Global Family Health
Introduction
Drug and substance abuse is one of the major public health issues in the United States. It is estimated that around 47000 American citizens died of drug overdose in 2014. Over recent years the United States has seen a rapid increase of hepatitis C, HIV outbreak and children born with neonatal abstinence syndrome. Drug abuse has also led to the loss of productivity, increase in stress and mental health issues and other sufferings in the community. Massachusetts is at the centre of drug and substance abuse in the United States and it is among the top ten states with rampant drug and substance abuse problems. Though America is a developed country the drug and substance abuse is a big problem that challenges the system thus the need for partnership with an organization from other nations (Nonprofits, 2017). The partnership allows organizations to bring together diverse and limited resources to achieve better results. This article seeks to develop a comprehensive partnership program between SAMHSA (substance abuse and mental health services association) in the United States and a nongovernmental organization (NGO) established in Germany to address the issue of drug and substance abuse in Massachusetts.
The SDGs developed by the United Nations (UN) seeks to develop a better world by 2030 thus the need for partnership from all corners of the world. But collaboration is faced by challenges such as lack of enough time and resource, inadequate investment and lack of a better-developed system for the establishment of a partnership(Nonprofits, 2017). But despite the challenges, the NGO in Germany has identified that SAMHSA offers a wide variety of services to help address the SDG target and indicators. The SDG target, in this case, is to enhance the prevention and treatment of drug and substance abuse in Massachusetts. The indicators include the coverage of all treatment intervention which consist of psychosocial, rehabilitation and pharmacological and aftercare services for people with drug and substance abuse disorders. The other indicator is the harmful use of drugs and other substances as indicated by the national guidelines on drug and substance abuse The German NGO, on the other hand, aims at maintaining peace and global solidarity by eliminating alcohol and other drugs in the community. The partnership will have its base in Massachusetts due to the proximity to individuals requiring these services. The NGO will provide SAMHSA with skills and research needed to identify the issues around drug and substance abuse and address them effectively.
For the partnership to work better strategic action plans are needed. The three action plans for the partnership include the reduction of drug availability, violence, and Crime in Massachusetts, reducing the demand of illicit drugs, and strengthening interdiction and national efforts focusing on disrupting the flow of the illicit drugs into the state of Massachusetts (Office of National Drug Control Policy and the United States of America, 1995). These action plans will help the state to tackle drug trafficker who preys on people for the sake of power and money. The drug users will also be provided with treatment services in various hospital across the state and where necessary apply forced abstinence. The partnership will also push for the prosecution of drug sellers and users for their criminal activities. The partners will also come together and generate statistics that will help drug addicts and society at large identify the harmful effects of drug and substance abuse. The action plan also seeks to persuade the residents of Massachusetts to get involved in the fight against drug and substance abuse since it affects all of them either directly or indirectly.
The demand reduction action plan includes the provision of treatment plans to those who need treatment including those in special populations such as pregnant women, prisoners and adolescents. Reducing the demand will also help the health care system to reduce the burden of infectious diseases related to drug and substance abuse. Reducing the number of hardcore drug users is one of the best ways of reducing the demand for illicit drugs. The NGO seeks to provide SAMHSA with information that will enable the effective use of federal funds for the treatment of many hardcore drug users (Canady, 2018). Massachusetts will also be encouraged to experiment with managed care to ensure the cost of treatment goes down. The partnership will help the state evaluate the effects of managed care on treatment outcomes as well as the cost of treatment. Since many criminal offenders are also drug offenders the partnership will also encourage the courts and correctional facilities to convince the drug users to seek “clean-up” treatment. Other than just improving health for the criminals, the treatment also ensures that there is less recidivism. The partnership programme will also provide better treatment research useful in the reduction of demand for various drugs. Prevention by partnering with the community will also reduce the demand for drugs.
Drug availability, violence and crime reduction action plan will be achieved by the establishment of strong linkages with the element of education, treatment and criminal justice. To achieve this the partnership has a 12-month program that seeks to guide the federal, state, county and local law enforcement agencies that will see the review and establishment of laws against drug use, selling and drug-related violence and crimes (Reno, Holder, and Marcus, 2000). The comprehensive programme will also facilitate the development of money laundering rules and regulation intending to curb illicit drugs trade. Finally, the action plan of strengthening interdiction and national efforts focuses on disrupting the flow of illicit drugs into the state of Massachusetts through national and international efforts. The programme also seeks to establish cooperation with the neighbouring states and countries that are associated with the flow of illicit drugs. International cooperation from nations such as Peru, Colombia, Bolivia and Mexico will see that the entry of illicit drugs into Massachusetts and the United States at large get reduced (Office of National Drug Control Policy and the United States of America, 1995). The 12-month program will see the coordinated effort of different states and countries to see that illicit drugs are eliminated in Massachusetts. The programme will also work together with federal drug control agencies in the United States and other countries to ensure that interdiction programs get implemented. International and national public diplomacy will also be enhanced to ensure that state agencies in Massachusetts work with other agencies in the United States and the world at large.
The comprehensive programme will be achieved if effective, mission, vision and organization goals are in place. The vision of the organization is to establish a healthy Massachusetts where people can reach their potential free of drug and substance abuse by reducing the demand, impact, use and supply of illicit drugs (Holland, and Ritvo, 2008). The mission of the organization, on the other hand, is to provide useful information, education and research in collaboration with SAMHSA that will assist, policymakers, medical practitioners, and the general public about drug and substance abuse in Massachusetts. The information will be useful for the prevention, treatment and control of problems associated with drug abuse and have negative effects on the family health (Reno, Holder, and Marcus, 2000). The organization aims at collaborating with all the stakeholders of drug and substance abuse in the long run for a better society. The core values and principles for the organizations include:
Educating the public about addiction- The organization role is to educate the general public about the harmful effects of drug and substance abuse to the brain, family health, social life and the economy at large.
