PRIORITIZATION
- Prioritization is a key component of public health leadership, particularly when dealing with finite resources and competing interests.
- Too often, policy makers rely on anecdotal evidence, "gut feelings", special interests-backed information, and incomplete data to prioritize populations' health issues.
- Personal and societal values unavoidably come into play when identifying criteria to be used when prioritizing. But at least, when criteria are defined prior to the prioritization process taking place, more rational and efficient decision-making can take place.
- Politics and economics always have a spot at the table... it really can't be just about the health and well being of populations.
- There are some really neat tried and tested prioritization models out there waiting to be used by more people for the purpose of achieving improved health outcomes for issues that matter most.
LAW AND ETHICS
- There is never a straight answer about whether something is right or wrong... it is quite mind-boggling!
- Where does the fine line fall between individual liberty and population health interests? Still mind-boggling...
- Principles used to support a certain Supreme Court decision may not be used in the same way in other similar Supreme Court rulings. A lot depends on the societal norms and culture of the time.
- The work I am doing (supervising intense case management of high risk pregnancies) may not be deemed as ethical or moral by some people... I am struggling with this myself as I strive to understand where I stand in terms of female empowerment, gender development, reproductive health rights, and maternal and infant health.
- How ethical, moral, and just is DCF involvement in many newborn-removal cases where the mother does not have all the support, tools, and resources necessary to provide a stable environment (as defined by current societal norms)? Why does DCF care about the baby and not a lick about the mother? Wouldn't it be a lot more beneficial in the long term if the mother-baby dyad were treated as one inseparable unit to be supported and nurtured?
- A woman who just gave birth six days ago, was encouraged to bond with and breastfeed her child, was subsequently separated from her newborn right before a three-day weekend during which no work was done to advance the case and assure reunification. In the meantime, she has been experiencing depression and anxiety while coping with incredible loss, as well as an incredibly non-supportive partner who kicked her out into the streets... in a town where all shelters are full and unable to provide the much needed safety net and shelter. Without a place to stay at tonight (or in the days to come) she doesn't even have a way to store her precious pumped breast milk so that she can be made to feel like she is still taking care of her child in this time of hardship, while allowing the baby to get the much needed breast milk from his own mother. Is this system just incredibly incapable of supporting fellow human beings in a time of need or what? It is very discouraging and quite immoral... how can we, as a society, as agencies, as families and fellow human beings let this happen? It is very troubling... and humbling.
Where there's a will, there's a way... I will find a way to positively affect change in my community for mothers, children, and their families while making the best, most ethical, most efficient, and most effective use of limited resources in an environment of competing interests. Bird by bird... keeping my eye on this prize: improved health outcomes, dignity, psychological and social well being of women and their offspring.
