Research Project: Pan American Health Organization
The current research project provides a needs assessment, a gap analysis, an intervention plan along with the implementation strategy, and the effectiveness evaluation of Pan American Health Organization. The analysis draws attention to the actual operations gaps characteristic of the institution's performance. It provides supportive data and statistics, as well as analytic thinking on various dimensions regarding the implementation of the intervention. Moreover, the project gives the detailed analysis of the stakeholders’ roles in the process, and provides the possible evaluation criteria of the effectiveness of the plan itself.
The current Strategic Plan of PAHO outlines the most burdening aims such as ensuring that all of the member countries receive equal-quality healthcare, preventing people from the impact of certain diseases, providing proper response to and raising awareness of the international epidemics or incidents, decreasing the infant and child mortality, and lengthening the general longevity of the population. Based on these needs, the following gaps were identified: inequity in the healthcare quality across the member countries and territories; high rate of infant mortality; low alertness and response to the disaster emergency; and a relatively decreased level of life expectancy. Results show that to improve the mentioned issues the organization needs to perform certain transformations to achieve the established goals.
The analysis does not exclude the roles of the stakeholders in terms of the implementation of the intervention to affirm their value. Apart from the implementation plan, the marketing communication plan and the plan for the effectiveness measurement of the intervention were established. This ensures a complex analysis of the situation. The necessary changes are not simply outlined, but justified from the three perspectives, and are detailed in accordance with the current status of the organization.
Health organizations in today's healthcare system frequently face challenges that are not effortlessly obvious until ordinarily the value of those challenges become urgently important. An organization's competence to recognize the essentials of the dealing with challenges and operate correspondingly to suppress the impairment, which has been done by quickly recuperating it, is principal for the institution to reach favorable outcomes.
The main aim of conducting such an analysis is learning the inconsistencies between the actual actions of an organization and the ideal image of its functioning. Therefore, it is crucial for the institution to understand the need for improvement and development in the chosen sphere.
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The current paper provides the detailed analysis of the Pan American Health Organization’s needs and gaps in operations. Through the critical thinking, it enables the complex understanding of the ways of how an institution can improve its performance. PAHO is a complex organization covering the two Americas in providing healthcare and promoting a healthy lifestyle.
Description of the Organization
Pan American Health Organization (PAHO) is the specific worldwide institution for the Americas, bettering and caring for the wellbeing of the area’s population, in addition to being the Regional Office of the World Health Organization. Its operations center is involved in technical collaboration with the participating territories (which include 48 countries) to oppose various illnesses and their origin, intensify health systems, and react to crises and catastrophes. The organization guarantees accessible and high-quality care. PAHO establishes alliances with various institutions and groups to accomplish these objectives. Its center for operations, situated in Washington DC, ensures that the cooperation system works for the sake of people’s well-being, instilling a healthy lifestyle as a primary value.
PAHO has a long history exceeding 110 years of functioning, during which it demonstrated significant achievements. Among others, there has been an increase in average longevity by 35 years since its foundation, elimination of several diseases (such as smallpox and polio, endemic transmission of measles and rubella) and decrease in the effect of others (leprosy, Chagas disease, and onchocerciasis), considerable devaluation of death among youngsters, and making healthcare more accessible to the poor.
The organization is striving for the dominant position in providing optimum healthcare for the American population. Therefore, PAHO sees its mission in advancing equal health, fighting illnesses, improving and increasing the longevity of people in cooperation with all the member countries. The institution prides itself for advocating for equity and high-quality mutual work, and ensuring clear, moral, and responsible acting.
The major spheres of the organization’s functioning are infectious and non-infectious illnesses, health systems and services, family and gender, crisis alertness and accident maintenance. PAHO’s administration consists of several bodies, including the Pan American Sanitary Conference, the Directing Council, and the Executive Committee. The institution is sponsored by measured donations from the participants, the World Health Organization and the volunteers.
