This of healthcare and its provision was

This week’s readings focus on the essential components of a well-functioning health care system. As I read the assigned chapters, I noticed the interconnectedness between the previous readings on Social Determinants of Health and how they all tie in with the Social Ecological Framework in Public health.
In previous decades, the subject of healthcare and its provision was largely left to healthcare providers and government officials. This, however, proved to be somewhat unsuccessful as outcomes of healthcare programs and initiatives did not translate into desired results. For this reason, in recent years, there has been a shift in addressing healthcare and what constitutes an effective health care system. According to the IOM Report (2003), the arms of a well-functioning health care system are multifaceted. It places a focal view on the community as a point of departure to addressing the issue of optimum health; Community engagement and collaboration is thus seen as a critical component of an effective healthcare system (IOM Report, 2003). This means that approaches to addressing health issues in any community should be a bottom-up method where community members contribute and brainstorm solutions to problems that affect them directly. Health programs that employ “the active participation of community leaders, members, and organizations in the earliest stages of community-based public health action” tend to be successful and are highly recommended (IOM Report 2003, pp. 183). Inclusion of community members at the early stages includes community assessment of existing health issues and involves incorporating the assets available in the society such as its members (e.g. community health workers), infrastructure (e.g. schools, hospitals) and institutions that have the potential to influence behavior change (IOM Report, 2003).
Secondly, the incorporation and involvement of local institutions and organizations such as religious bodies, local clubs and “groups that represent the interests of ethnic communities” (pp. 190) is key in the facilitation and implementation of health action. Several success stories provide evidence to support this, including ‘Project Joy’ which was implemented in Baltimore and sought to promote cardiovascular health among church-going African-American women. The results of the program showed significant improvement in blood pressure and considerable weightloss of participants who had a spiritual component added to their aerobics routine. (IOM Report, 2003).
Again, policy change at national, state and local levels are crucial in ensuring that the healthcare system runs smoothly. This should, however, not only be carried out by government officials and people of power but must equally include community representatives (people chosen by the community who represent their interests) who will shed light on the priority concerns of inhabitants health-wise. Andresen ; Bouldin (2010) provide an example of a successful state reform initiative in Massachusetts (USA) which serves as an example of how states or local governments can ensure that health systems run effectively through a change or modification in existing policies that are disadvantageous to an increasing vulnerable population.
The IOM Report (2003) suggests that once these collaborations are set in place a framework for collaborative community action is necessary to ensure the step by step efficient and smooth running of healthcare systems (pp. 186).
In summary, the readings of the week highlight the importance of community collaboration in all aspects of healthcare implementation to ensure effectiveness of healthcare systems. I have learned that shared governance which is representative of the population, collaborative with the community and institutions of trust such as churches and unions go a long way to ensuring the smooth running of healthcare system. Health Programs and policies that exclude and ignore vulnerable populations and stakeholders (community members) many times are unsuccessful and hinders population health.

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