Class 7 - advocacy, policy, & collab Flashcards
Why is advocacy a critical strategy for population health
- emphasizes collective actions to effect systemic change
- focuses on changing upstream factors related to the SDOH
- explicitly recognizes the importance of engaging in political processes to effect desired policy changes at organizational and system levels
What are 3 strategic areas of work to strengthen PHC worldwide, according to WHO
- providing a ‘one-stop’ mechanism for PHC implementation support
- producing PHC-oriented evidence and innovation (focus on ppl eft behind)
- promoting PHC renewal (through policy leadership, advocacy and strategic partnerships
Which principles of primary health care help strengthen PHC
- public participation
- intersectoral collaboration
What are the different levels of public involvement (least to most)
- inform
- input
- engage
- collaborative
- empower
Public involvement, inform:
- info out
- info goes from a health organization to the public
- purpose: creating awareness and public education
public involvement, example of inform
social marketing campaign is used to increase public awareness about active living strategies
public involvement, input:
- info in
- input comes from the public to a health organization
- purpose: getting citizen and/or stakeholder input, advice, and feedback
public involvement, example of input:
a broad community survey is used to obtain public input on play-ground safety
public involvement, engage:
- health organization and the public talk and understand each other
- purpose: in-depth exploration of views, perspectives, and interests, with emphasis on listening and achieving mutual understanding
public involvement, example of engage:
a structured public consultation day is held to explore a geographic community’s perspectives on the determinants of health
public involvement, collaborate:
- a health organization and the public work together over a period of time
- purpose: to make decisions and/or develop policy on an issue
public involvement, example of collaborative:
a health organization works collaboratively with community partners on issues
public involvement, empower:
- a health organization works with the public to build capacity
- purpose: to enable the public to make decisions and take action in areas that affect health
public involvement, example of empower:
communities make decisions in areas that impact health through community development and social action
define collaboration
- process in which parties with a stake in the issue actively seek a mutually determined solution or plan
- often short term, less formal
define partnership
- a type of collaboration
- occurs when purpose of collab is to advance a shared vision of a need, and the expected outcome is to develop and implement a joint agreement to address the problem and bring the vision reality
- usually longer term, more formal
What is the advantage of collaboration and partnership
collectively, we can achieve something that could not have been achieved by any one individual, group, organization working alone
Partnership is characterized by…
- shared authority, responsibility, management
- shared liability, risk-taking, accountability, rewards
- detailed communication strategies
- joint investment of resources (time, work, funding, material, expertise, info)
What actions are required for partnerships?
require…
- building trusting relationship
- constant evaluation
- ability to respond/adapt to change
- re-negotiate purpose and revise action plan, if necessary
What are the guiding principles of partnerships (shorten)
- same mission, goals, objectives, and guiding principles
- partners are recognized for unique, essential contributions
- all partners agree to share everything
- should enhance capacity while achieving common purpose
- accommodate changing needs
- all communication and activities embody principles of social justice and equity
Himmelman’s Collaborative Continuum
- Networking (info exchange)
- Coordination (altering activities)
- cooperation (sharing resources)
- collaboration (mutual benefit)
Collaboration and partnership, mutual concepts
- connect
- foster shared understanding
- create a shared vision
- plan collaboratively
- work together for change
- celebrate, evaluate and renew
Collaboration and partnership, connect
reaching out to new partners
Collaboration and partnership, foster shared understanding
getting to know one another and building a deeper understanding
Collaboration and partnership, create a shared vision
common ground between all
Collaboration and partnership, plan collaboratively
appreciating diversity
Collaboration and partnership, work together for change
documentation of your work plan
Collaboration and partnership, celebrate, evaluate and renew
- partnerships must be nurtured
- identify and celebrate the impacts you might never have achieved alone
Collaboration and partnership; what is a participatory approach
- community is involved in planning, problem solving
- members have ownership of initiative
- commitment is to long-term change
Collaboration and partnership; advantages of participatory approach
- sustainable; it’s more long-term
- voices are heard
- better ‘big picture’
- decrease resistance
Collaboration and partnership; disadvantage of participatory approach
may take longer; takes time
Collaboration and partnership; what is a directive/prescriptive approach
change process imposed by outside force (ex health professional)
Collaboration and partnership; advantage of directive/prescriptive approach
takes less time; dont need to involve everyone
Collaboration and partnership; disadvantage of directive/prescriptive approach
- increase resistance; community doesnt buy-in
Where is advocacy seen for policy change?
- Ottawa charter strategy
- empowerment strategy
- capacity building
- health equity
What are the 4 actions of advocacy and health equity
- action 1: strengthening individuals = representational or client advocacy
- action 2: strengthening communities = community development advocacy
- action 3: improving living and working conditions = social policy reform advocacy
- action 4: promoting healthy macro-policies = community activism advocacy
Advocacy for policy change; non-linear approach description
- Political stream
- Problem stream (agenda setting): need to be addressed; influences policy option
- policy stream (policy formulation): solutions identified
- decision making: select policy option(s) considering the direct and indirect costs and benefits, and moral and ethical arguments
- policy window: opens if the work of the problem and policy streams align
- implementation eval
What are the 3 phases for developing a healthy public policy
- planning
- implementation
- evaluation
Eight step break down for developing healthy public policy; planning phase
- step 1: identify, describe and analyze the problem
- step 2: identify and analyze policy options
- step 3: determine and understand decision makers and influencers
- step 4: assess readiness for policy development
- step 5: develop an action plan
Eight step break down for developing healthy public policy; implementation phase
- step 6: implement the action plan
- step 7: facilitate the adoption and implementation of the policy
Eight step break down for developing healthy public policy; evaluation phase
step 8: evaluate the policy
How do CHNs directly influence the policy process
developing, implementing, and/or evaluating policy
How do CHNs indirectly influence the policy process
- conducting policy-relevant research
- advocating for policy change
- facilitating/enabling a community to identify its health or social needs and health or public policies to fulfill these needs
Advocacy for policy change; examples of low profile
- meeting/speaking to/writing to decision-makers on behalf of a client
- sharing info (eg. research findings)
- preparing non-public briefing note
- publishing policy recommendations from research findings
Advocacy for policy change; example of medium profile
- ‘feed’ the opposition
- deputations at committee meetings w/ elected officials/decision-makers
- alliances/partnerships with other groups
- letters to elected officials/newspapers
- use of social media/blogs
Advocacy for policy change; example of high profile
- ad campaigns
- media interviews (especially radio/TV)
- demonstrations and rallies
For successful advocacy, you need to be prepared to respond to/deal with what?
counter-arguments
- ‘proposed change is too costly’
- increase restrict individual freedom to an inordinate degree’
- ‘there is an alternative way to address’ (non-policy)
For successful advocacy, who do you need to convince?
decision makers
How is health inequities described?
- predictable
- systemic
- modifiable & avoidable
- unfair
What are the global call to action
social injustice is killing people on a grand scale
- improve daily living conditions
- tackle inequitable distribution of power, money, and resources
- measure and understand the problem and assess the impact of action
What is intersectionality
the interconnected nature of social categorizations such as race, class, and gender as they apply to a given individual or group, regarded as creating overlapping and interdependent systems of discrimination or disadvantage
Using a intersectionality approach includes:
- prioritize social justice
- disrupt systems of oppression that create inequities
- centre and engage people from historically oppressed groups
- recognize communities are heterogenous with diverse needs and experiences
CHN 21st century
- roots in caring
- focus and act ‘upstream’
- evidence informed, access to an use of local data to informed decisions
- community engagement
- relationships key
- leadership and organizational commitment (recognition that health equity is everyone’s job)