PAHO has a significant length of service, being established in December, 1902. It is an institution that provides care in both rural and urban areas, making a complex assessment of health needs throughout its territories. The organization has headquarters located in Washington, DC, governing 27 country offices and three specialized centers in the region. With the help of such structure PAHO promotes healthy lifestyle as a catalyst to reasonable improvement. Its satellites include the World Health Organization located in Geneva, Switzerland.
It is problematic to determine a definite number of employees, as the organization has 43 country members, each having an office. The last known statistics on the topic refers to the year 1995, which is not actually up-to-date. As for the number of clients served, it obviously reaches up to millions of people, because PAHO provides care for dozens of member territories. In addition, the organization conducts a lot of demographic researches and surveys to determine the health needs of the population.
Needs Assessment/Gap Analysis
A common problem for all the organizations, regardless of their type, is that there always exists something to strive for, as there are ways for perfecting the operations. After all, it is the sense of development and improvement of the institution. Therefore, every organization should perform the needs assessment and gap analysis to figure out what inconsistencies there are in its functioning, and to find the ways to better their performance.
Because the Pan American Health Organization is an international and complex system, its operations’ field is quite vast, spreading over the dozens of countries and territories. It causes some difficulties in organizing the work properly and ensuring equity in service. However, as the “equity” itself is one of the values of PAHO, it probably should be one of the most developed spheres. Nevertheless, judging from the Strategic Plans analysis, one can see that it leaves much to be desired. This fact illustrates the baffling complexity of running the multinational organization and maintaining the highest possible level of service.
The current Strategic Plan of PAHO demonstrates that the most troublesome goals to complete are: ensuring that all of the member countries receive equal-quality healthcare, protecting people from the impact of certain diseases, providing proper response to and alertness of the international epidemics or incidents, decreasing the infant and child mortality, and lengthening the general longevity of the population. These are the areas that have room for improvement.
Currently, the organization is not offering equal care for all the member territories. Especially burdening is the existing gap in health management quality across the countries based on the poverty level. It results in high mortality level because of the neglected and non-communicable diseases (NCD). For example, the recent statistics showed that the four most common NCDs caused 79% of all death incidents in 2012. 35% of them happened too early for people aged 30 to 70 years (Figure 1). The chance for a person under 70 of ending up with an NCD has lowered by 2012. Thus, the goal of the PAHO is to reduce the mortality level even more by attempting to control the mentioned illnesses.
Furthermore, as the Americans suffer from the accidents and natural disasters to a significant extent compared to the rest of the world (almost 25% of all the emergencies happened in the region of the Americas during the period 2006-2010), it is crucial to ensure excellent alertness and reaction to these situations to prevent people from getting severely injured or killed. The problem lies not only in the amount of accidents but also in such prosaic incidents as hospitals destroyed because of the catastrophes resulting in the complete absence of care for people. It forms another need for PAHO to consider – alert system of healthcare provision in the situations of emergency.
One of the most important issues is also the infant and child mortality, because keeping the young population healthy and strong enough to survive would result in building a healthy nation. Although the index of death rate is decreasing, it is significant in the region (in Bolivia and Haiti it is still 40 to 45 per 1000 births). Therefore, PAHO needs to improve the health state of the newborns and infants ensuring their stable good health from the very beginning of their lives.
Another significant need is as follows: lengthening the general longevity of the population in the region. Due to the premature deaths, child mortality and other factors, the average length of life in the Americas does not reach a normal level. Generally, the regional life expectancy increased during the period of 2005-2012 to 76.4 years. However, there still exist meaningful discrepancies depending on the country. Thus, PAHO needs to equalize the statistics across the Americas and keep improving it.
On the basis of the needs assessment, one can realize the gaps that should be filled for the organization to improve its operations. These inconsistencies include: unequal care in various countries in the region, the unfavorable impact of the infectious diseases and NCDs, improper response to emergency, infant and child mortality, and unequal life expectancy. The established gaps will be used for further analysis.
