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Provision of primary care to the community and ensuring that people are empowered to take care of themselves are important aspects of the intervention outlined in the video. Therefore, it would fall under the Community Themes and Strengths Material.
The occurrence of natural disasters that prevent the delivery of health care to the community, such as Hurricane Katrina, ends up affecting the delivery of health care negatively. A hurricane disaster is a force of change. A particular opportunity created by such a disaster is the option to access the strengths of the existing health care delivery system and then work on strategies for improvement. This should eventually make the current system better in the provision of services and the ability to withstand future shocks from the same kind of disturbance.
There was a growing trend of the increased burden on the health system of New Orleans, which was not addressed adequately. This trend was a force of change, which would eventually manifest itself with a catastrophe such as a hurricane. Even if the disaster did not happen, there was going to be another incident that would expose the inefficiencies in the health system. The system was facing an increase in demand, yet there was no sufficient investment to make sure that it catered to the growing needs of patients.
The demographics were also changing. There was no access to primary health care, yet the population had a high poverty prevalence compared to the rest of the country. The population was already uninsured, and it would not access hospital services until it was an emergency. The population mainly accessed health care facilities at the charity facility. Shutting down of the charity as a hospital was another force of change.
One threat to change is rebuilding the facilities to their former state, which would present the problem once more. Recovering what was lost would lead to a repeat of a terrible health situation. Other trends were high rates of alcohol abuse and premature deaths.
Bill Rouselle mentions that leaders should be focused on. He also understands that getting the necessary talent will not be easy. Therefore, the support of the community is essential, which requires the recruitment of parents, community leaders, and other community members to sit on boards and committees. Lastly, leadership must consider the unknown factors, such as community retaliation, and, therefore, have a long-term picture of things (Bolman & Deal, 2013).
Stephanie Baile compares well with Bill Rouselle in the video. She understands that public health happens locally. She also understands that it is crucial to tell the health story through what the health service is doing. Having elected officials on board as part of the strategic planning ensured that the health plan was adopted and supported.
Other than considering the challenge as the recovery of the health facilities, the challenge was to use the opportunity to increase the public’s perception of health care so that public health provision of health care only became the last option for people. Providing preventive health care was the intention of rebuilding. Defining public health was an important step in reframing, with the prevention, primary care, and patients as the new focus of health care to move away from hospital care. Indicators of the process would be on the level and number of programs used to ensure that communities are no longer promoting health deterioration; instead, they support primary care.
The MAPP Community Themes and Strengths Assessment materials require the preparation of the local public health system assessment, discussion of essential services, and identification of areas of activity for an organization (MAPP, n.d.). There are discussions and the completion of the performance measurement instrument. Finally, a review of the results and determination of challenges and opportunities ensue. In the Katrina case, there was the use of the definition of public health services as indicators to use in addressing gaps before and after the disaster. The national, public health standard would then be used as a performance measurement instrument.
Reframing change under the political frame in the Katrina case required assessment, policy development, and assurance. The challenge of implanting the plan was that many people involved with the change were affected personally by the hurricane strategy, losing homes, jobs, and being relocated. The population was also scattered after the storm, which made it difficult to sustain community engagement as required in the forces of change assessment, where community members need to share ideas and identify new forces.
The state is expected to provide financing and infrastructure to enable an affected community to use the available opportunities to rebuild and strengthen its health services. Reframing change requires asking about future challenges and what is needed currently to mitigate those forces (MAPP, n.d.). This is part of identifying new forces. The relocation of victims of the storm presented an opportunity to use a multi-pronged strategy. It included the use of a PR firm to reach out to people and urge them to attend meetings. There was also the use of the web so that people located remotely would access information. Impromptu caucuses were also other instruments used for gathering concerns and solutions for a better health care system.
People used the storm and relocation effects to understand the need for self-sustenance. Therefore, they gave informed suggestions, often being creative in solutions for engagement and improvement of health care. The use of individuals with established networks, such as community leaders was an important strategy for beating the existing challenges (Roper, 2006).
References
Bolman, L., & Deal, T. (2013). Reframing organizations: Artistry, choice, and leadership (5th ed.). San Francisco, CA: Jossey-Bass.
MAPP. (n.d.). A strategic approach to community health improvement. Web.
Roper, W. L. (Director). (2006). After Katrina: Building a better public health system for the future [Motion Picture]. Chapel Hill, NC: Public Health Grand Rounds. Web.
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