The Delegated State

2021 ◽  
pp. 141-166
Author(s):  
Charley E. Willison
Keyword(s):  
Decision Making ◽  
Housing Policy ◽  
Municipal Government ◽  
Continuum Of Care ◽  
Supportive Housing ◽  
Chronic Homelessness ◽  
Downtown Development ◽  
Policy Goals ◽  
Pass Through ◽  
The Continuum

Shreveport serves as the representative case for municipalities without a local government level supportive housing policy. Shreveport is a case where the Continuum of Care, municipal policy goals, decision-making, and implementation remain very separate. The separation is evident in policy decision-making and implementation, where the municipal government has little to no involvement in homeless policy aside from coordinating pass-through federal funding. Limited involvement by Shreveport’s municipal government presents direct barriers to supportive housing policy design and implementation by restricting authority and resources available to the Continuum of Care to coordinate policy activities. Policy activities constrained by the limited municipal authority for the Continuum of Care include challenges reducing policing of persons experiencing chronic homelessness and severe mental illness and limited ability to participate in municipal decision-making, which disadvantaged the Continuum of Care in debates over new shelter or low-income housing constructions compared to economic elites in the Downtown Development Authority.

The Fragmented State

2021 ◽  
pp. 111-140
Author(s):  
Charley E. Willison
Keyword(s):  
Housing Policy ◽  
Municipal Government ◽  
Continuum Of Care ◽  
Policy Coordination ◽  
Supportive Housing ◽  
Chronic Homelessness ◽  
Pilot Programs ◽  
Governmental Funding ◽  
The City ◽  
The Continuum

Atlanta represents municipalities with a supportive housing policy in municipalities that are majority Black and in states that have not expanded Medicaid. Atlanta’s Continuum of Care is integrated into municipal government. Atlanta’s move to integrate the Continuum of Care into local government occurred when the Continuum of Care restructured, moving from a trijurisdictional arrangement to separate city and county institutions. The restructuring was prefaced by an investment in homelessness and chronic homelessness prevention and services by the city of Atlanta. Subsequently, the city adopted a supportive housing policy and implemented pilot programs to reduce policing of persons experiencing chronic homelessness. Despite positive changes, Atlanta still suffers from barriers to policy implementation resulting from: histories of race and segregation, including separate policy efforts mobilizing police to move persons experiencing chronic homelessness to other jurisdictions; limited governmental funding and reliance on nongovernmental actors as providers and funders; and metropolitan fragmentation inhibiting policy coordination.

Measuring Municipal Participation in Homeless Governance

2021 ◽  
pp. 52-66
Author(s):  
Charley E. Willison
Keyword(s):  
Housing Policy ◽  
Urban Areas ◽  
The United States ◽  
Supportive Housing ◽  
The Political ◽  
Evidence Based ◽  
Housing Policies ◽  
Chronic Homelessness ◽  
Data Set ◽  
Municipal Level

Chapter 4 examines national variation in municipal responses to chronic homelessness, identifying the prevalence of municipal-level supportive housing policies among municipalities affected by homelessness in the United States and identifying and examining factors associated with the presence of a municipal-level supportive housing policy. The presence of municipal-level supportive housing policies is an indication of evidence-based policy adoption to address chronic homelessness effectively in urban areas. To date, there has been almost no research on the political predictors of the adoption of these evidence-based policies. Results demonstrate that most municipalities facing homelessness challenges do not have supportive housing policies. Of the municipalities in the data set, only 40% had a municipal-level supportive housing policy. These municipalities tend to be: more liberal; sanctuary cities; have fewer but better funded nonprofit health organizations; lower rates of municipal governmental fragmentation; and located in states without Medicaid expansion.

scholarly journals Counseling at all contacts for postpartum contraceptive use: can paper-based tools help community health workers improve continuity of care? A qualitative study from Ethiopia

2019 ◽  
Vol 3 ◽  
pp. 1652 ◽  
Author(s):  
Muluneh Yigzaw Mossie ◽  
Anne Pfitzer ◽  
Yousra Yusuf ◽  
China Wondimu ◽  
Eva Bazant ◽  
...  
Keyword(s):  
Decision Making ◽  
Health System ◽  
Community Health ◽  
Low Income ◽  
Health Workers ◽  
Continuum Of Care ◽  
Low Income Countries ◽  
Health Extension Workers ◽  
Pregnancy Risk ◽  
The Continuum

