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

• 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

Different types of macrosystems

•Non-governmental organizations (NGO’s)•Governmental organizations (Go’s)

World JönköpingWorld Continen

tNational Regional

NGO’s Red cross, MSF

Stepchildren of Society

GO’s WHO, UNICEF

EU – DG SANCO

Statens Folkhälsoinstitut

Länssjukhuset Ryhov

Non-governmental organizationsMedecins 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

Governmental organizationsWorld 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 National 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).

How does a macrosystem work?

Macrosystem

Microsystem Strategic

Plan (PDSA)

Microsystem

Microsystem

Macrosystem

Change within multiple units

Change within a unit

Implementation

Policy change

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

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

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.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

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