Question

For all the questions below, please pick one of the following health issues identified as salient Bowe County's most recent community health needs assessment: vaccination, adolescent pregnancy, gunshot wounds, or type 2 diabetes.

1. Give examples of how the outputs of the organizational plan and the services utilization plan relate to the process theory objectives.

2. What type of social marketing would you use?

3. How might you minimize under-inclusion or over-inclusion in such a health program?

Answer 1

VACCINATION

0UTPUTS OF THE ORGANIZATIONAL PLAN AND THE SERVICES UTILIZATION PLAN RELATE TO THE PROCESS THEORY OBJECTIVES

1. Service delivery

Ensure that:

•             All areas of the country are reached regularly.

•             There is adequate support for outreach sessions to be carried out as scheduled and that this is                     monitored.

•             All districts have received training in the RED strategy.

•             There are adequate strategies for reaching the urban poor.

•             Polio, measles and maternal and neonatal tetanus staff meet regularly to coordinate surveillance and immunization activities.

•             Newly introduced vaccines are available equitably to the whole population at all health facilities.

2. Linking services with the community

Ensure that:

•             There is a national communication plan with strategies to improve immunization uptake.

•             National volunteer groups, influential community leaders and community mobilizers are systematically involved.

•             Communities in areas with low coverage are engaged in planning and linked with service-delivery strategies.

3. Vaccine supply, quality, logistics, cold chain

Ensure that:

•             There is a cold-chain inventory.

•             There is a plan to upgrade or rehabilitate the cold chain in preparation for the introduction of a new vaccine.

•             Information on vaccine stocks is freely available.

•             There is a plan to improve supply to areas where vaccine stock-outs are a

problem.

•             There is an effective system for packaging auto-disable syringes with vaccine.

4. Surveillance and monitoring

Ensure that:

•             A reliable system for monitoring district immunization system performance is in place.

•             Areas with poor reporting are identified and have support.

•             Supervisors make regular planned and scheduled supervisory visits.

•             National population figures are available and accurate.

SOCIAL MARKETING

Social Marketing seeks to develop and integrate marketing concepts with other approaches to influence behaviours that benefit individuals and communities for the greater social good

. • Social Marketing practice is guided by ethical principles. It seeks to integrate research, best practice, theory, audience and partnership insight, to inform the delivery of competition sensitive and segmented social change programmes that are effective, efficient, equitable and sustainable.

Vaccination uptake behavior: more than a communication problem

“Given the diverse reasons for parental refusal of or delay in immunizations, a one-size-fits-all approach to health promotion founded on expert authority or the articulation of the scientific evidence that supports immunization ignores the realities of how people are persuaded. Social marketing may hold the key.”

Product What vaccination are you trying to get people to “buy”? (Core product) What is the benefit of that vaccination (actual product) Are there tangible or non tangible objects or services that would support vaccination uptake?

THE SOCIAL MARKETING             

product	Product What vaccination are you trying to get people to “buy”? (Core product) What is the benefit of that vaccination (actual product) Are there tangible or non tangible objects or services that would support vaccination uptake?	HPV Vaccination Flu vaccination Whopping cough vaccination To follow the vaccination schedule
Price	What is the perceived “value” of vaccination? What are the barriers to uptake? What do people get in return? (monetary and non monetary)	Psychological, Emotional, Cultural, Social, Behavioural, Financial
Place	Where is vaccination available? How easy is vaccination to access?	School, Doctor’s office, Pharmacy, Primary Health Clinic, Community events, Homes
Promotion	What messages work? Who are trusted sources? Where do people get information about vaccination?	Communication, Advertising, Direct mail, Doctor, Teacher, ICT
Policy	What policies influence vaccination uptake?	Reimbursement, Location (access), Exemptions
Partnerships	Are all partners who facilitate vaccination uptake involved?	HCPs, schools, media, parents, the public, and policy makers

CONCLUSIONS

Too many have excuses for not doing social marketing properly

Social marketing looks beyond communication and investigates the determinants of vaccination in context

HOW TO MINIMIZE UNDER-INCLUSION OR OVER-INCLUSION IN A HEALTH PROGRAM IMMUNIZATION

Equality and inclusion within health and social care is vital to ensuring people's differences are valued and that people are treated equally and supported to take part in whatever they wish to do but also that services support people in all areas to be able to look after themselves and prevent issues from becoming .

Underinclusion happens when a few members of a target audience do not obtain the program. Overinclusion is when some members in the program are not part of the target audience. According to Issel, there are numerous steps that can be taken to help minimize overinclusion or underinclusion. First, developing the process theory, in terms of stipulating how those needing the program can get into the program. Second, have a solid, marketing plan, that is another component in the services utilization plan, Once finding the target audience, a need to screen both extremely sensitive and precise can minimize both overinclusion and underinclusion.

IN IMMUNIZATION PROGRAM TO IMPROVE FEW POINTS GIVEN BELOW

Integrated service delivery and strategic partnerships.

Engaging the community at the grassroots level.

A robust health system and evidence-based prioritization.

Accountability and local ownership.

Political support and sustainable financing.