Macrosystems

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. 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 The 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, MSF Stepchildren of Society GO’s WHO, UNICEF EU – DG SANCO Statens Folkhälsoinstitut Länssjukhuset Ryhov

5. Non-governmental organizations Medecins Sans Frontieres (MSF) Stepchildren of Society “International , independent, medical humanitarian organisation that delivers emergency aid to people affected by armed conflict, epidemics, natural disasters and exclusion from healthcare. MSF offers assistance to people based on need, irrespective of race, religion, gender or political affiliation” (Medecins Sans Frontieres, 2011) The National Association for the Society’s Stepchildren is an interest organisation for adults and young people who have been cared for by the community childcare - Offering of services to children and adults

6. Governmental organizations World Health Organization (WHO) Statens Folkhälsoinstitut Supra-national Responsible for public health within the United Nations system “WHO provides technical support to Member States, monitors and assesses health trends, generates and shares health information, and provides emergency aid during disasters, acting as a bridge between sub-regions” (WHO, 2012). World Health Assembly once a year Swedish N ational Institute for Public Health State agency under the Ministry of Health and Social Affairs “The Institute works to promote health and prevent ill health and injury, especially for population groups most vulnerable to health risks...through conveying knowledge for better health” (Cedervärn, 2010).

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

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.ht ml 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 7 th 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