Context: During the past few years, the Americas faced the inequity in health provision, which is the social dimension of health itself. There is a considerable gap in the quality of received care varying from country to country. It causes the death rates to rise simply due to the lack of health management. Some countries, for example, South America, do not receive proper care because of poverty. Apart from that, various communicative and non-communicative illnesses cause the decrease in the level of health. The diseases, such as leprosy, Chagas disease, onchocerciasis, smallpox and polio, measles and rubella, cardiovascular and respiratory diseases, cancer, and diabetes, are threatening the population. The same refers to the problem of infant mortality. The rate has risen up to four percent of all births in some areas. Furthermore, one should not underestimate the emergency situations, which give room for alertness improvement.
The goals for improvement are: to reduce child mortality rate by 15% and provide a safe environment for the newborns; to increase the quality of disaster response by 70%; to provide equal healthcare for the population; to promote healthy lifestyle and increase longevity.
In addition to these aims, one can identify several tactic target spheres:
- Lowering the impact of infectious illnesses, including HIV/AIDS, sexually transmitted infections, and viral hepatitis; tuberculosis; malaria; neglected, tropical, and zootonic illnesses; and vaccine-preventable illnesses.
- Lowering the impact of non-communicable illnesses, including cardiovascular diseases, cancer, chronic lung illnesses, diabetes, and mental health disorders, through propaganda of a healthy lifestyle and risk lowering, care, and consideration of NCDs.
- Approaching healthcare in terms of gender equality, ethnicity, equity, and human rights.
- Enhancing health system by focusing on empowering the social, legislative, and managing dimensions; bettering financial care to ensure the equal rights to health accomplishment; building individual-oriented service system; the use of quality, safe, and effective health technologies; technical cooperation; and encouraging the sharing of knowledge and facilities.
- Lowering emergency accidents' mortality, despair, and societal splitting by paying attention to risk decrease, alertness, response, and rehabilitation actions.
For the goals to be met, PAHO should implement the multispectral approach. It means that the complex of actions must be introduced to ensure that all of the gaps are filled. Therefore, the intervention would be in the spheres that are most difficult to control: equity, longevity, disaster, and child deaths.
Finance and staffing elements required for the implementation of the intervention in the plan include encouraging the interested stakeholders to donate in the implementation of the plan. The additional expenses would include training the personnel according to the needed improvements, as well as hiring the new staff for complex engagement in the response procedures.
The proposed intervention can be justified from the cultural, social, and economic perspectives. According to the first one, after the implementation it would become clear, whether the general view of the population concerning the health issues has changed. The social perspective confirms the intervention due to the prospected outcomes in the longevity rate varying or not. Finally, the investments should be paid off after the implementation, demonstrating the economic side of the plan.
Intervention Implementation Plan
The intervention would target the following groups of the population: infants, mothers, adult population, healthcare staff, and stakeholders. Engaging the latter in the implementation of the intervention is reasonably significant for the risks control when it becomes necessary to analyze all the opposing views.
There would be two groups of stakeholders involved: the key group and other stakeholders. The first one makes the most important decisions while evaluating the intervention, while the second is affected by the decisions during the evaluation and post factum. Although the stakeholders of PAHO are big donating institutions, it is crucial to engage them in the process of implementation. However, inviting all of them is not appropriate.
The roles of the stakeholders include sharing views on the credibility, quality, and usability of the intervention; logically structuring the plan and shaping the principal issues; and initiating the search for quality data and its further interpretation.
The intervention implementation plan by goals is as follows:
- In order to decrease the infant mortality rate at an early age, some serious measures should be taken. First of all, the special newborn care services should be established to provide infants with necessary care from the first days of life. This includes hiring specially trained personnel (or training the existing) and financing these certain managements. Infants' disease identification at an early stage (diarrhea, respiratory infections) is also important. To achieve this goal, PAHO should inform mothers about the breastfeeding and immunization benefits, and provide the infants with sufficient nutrition.
- During the emergency, the healthcare system goes through the period of crisis - the structuring, organization, and operating, all of which are tested in terms of surviving the situation. To increase the disaster alertness and response quality, PAHO has to maximize mobilization of all existing human resources to ensure proper response and reaction to the accident. The forces involved in such operations need to be well-prepared and educated on how to act in these situations. Moreover, to provide an extra insurance, in case of emergency, all warehouses should have medicaments and essentials for the first aid.
