Macrosystems are the outermost layer of the environment that shape human development through broad ideological and organizational values. They include cultural contexts as well as governmental and non-governmental organizations that provide overarching policy and strategic direction. While macrosystems can impact development, change often occurs through collaboration between macro- and microsystems, such as when a hospital department implements quality improvement strategies that are later adopted as policy.

1. Macrosystems
The Dinh Thi
Jasmine Paul
Eva van Swaaij

2. What is a macrosystem?
• “Macrosystems are
the cultural
contexts, not solely
geographically or
physically, but
emotionally and
ideologically”
(Bronfenbrenner,
1979)
• Outside in

3. 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

4. Different types of macrosystems
• Non-governmental organizations (NGO’s)
• Governmental organizations (Go’s)
World    Jönköping
World Continent National Regional
NGO’s Red cross, Stepchildren of
MSF Society
GO’s WHO, EU – DG Statens Länssjukhuset
UNICEF SANCO Folkhälsoinstitut Ryhov

5. Non-governmental organizations
Medecins 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)

6. Governmental organizations
World 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).

7. How does a macrosystem work?
Macrosystem Policy change
Microsystem Microsystem Strategic Plan
(PDSA)
Microsystem Macrosystem
Change within Change within
multiple units Implementation
a unit

8. How can this be applied to a local
level?
• 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

9. How can this be applied to a local
level 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

10. 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”

11. 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.

12. 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

13. 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

14. 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