When responding to your peers, provide your own evaluation of the policies discussed in their posts. Respectfully agree or disagree with your peers’ evaluations. What suggestions for improving the policies can you add? What suggestions provided by your peers do you see as the most valuable?

post #1

Michelle Morrill 

Many states have their own policies on providing for the elderly populations, however, the United States established a policy in the 1960’s to provide for this population. According to the US Census bureau there are 47.8 million people over the age of 65 in the United States. (Bureau, 2020) The Older Americans Act began in 1965, with a goal to provide meal services, legal guidance, home care, protection against elder abuse, and transportation for the older population. The plan for this policy was to ensure that people of this population could remain at home longer, and have community based resources provided for them. This policy is funded by US federal tax dollars. Congress works with Medicare to establish the needs of this population. “Area Agencies on Aging (AAAs) were added to the Act in 1973 to be the “on-the-ground’ organizations charged with helping vulnerable older adults live with independence and dignity in their homes and communities. The OAA mandates that AAAs use the flexibility provided in the law to ensure that local needs and preferences are taken into consideration and that the resulting local service delivery system is tailored to the community. (Naylor, 2020)” 

The policy offers a good outlook, however, the policy faces many challenges. The older population is growing each year, and the federal funding lessens each year. With a growing population of older Americans, this means a higher demand on the healthcare system. In old age is when medical expenses are the highest. To provide for a large portion of the population, a population with a higher acuity of care, is difficult. Inequality in the level of care occurs because of this. Those of this population that do not require as much of the services are not granted them. On the other hand, those whom require a significant level of care receive more support and lessen the resources for others. Additionally, the services offered by the policy are community based, there is an unequal opportunity to utilize these services. Those communities with lower socioeconomic status do not have the same resources available as higher socioeconomic status. Cultural preferences must also be considered when evaluating the effectiveness of this policy. This policy is funded by federal funds, because of this funding varies year to year. This poses a large issue. My recommendation for the policy would be moving away from a community based care system, and formalizing care in collaboration with local hospitals. With this recommendation, funding would need to be more consistent. The funding could be allocated from Medicare or insurance companies. The biggest issue with this policy is how to properly provide services for what is projected to be the largest part of the population equally, and promptly. This will require multiple levels of involvement, which is another difficult aspect to address. If this policy is left unaddressed more of the older population will suffer from inequalities, and lack of resources. This then strains the healthcare system more, and further decreases resources for all populations. 

Bureau, U. (2018, August 03). Older Americans Month: May 2017. Retrieved July 28, 2020, from https://www.census.gov/newsroom/facts-for-features/2017/cb17-ff08.html

Naylor Association Management Software. (n.d.). Retrieved July 28, 2020, from https://www.n4a.org/olderamericansact

Older Americans Act. (2020, March 06). Retrieved July 28, 2020, from https://www.ncpssm.org/documents/older-americans-policy-papers/older-americans-act/

Post #2

Marinelly Ventura posted 

A policy that stuck out to me was the Integrated Management of Childhood Illness (IMCI). A policy that is compiled of three factors, such as:

• The improvement of the staff’s case management skills
• The improvement of health systems
• The improvement of health practices for families and communities.

This policy was implicated to focus on the well-being of children and the achievement of the community and families by utilizing preventative and corrective elements. IMCI’s creation was to focus on children under the age of 5 and by promoting advances and improvements to lessen illness, death, and disability. To enforce this policy, there must be a lot of planning with the government and health programs. This strategy has been received by over 70 countries and also has a list of steps to begin. The steps would be 1. The development of a support system within the communities it will serve and prevent diseases, caring for sick children, and transporting those children to hospitals when need be. 2. The training of health care workers at local clinics to adequately instruct parents on their children. 3. Bolster hospitals for children who are too ill to only be treated in an outpatient setting. 4. New training methods for staff to implement the necessary enhancements for treatment. 5. Integration and adoption idea for child health in national policy. 6. Preparing IMCI guidelines for what the country may need to have drugs available, local foods, and policies. 7. Making sure upgrades assist in the availability of simple equipment and low-cost medications (WHO, n.d)

The countries that have utilized the Integrated Management of Childhood Illness (IMCI) consist of the United Republic of Tanzania, Peru, Bangladesh, Brazil, and Uganda. These countries participated in an MCE (Multi-Country Evaluation) where the cost, effectiveness, and impact of the IMCI. The outcome of this evaluation would be encouraged through the continued support for the advancement in child health through partners both nationally and internationally. IMCI was introduced as a pilot program which then became a national program whose purpose became effective. The improvement of IMCI that can be completed would be more adoption of this program globally. Case management is utilized to improve the quality of care for children under the age of 5, which will require the understanding of reading and comprehension from the case managers’ training. A few barriers that are challenges would be financially by not having sufficient funding available, political absence, etc (Goga & Muhe, 2011). Consequences that can occur from not improving can be increased mortality on children under the age of 5, since this service targets these individuals.

Gera, T., Shah, D., Garner, P., Richardson, M., & Sachdev, H. S. (2016). Integrated Management of Childhood Illness (IMCI) Strategy for Children under Five. Retrieved on 7/28/20 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943011/

Goga, A., & Muhe., L. (2011). Global Challenges with Scale-up of the Integrated Management of Childhood Illness Strategy: Results of a Multi-Country Survey. Retrieved on 7/29/20 from https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-11-503

NCBI. (2013). Does Implementation of the IMCI strategy have an Impact on Child Mortality? Retrospective analysis of Routine Data from Egypt. Retrieved on 7/29/20 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3563136/

WHO. (N.D). Integrated Management of Childhood Illness (IMCI). Retrieved on 7/28/20 from https://www.who.int/maternal_child_adolescent/topics/child/imci/en/