- To provide equal healthcare for the population of the region, PAHO firstly has to study the specified needs of every member country and territory. It is necessary, because this is the way of providing sufficient and, most importantly, needed care. It would help to narrow the gaps regarding the healthcare quality in various countries. Moreover, the organization is striving for the universal health system, so that any territory would have the same high-quality care of excellent standards. This issue is highly questionable from the financial side, because ensuring equal healthcare would be associated with significant expenses. However, this is where the stakeholders are needed and expected. With their help it will be possible to raise the necessary amount of finances.
- To promote healthy lifestyle, PAHO should set up informational meetings and propaganda in the streets concerning the healthy life. The significant step here would be reducing the most common risks (alcohol, nicotine, bad nutrition, etc.) as a part of proper preparation. The human resources involved in such an issue need to be well-trained and demonstrate healthy living themselves. Furthermore, to increase the longevity of the population of the Americans, the threatening diseases should be eliminated completely.
Marketing Communication Plan
Marketing communications are crucial for creating targeted demands and fundraising. To keep the stakeholders aware of what is going on with the plan implementation, PAHO needs to inform them properly about it at different stages of its development, from the idea to the results. The first part of communicating with donators should be devoted to the actual planning of the implementation of the intervention. Therefore, at this stage, the stakeholders need to get acquainted with the plan and may express their opposition if any. They should be informed in the form of a round table because it would be effective for sharing the views.
The next step of informing the stakeholders is during the actual process of implementation. It is necessary to reassure them of the fact that the donations are used in a proper way. The information should include the stage of the implementation process, the troubles if any, the scheduling, and the up-to-date data.
The final step of informing the stakeholders is expressing ideas about the results of the implementation of the intervention. This stage involves discussions on the effectiveness of the implementation, and the gained outcomes.
Plan for Measurement Effectiveness of the Intervention
Improvement of the organization depends on how effectively each part of the intervention was carried out. The success of the plan can be measured based on the outcomes. The discussed intervention had four components: decrease of the infant mortality rate, providing high-quality disaster alertness, equal healthcare for every member country, promoting the healthy lifestyle and increasing longevity. For each of the issues one can set some markers that will show the overall effectiveness of the plan.
First of all, these points' effectiveness can be measured by assessing the actual health improvements. Therefore, the success in reducing child mortality would be a decrease in the percentage by minimum of 2% in Bolivia and Haiti, where this number is the highest, and by 0.05% throughout the region. The effectiveness of the alertness and response to the accidents would demonstrate the lowered level of injured, ill and dead after the disaster. In addition, the independency of areas storing first aid would vividly show the success of the intervention. As for the effectiveness of the third point - equal healthcare, it should be said about the narrowed gap in the quality of care between the groups of countries. Moreover, the increase in the healthcare quality in certain South American countries would presuppose the same. Finally, if the implementation of the plan is effective, the level of people’s health would generally improve, causing the longevity rate to rise even more.
After conducting the needs assessment and gap analysis of the Pan American Health Organization, the room for improvement was identified forming four main gaps: lack of equity in health service, high infant mortality rate, the low-quality response to a disaster, and low average longevity rate. In the process of analysis, strategies to solve these problems were found. It all formed an intervention plan, which was focused on the operations perspective.
As a result, it was concluded that to improve the functioning of the organization, PAHO should perform certain actions. These are: to establish special departments for infants care with trained personnel; to ensure maximum involvement of human resources in an emergency situation; to take into consideration the specific needs of every single member country and territory to ensure high-quality care; to promote a healthy lifestyle and reduce risk factors.
Pan American Health Organization is performing its functional responsibilities on a sustainable level. However, it shows the gaps in operations, which should be assessed for the future development of the institution. PAHO is working on its needs and is aware of the inconsistencies, which are depicted in their current Strategic Plan for the period 2012-2019.
In general, the assessing and evaluating work performed ensured a complex understanding of the healthcare organization functioning and allowed thinking analytically about the implementation of the intervention plan. PAHO operations were evaluated and analyzed, and the necessary changes were suggested to ensure the possibility of further growth.