Policy Analysis and Systems Change
In concert with several public health and education colleagues, VISIONS has developed a thinking tool (module) and workshop process for use in providing TA to leaders who are seeking to create systems change from a multicultural perspective. The module provides information and questions that engage stakeholders in a collaborative approach to policy and systems analysis and change that includes understanding and utilizing each others' "cultures" or ways of being and doing.
Using the lens of fairness (equity), inclusion, and disparities, stakeholders examine needed changes in a system to support fair outcomes from all. They explore further how equity impacts resources, delivery systems and opportunities for change. It is organized to address the following questions with respect to any needed systems change:
1. Focus on Inclusion, Power and Fairness: What are our interests? What outcomes do we want? How does this differ from other "actors"? How do we engage all relevant "actors" in our policy change agenda, strategy, and advocacy?
- Focus on Resources: How does the money flow? How does this impact outcomes? How does our policy agenda and strategy address the full range of financing issues?
- Focus on Delivery Systems: How are providers working? How do our health centers/schools/programs fit into the larger delivery system? How does this impact outcomes? How does our policy agenda and strategy focus on improvements to health care/education systems?
- Focus on Opportunities for Change: Can we address root cause of poor outcomes? How can outcomes be improved in the short run? How do our policy change strategies, messaging, and sustainability planning address both root causes and short run improvements?
The module suggests that such change efforts, to be transformative, must include on-going relationship development with people and groups who are similar and different. The suggested implementation process supports on-going multicultural community and/or organizational engagement. This process involves identifying values, objectives and interests of the various collaborators and competitors and the policies needed to support effective change.
It is on-going and requires revisiting, as stakeholders and partners change and as organizations are in different stages of development.
The VISIONS model helps participants see themselves as individuals and as social beings, both of which are brought into their policy and systems change work. On-going collaboration requires understanding both elements (individual and group identity) in self, others, organizations and communities. Change needs to occur at four interlocking levels: personal, interpersonal, institutional/systemic and cultural.