Background: Globally, there has been a resurgence of interest in postpartum family planning (PPFP) to advance reproductive health outcomes. Few programs have systematically utilized all contacts a woman and her baby have with the health system, from pregnancy through the first year postpartum, to promote PPFP. Nested into a larger study covering two districts, this study assessed the use, acceptability, and feasibility of tools for tracking women’s decision-making and use of PPFP in the community health system in Oromia region, Ethiopia. Community-level tracking tools included a modified Integrated Maternal and Child Health (IMCH) card with new PPFP content, and a newly developed tool for pregnant and postpartum women for use by Women Development Armies (WDAs). Proper completion of the tools was monitored during supervision visits. Methods: In-depth interviews and focus group discussions were conducted with health officials, health extension workers, and volunteers. A total of 34 audio-files were transcribed and translated into English, double-coded using MAXQDA, and analyzed using a thematic approach. Results: The results describe how HEWs used the modified IMCH card to track women’s decision making through the continuum of care, to assess pregnancy risk and to strengthen client-provider interaction. Supervision data demonstrated how well HEWs completed the modified IMCH card. The WDA tool was intended to promote PPFP and encourage multiple contacts with facilities from pregnancy to extended postpartum period. HEWs have reservations about the engagement of WDAs and their use of the WDA tool. Conclusions: To conclude, the IMCH card improves counseling practices through the continuum of care and is acceptable and feasible to apply. Some elements have been incorporated into a revised national tool and can serve as example for other low-income countries with similar community health systems. Further study is warranted to determine how to engage WDAs in promoting PPFP.

scholarly journals Counseling at all contacts for postpartum contraceptive use: can paper-based tools help community health workers improve continuity of care? A qualitative study from Ethiopia

2021 ◽  
Vol 3 ◽  
pp. 1652
Author(s):  
Muluneh Yigzaw Mossie ◽  
Anne Pfitzer ◽  
Yousra Yusuf ◽  
China Wondimu ◽  
Eva Bazant ◽  
...  
Keyword(s):  
Decision Making ◽  
Health System ◽  
Community Health ◽  
Low Income ◽  
Health Workers ◽  
Continuum Of Care ◽  
Low Income Countries ◽  
Health Extension Workers ◽  
Pregnancy Risk ◽  
The Continuum

Background: Globally, there has been a resurgence of interest in postpartum family planning (PPFP) to advance reproductive health outcomes. Few programs have systematically utilized all contacts a woman and her baby have with the health system, from pregnancy through the first year postpartum, to promote PPFP. Nested into a larger study covering two districts, this study assessed the use, acceptability, and feasibility of tools for tracking women’s decision-making and use of PPFP in the community health system in Oromia region, Ethiopia. Community-level tracking tools included a modified Integrated Maternal and Child Health (IMCH) card with new PPFP content, and a newly developed tool for pregnant and postpartum women for use by Women Development Armies (WDAs). Proper completion of the tools was monitored during supervision visits. Methods: In-depth interviews and focus group discussions were conducted with health officials, health extension workers, and volunteers. A total of 34 audio-files were transcribed and translated into English, double-coded using MAXQDA, and analyzed using a thematic approach. Results: The results describe how HEWs used the modified IMCH card to track women’s decision making through the continuum of care, to assess pregnancy risk and to strengthen client-provider interaction. Supervision data demonstrated how well HEWs completed the modified IMCH card. The WDA tool was intended to promote PPFP and encourage multiple contacts with facilities from pregnancy to extended postpartum period. HEWs have reservations about the engagement of WDAs and their use of the WDA tool. Conclusions: To conclude, the IMCH card improves counseling practices through the continuum of care and is acceptable and feasible to apply. Some elements have been incorporated into a revised national tool and can serve as example for other low-income countries with similar community health systems. Further study is warranted to determine how to engage WDAs in promoting PPFP.

Gaining patient experience insights

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Maitane GARCÍA-LÓPEZ ◽  
Ester VAL ◽  
Ion IRIARTE ◽  
Raquel OLARTE
Keyword(s):  
Type 1 Diabetes ◽  
Patient Experience ◽  
Patient Perspective ◽  
Continuum Of Care ◽  
Theoretical Framework ◽  
Cognitive Responses ◽  
The Continuum

Taking patient experience as a basis, this paper introduces a theoretical framework, to capture insights leading to new technological healthcare solutions. Targeting a recently diagnosed type 1 diabetes child and her mother (the principal caregiver), the framework showed its potential with effective identification of meaningful insights in a generative session. The framework is based on the patient experience across the continuum of care. It identifies insights from the patient perspective: capturing patients´ emotional and cognitive responses, understanding agents involved in patient experience, uncovering pain moments, identifying their root causes, and/or prioritizing actions for improvement. The framework deepens understanding of the patient experience by providing an integrated and multi-leveled structure to assist designers to (a) empathise with the patient and the caregiver throughout the continuum of care, (b) understand the interdependencies around the patient and different agents and (c) reveal insights at the interaction level.

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