Health care is an inalienable right and a collective responsibility. Built on that belief, the 5-2035 plan creates a new class of health professional: the CHNP (community health nurse practitioner). CHNPs work closely with the citizens they serve, driven by the SEED-SCALE model ([1]: Self-Evaluation for Effective Decision-making + System for Communities to Adapt Learning and Expand) for sustainable community empowerment. The goal: integrated, community-centered health care with the CHNP at its heart, frugally innovative enough to become a model for the rest of the world.
Introducing the 5-2035 CHNP Innovation
Introducing the SEED-SCALE* model for sustainable community empowerment for 5-2035
*Self-Evaluation for Effective Decision-making + System for Communities to Adapt Learning and Expand
The key to the SEED-SCALE model [1]: building better lives doesn’t necessarily need technical breakthroughs. It needs changed behavior at the community level. We see SEED-SCALE as a syncretism of three traditions: the Koranic concept of Umma | Shura | Maslaha (community | mutual consultation | public interest), American pragmatism, and the Indian practice of jugaad (frugal innovation). Together, they re-imagine the relationship between stakeholders, content experts, officials and the community itself (Fig. above).
In the traditional model (Fig. above, A), there’s a one-way, top-down flow: content experts advise government officials, who then implement programs in communities. Grassroots efforts often fail under this model. Larger, more complex systems are required for communities to learn how to take advantage of opportunities, and the model usually runs on a tight timeline with changing experts and officials, with no follow-through or sustainability.
Effective change, write the Taylors [1], grows from the community level. But bottom-up growth doesn’t happen on its own. Grass offers an analogy: to grow its roots, grass needs top-down nourishment from sun and rain (government help) and outside-in nourishment from fertilizers and micro-nutrients (content experts).
The SEED-SCALE approach (Fig. above, B) builds from the same self-evident truth: communities rarely make significant behavioral changes on their own. Mobilizing community growth takes a three-way partnership: top-down support from government, outside-in innovation from experts, and bottom-up hard work from local people, all interacting seamlessly.
With the CHNP / CHDr team at its center, the 5-2035 vision motivates new and existing institutions to unleash the power of SEED-SCALE, strengthening communities toward the 5-2035 goal. SEED-SCALE views community development like successful parenting: a child must believe in their own capacity and build on their strengths. Communities that are skeptical about their potential may endure, accommodate, or pretend, but they will not develop.
Privileged starting points and resources matter less than resourcefulness and a positive conviction about the future. A shared vision, a community-wide conviction that the future will be better: that is the foundation for development. Please see the 5-2035 Executive Summary for an overview of our plan, or request the full 76-page 5-2035 White Paper for further details. The GFCH Mission Statement and Charter can be found here. If you have any specific questions, please do not hesitate to contact us. Our response time may be slow as all of us at the GFCH are volunteers for the 5-2035 mission and have full time commitments.
References:
- Taylor-Ide, D. and C.E. Taylor, Just and Lasting Change. 2002, Baltimore, MD: The Johns Hopkins University Press.
- O’Brien JB. How Nurse Practitioners Obtained Provider Status: Lessons for Pharmacists 2003 Am J Health Syst Pharm 60(22): 2301-2307
- Donaldson, M.S., et al., eds. Primary care: America’s health in a new era. 1996, National Academy Press.