MacrosystemsThe Dinh ThiJasmine PaulEva van Swaaij
What is a macrosystem?• “Macrosystems are the cultural contexts, not solely geographically or physically, but emotionally and ideologically” (Bronfenbrenner, 1979)• Outside in
The Macrosystem• Macrosystems are the outer layer of a persons environment. They form the “blueprints” for interlocking social forces on a large scale and therefore have an impact on shaping human development – e.g. Western culture, healthcare systems• They provide broad ideological and organizational values that shape the environment• Macro-systems are not static, but might change through evolution and revolution. For example, economic recession, war, and technological changes may affect the development of a macrosystem
Different types of macrosystems • Non-governmental organizations (NGO’s) • Governmental organizations (Go’s) World Jönköping World Continent National RegionalNGO’s Red cross, Stepchildren of MSF SocietyGO’s WHO, EU – DG Statens Länssjukhuset UNICEF SANCO Folkhälsoinstitut Ryhov
Non-governmental organizationsMedecins Sans Frontieres Stepchildren of Society(MSF)• “International, independent, • The National Association for medical humanitarian the Society’s Stepchildren is an organisation that delivers interest organisation for adults emergency aid to people and young people who have affected by armed conflict, epidemics, natural disasters been cared for by the and exclusion from healthcare. community childcare MSF offers assistance to - Offering of services to people based on need, children and adults irrespective of race, religion, gender or political affiliation” (Medecins Sans Frontieres, 2011)
Governmental organizationsWorld Health Organization Statens Folkhälsoinstitut(WHO)• Supra-national • Swedish National Institute for• Responsible for public health Public Health within the United Nations system • State agency under the• “WHO provides technical Ministry of Health and Social support to Member States, Affairs monitors and assesses health • “The Institute works to trends, generates and shares promote health and prevent ill health information, and health and injury, especially provides emergency aid during disasters, acting as a bridge for population groups most between sub-regions” (WHO, vulnerable to health 2012). risks...through conveying• World Health Assembly once a knowledge for better health” year (Cedervärn, 2010).
How does a macrosystem work? Macrosystem Policy change Microsystem Microsystem Strategic Plan (PDSA) Microsystem MacrosystemChange within Change withinmultiple units Implementation a unit
How can this be applied to a locallevel?• 1. Collaboration of macrosystems and microsystems –Policy guidelines, Emergency Department and Radiology Department• 2. Common goal for change: Decrease x-ray turnaround times, decrease mortality, and increase patient satisfaction• 3. Plan-do-study-act model is implemented
How can this be applied to a locallevel continued• 4. Monitor change through collection of data – e.g. number of deaths since implementation, surveys on patient satisfaction• 5. If positive change occurs, macrosystems will see this as a benefit and may be inclined to change policies
Search Process• Started with the topic “macrosystems” as a general search term and read abstracts of scholarly articles• Went back and researched how microsystems make change to understand the importance of macrosystems• Refined search to, “application of macrosystems as impacting the local level”
Search Process continued• Looked for different types of organisations• Looked on the website of the organisations to find information on their structure and goals• Used Google translate for websites unavailable in English.
Collaboration Process• We successfully collaborated by sharing ideas on the topics we wanted to cover within the discussion of macrosystems, and based on our personal interest chose the topics• Democratically chose the presenter by creating a game that would ensure a fair and equal chance for all group members who wanted to present
References• Bronfenbrenner, U. (1979). The ecology of human development: Experiments by nature and design. Oxford: Elsevier.• Cedervärn, J. (2010). Statens Folkhälsoinstitut: About the national institute. Retrieved April 7, 2012, from http://www.fhi.se/• Davies, T.R. (2010). Project on the evolution of international non- governmental organizations: Organizations. Retrieved April 7, 2012, from http://www.staff.city.ac.uk/tom.davies/Organizations.html• Kail, R.V., & Cavanaugh, J.C. (2010). Human development: A life- span view (5th ed.). Cengage: Belmont, CA: Wadsworth/Cengage Learning.• Kosnik, L.K., & Espinosa, J.A. (2003). Microsystems in healthcare: Part 7. The microsystem as a platform for merging strategic planning and operations. Joint Commission Journal on Quality and Safety, 29(9), 452-459
References continued• Landstinget Jonkoping (2012). Health and social work. Retrieved April 7, 2012, from http://www.lj.se/• Medecins Sans Frontieres. (2011). About MSF. Retrieved on the 7th of April 2012 from, http://www.msf.org/msf/about-msf/about-msf_home.cfm• O’Keeffe, J. (2009). Urie Bronfenbrenner and the ecological systems theory. Retrieved April 8, 2012, from http://lardydardyda.wordpress.com/• Samhällets Styvbarn. (2011). Stepchildren of society. Retrieved April 7, 2012, from: http://www.styvbarn.se/• Vogel, G.E., & Givey, J. (1985). Improving x-ray report turnaround. Pub Med, 14(1), 39-40• World Health Organization. (2012) Introducing the WHO regional office for Europe. Retrieved April 7, 2012, from http://www.euro.who.int/__data/assets/pdf_file/0017/122912/who_office_brochure- UK-www.pdf• Zeitlin, M.F., Megawangi, R., Kramer, E.M., Colletta, N.D., Babatunde, E.D., & Garman, D. (1995). Strengthening the family – Implications for international development: The family from a child development perspective. United Nations University Press: Tokyo, New York, Paris