Community members in case studies believed that more could be done by community leaders to improve the price and choices for healthy foods.

7.1.4 Other Best Practices Related to Food and Nutrition

Case studies and the literature review found several other programs that were effective in promoting nutrition and food choices in isolated northern communities in Canada:

• School breakfast and lunch programs were found to be effective in addressing food security for youth and promoting healthy food choices;
• Cooking classes, nutrition workshops, and taste tests offered through Health Canada or community programming helped develop cooking skills and promote the consumption of healthy food; and
• Good Food Box or Buy Direct programs support the procurement of fruits and vegetables which has increased healthy eating; and

Harvester Support Programs that assist with the hunting, gathering, and fishing of local country food increase the consumption of nutritious foods, support traditional harvesting practices, and promote a culture of sharing.^{Footnote 88}

Iqaluit, Nunavut

Main Website: City of Iqaluit

Text alternative for Iqaluit Map

This political map shows a close up view of Iqaluit, Nunavut. Iqaluit is located northwest of the Koojesse Inlet which is on the eastern coast of Baffin Island. Baffin Island itself is located in the northeast of Canada.

Mayor: John Graham

MLA: Hunter Tootoo

Aklavik, Inuvik Region, Northwest Territories

Main Website: Aklavik Northwest Territories

Text alternative for Aklavik Map

This political map depicts the location of Aklavik in the Inuvik region of the Northwest Territories. It is located on the Peel Channel of the Mackenzie River Delta, about 113km south of the Arctic coastline.

Mayor: Arnie Steinberg

MLA: David Krutko

Cape Dorset, Nunavut

Text alternative for Cape Dorset Map

This political map depicts the location of Cape Dorset, Nunavut. Cape Dorset is located in the north of Dorset Island, which is located within the Foxe Channel, and west of the Hudson Strait. Dorset Island is located south of Baffin Island and north of Salluit, Quebec.

Mayor: Cary Merritt

MLA: Hunter Tootoo

Poplar River, Manitoba

Text alternative for Poplar River Map

This political map depicts the location of Poplar River First Nation Reserve, Manitoba Canada. Poplar River First Nation is located on the Popular River, east of Lake Winnipeg in Manitoba. The Nation is located approximately 400km north of Winnipeg, Manitoba.

Chief: Guy Douglas

MPP:

Statistical Overview:

Overview

Population 2011	848
Population 2006	643
Population Density	51.1 people/km2
Land Area	16.59 km2
Median Age	22.1

Demographics

% of Population over 15 years	63.3%
Total Aboriginal over 15 years	385
Average # of Children per family	2.0
Aboriginal	630
Non-Aboriginal	10

Education

No Diploma	325
High School or Equivalent	30
College, CEGEP or Non-University Diploma	20
University Diploma or Certificate	10

Labour Force

Employment Rate	40.3%
Unemployment Rate	18.4%
Median Annual Income	$11,477
Earnings as % of Income	62.6%
Government Transfers as % of Income	23.2%

Overview statistics from the 2011 Census; Demographics, Education and Labour Force from 2006 census

 

Revised Northern Food Basket - Case Studies

Data based on the Revised Northern Food Basket^{Footnote 93}, Case Study Communities shown.

Text alternative for the Data based on the Revised Northern Food Basket

The above graph depicts the Revised Northern Food Basket (RNFB). This tool is utilized by Aboriginal Affairs and Northern Development Canada to monitor trends in healthy eating in remote, northern communities who are eligible for the Nutrition North Canada (NNC) program. This particular graph highlights the cost of food over time in the four case study communities.

On the y axis of the graph is the price of food in Canadian dollars. Beginning at zero, this graph increases by increments of one hundred until it reaches six hundred dollars. On the x axis is time, beginning in March 2011 and increasing at monthly intervals until September 2012 on the far right of the graph. This graph contains four colour coded lines, each coloured line representing a different community. The legend, showing which coloured line represents each community, is depicted on the right side of the graph. In general, the four lines run parallel to each other with a downward slope beginning in March 2011 to about March 2012 and then there are some slight divergences in trends. Notably, the four lines never intersect. Cape Dorset, the purple line, has the most expensive food prices of the four communities and as such it is the line closest to the top of the graph. In March 2011, food prices were approximately $490 and progressively moved downwards to $445 in March 2012. From there, food prices gradually increased to approximately $460 in June 2012 and then drop back down to $445 in September 2012. Aklavik, the red line, is the second line from the top. It has a very mild downward slope, beginning at $460 in March 2011, then continuing downwards to $430 in June 2012. This line ends by increasing slightly to approximately $435 in September 2012.

Iqaluit, the green line, is the third line from the top and it starts at approximately $440 in March 2011 and gradually declines to just below $400 in March 2012. From March to June 2012, food prices remain around $400 and come to under the $400 mark by September 2012.

The last line, Poplar River, is the blue line and it is the community with the least expensive food basket. It begins with food basket prices at $430 in March 2011. This food price index decreases gradually to approximately $395 in March 2012. There is a slight increase in food prices to just under $400 in June 2012 but the prices return to about $395 in September 2012.