Focus and Scope

Health Reform Observer – Observatoire des Réformes de Santé is an open access, peer-reviewed, online journal presenting descriptive and comparative analyses of important reforms related to the governance, financing and delivery of health care (including public health care) in the Canadian provinces and territories. The journal aims to be a bridge between scholars and decision-makers and facilitate the flow of rigorous, evidence-based information and is successful in reaching top-level health system policymakers and stakeholders across Canada.

 This initiative was born out of a recognition of the decentralized nature of the Canadian health systems and the need to support inter-jurisdictional learning. The journal publishes four types of content:

  • Provincial/territorial Health Reform Analyses (HRAs): These are short (max. 2,000 words), primarily descriptive articles pertaining to one salient health reform in a specific jurisdiction. Candidate reforms for HRAs may include: (i) proposed reforms that resulted in a “no-go” decision; (ii) reforms originating at the federal level such as those pertaining to First Nations and Inuit health care; and (iii) reforms originating at the regional level, if particularly far-reaching and significant in scale and/or emerge from a unitary health authority. HRAs will follow a standardized format to facilitate cross-issue and cross-jurisdiction analyses of Canadian health reforms and are peer-reviewed. See HRA GUIDELINES.
  • Comparative Health Reform Analyses (CHRAs): These longer (max. 4,000 words) analytic articles may include cross-issue and cross-jurisdiction comparisons of Canadian health reforms. The latter may include comparisons across provinces and territories or comparisons with reforms in other countries. CHRAs will follow a standardized format and are peer-reviewed. See CHRA GUIDELINES.
  • Letters to the Editor / Commentaries: In this category, HRO-ORS invites two types of contributions: Letters to the Editor are short, specific comments aimed at disputing, nuancing, or supporting and illustrating a statement made in an HRA, CHRA or a Network Editorial published by the journal. Commentaries are longer pieces prompted by a HRA or CHRA, and either provide background information or respond in some way to conclusions reached in a HRA or CHRA. Both letters and commentaries are peer reviewed and can be rejected or revised for resubmission, but are not subject to the guidelines for HRAs or CHRAs. 
  • Network Editorials are invited. They are reviewed by the Editorial Team and, in some instances, by the Editorial Board.

Should you have any questions about the suitability of your manuscript for submission to Health Reform Observer – Observatoire des Réformes de Santé, please feel free to email us at this address:

Peer Review Process

Health Reform Observer – Observatoire des Réformes de Santé operates a rigorous and open review process, meaning that the identities of both the author(s) and reviewers are disclosed to one another.  Our reviewers are encouraged to provide all prospective authors with constructive and timely advice regarding how to improve their manuscript regardless of their recommendation to accept or decline the manuscript for publication.

All submissions are screened by the editors to determine whether or not they should be sent for external review. If your paper is deemed unsuitable for the journal, it will be returned to you without being sent to review. A paper may be found unsuitable if it does not fit within the journal's focus and scope or it does not sufficiently follow the appropriate article format. (Please refer to "Section Policies" as well as HRA GUIDELINES and CHRA GUIDELINES.)

Once it has been determined that a submission is to be sent to review it will be assigned to two independent reviewers. Reviewers are chosen on the basis of their familiarity with the subject health care reform(s) as well as their availability for completing the review within the allotted time. The journal endeavours to complete the review process for Health Reform Analyses (HRAs) within 6-8 weeks and that for Comparative Health Reform Analyses within 10-12 weeks. Occasionally, either review process can take longer. We regret any delays that authors may experience during the course of the review process, as these are often out of our control.

Health Reform Observer – Observatoire des Réformes de Santé asks its referees to evaluate all manuscripts based on the following general criteria:

  1. Whether it represents a valuable new contribution to: the available evidence on a particular health care reform in a Canadian province or territory (HRAs), or the scholarly literature on comparative health care reform analysis (CHRAs).
  2. Whether it is accessible to both a scholarly and decision-maker audience.

Reviewers are asked to consider the usual questions of peer review, with an idea to improving the article through concrete suggestions for revision. These questions include:

  1. Does the article describe (and in the case of CHRAs, compare) in an accurate and fair way the following: history and context of the reform(s), goals of the reform(s), factors that brought the issue(s) to the agenda and influenced the policy choice(s), how the reform(s) was/were achieved, and evaluation plans/efforts?
  2. Does the article provide a concise and balanced analysis of the strengths, weaknesses, opportunities and threats of/to the health care reform (HRAs) or what can be learned about the linkage between processes, contexts, and outcomes (expected or demonstrated) from the compared reforms (CHRAs)?
  3. Does the article touch on the most important or salient points to be made about the health care reform (HRAs) or about the comparison of reforms (CHRAs)?
  4. Is the writing style clear and effective? Is information presented in a way that helps to clearly communicate the key points to the intended audience (i.e., scholars and decision-makers)?

Publication Frequency

Journal items are published as soon as they are ready by adding them to the current issue. An issue is "closed" at the Editors' discretion. Health Reform Observer – Observatoire des Réformes de Santé aims to publish 2-4 issues per year.

Open Access Policy

This journal provides immediate open access to its content on the principle that making research freely available to the public supports a greater global exchange of knowledge.

About the Journal

Health Reform Observer – Observatoire des Réformes de Santé does not charge any fees to readers or contributors, nor does it compensate its reviewers. Its goal is to provide free and immediate access to concise, standardized, plain-language analyses of reforms/initiatives related to the governance, financing and delivery of health care in the Canadian provinces and territories, as well as to in-depth, cross-issue and cross-jurisdictional “roll-ups” of these reforms. Together these Health Reform Analyses (HRAs) and Comparative Health Reform Analyses (CHRAs) form an ever-growing compendium of knowledge and experience about health reform attempts – successful and unsuccessful, fully implemented or in their nascent stage – across Canada.

 Health Reform Observer – Observatoire des Réformes de Santé is an invaluable resource to local, provincial, national, and international decision-makers who undertake the time-consuming and challenging task of identifying and learning from restructuring efforts initiated within Canada’s vast and decentralized health care “system”. For researchers and academics, the journal provides a unique on-line, peer-reviewed platform to document, analyze, and evaluate health reforms as well as to make this information easily and quickly available to other researchers and scholars, decision-makers and members of the interested public including health system stakeholders and the media.

 Health Reform Observer – Observatoire des Réformes de Santé is edited by leading health system researchers from across Canada. The Journal’s editorial board currently includes representatives from eight provinces – British Columbia, Alberta, Saskatchewan, Manitoba, Ontario, Quebec, Nova Scotia, and Newfoundland -- and a representative from the three territories.

Sources of Support

Health Reform Observer – Observatoire des Réformes de Santé gratefully acknowledges the financial assistance provided by the Canadian Institutes of Health Research (CIHR) Institute of Health Services and Policy Research (IHSPR) in the form of the Spring 2012 Planning Grant Priority Announcement (Health Services and Policy Research) (Principal Applicant: Michel Grignon) as well as sponsorship of the keynote plenary panel "The Pan-Canadian Health Reform Analysis Network (PHRAN)" at the 2013 Conference of the Canadian Association for Health Services and Policy Research (CAHSPR). The journal was also supported by a grant from Health Canada / Santé Canada (October 2013 to March 2014).

It presently receives support from McMaster University Library Press, the North American Observatory on Health Systems and Policies, the Centre for Health Economics and Policy Analysis (CHEPA) at McMaster University, and the Institute of Health Policy, Management and Evaluation (IHPME) at the University of Toronto..

Journal History

Health Reform Observer - Observatoire des Réformes de Santé published its first article in July 2013. For the initial 15 months of its publishing history, the journal was available to readers via DigitalCommons at McMaster University Library. On 1 October 2014, the journal became part of Public Knowledge Project's Open Journal Systems and Escarpment Press (a new imprint supported and published by McMaster University Library). All issues previously available at DigitalCommons at McMaster University are available under the new imprint.