Innovation-The organization believes in the development of new ways to solve problems and develop strategies for dealing with drug and substance abuse. All members are encouraged to bring their ideas on board, discuss them and get the best way forward. The organization also demonstrates creativity in the development and implementation of effective and efficient programmes.
Accountability-The organization demonstrates a high degree of accountability to clients, donors, funders and the society at large. The organization demonstrates accountability through its transparency in its activities.
Collaboration- The organization believes that the problem of drug and substance abuse cannot be addressed single-handedly and requires the collaboration with different people, institutions and the community at large. Collaboration is essential for the achievement of mutually beneficial objectives.
Integrity- the organization takes responsibility for the action of its staff and maintains a high standard of professional conduct with the clients. The organization, therefore, build trust with its partners and the community at large to ensure that its name remains better. Financial decisions are made inclusively and transparently.
Advocacy- The organization advocates for the treatment of drug and substance abuse addicts and mental illnesses associated with it (Reno, Holder, and Marcus, 2000). The organization also supports and advocates for social and legal issues that support the vision and mission of the organization.
A partnership will be developed between SAMHSA and the German NGO to increase the effectiveness and his efficiency in the fight against drug and substance abuse in Massachusetts. The NGO will also support various SAMHSA research that will provide the state of Massachusetts with knowledge concerning the causes, treatment, consequences and prevention of drug and substance abuse. To address Massachusetts drug problem the NGO and SAMHSA need to develop coordinated law enforcement, treatment and prevention programs. The partnership has a collaborative advantage which allows for the delivery of more than the sum of a single organization (Stibbe, Reid, and Gilbert, 2018). This means that the partnership allows for the bringing together of resources from different sectors. The partnership allows the German NGO to bring on board different perspectives of tackling the issue facing Massachusetts to enable SAMHSA to deliver a better holistic approach to the issue. The German NGO deals with helping people fight the problem of drug and substance abuse and thus the partnership will create a sufficient weight of action to tackle the issue evidenced in Massachusetts. Since SAMHSA has faced challenges dealing with the issue the partnership with the NGO is useful for the exchange of knowledge so the two organization can learn from each other (Canady, 2018). Capability building and collective learning from the partnership is useful for the achievement of set objectives.
SAMHSA has been selected since just like the German NGO its objectives and goals and aligned. SAMHSA is also well established and is known for providing various treatment programs for addicts all across the United States. SAMHSA has also partnered with other organization and thus has better experience with partnerships which will help address the problem of drug and substance abuse in Massachusetts. The partnership is intended to last longer and advance in time to include other cities faced with similar issues. Other than the provision of information and research The German NGO will also look for additional donors to help establish various treatment centres as well as have several campaigns to create public awareness on the harmful effects of drug and substance abuse. The partnership will help raise the standards of the fight against drug abuse by bringing together the combined legitimacy and collective knowledge. Since the partners are from different countries the partnership will have sustainable solutions due to cross-sector approaches and perspectives. Finally, the partnership will enable Massachusetts’s fight against drug and substance abuse to have a larger connection and networking that will help create other relationship useful in the fight.
Organizations working in the drug and substance abuse sector are usually faced with various ethical dilemmas at individual and societal levels. Various organizations have been established in Massachusetts to help fight drug and substance abuse. The care of drugs addicts is usually faced with challenges associated with personal values, beliefs and judgements. Working in this sector is also more challenging when the concept of HIV/AIDS is thrown into the mix. People with this disease are usually stigmatized and when the issue of drug and substance abuse is added the issue becomes too complex. Therefore the organization should note that the individual suffering from, HIV/AIDS coupled with drug and substance should be given special consideration without any discrimination. The syringe exchange program which is useful in the prevention of drug and substances abuse is usually faced with ethical dilemmas with some questioning its effectiveness. The organization should also offer training to allow for the balancing of professional and personal standards. The NASW Code of ethics dictates professionals in this sector to reconcile professional code with personal beliefs (Center for Substance Abuse Treatment, 2000). The working environment also has various ethical dilemmas related to the release of patient information, the common good of the society patient autonomy and protecting client information.
The sustainability of the partnership in the United States will depend on understanding the working environment and the ethical framework in this sector. NASW Code of ethics shows that the organization should consider the clinical, legal, system, cultural and ethical issues while making decisions. It is also essential for organizational heads to seek legal consultations to enable them to cope better in the highly engaging Massachusetts environment.
Before entering into a partnership with any organization in the host country ample preparation including visits to the country are necessary. Visits must be conducted to ensure that the selected partner meets the eligibility criteria and thus a good match. Such a visit will also allow the partners to understand each other’s strength and weaknesses and come up with a plan of complementing their efforts. The eligibility criteria will depend on the institution capability, reputation, relation with authorities, proven track record, finance and compliance, geographical coverage, and compatible value and principles (Brandstetter et al., 2006). Other preparation involves the capacity assessment of the partner’s suitability of operational, financial and programmatic capacity. A short visit where the partner fills a capacity assessment questionnaire coupled with direct observation is enough. The partner should be aware of the assessment and the reason for conducting it. Assessment should also include due diligence due to various concerns such as political affiliation, nepotism, Corruption, conflicts and abuse of power among others. The partners then get together and select a committee that will oversee the implementation of joint tasks later.
Agreeing on the terms and conditions of a partnership is usually a lengthy process that requires many discussions. It is, therefore, necessary that a framework is developed earlier enough to avoid delays. Contracting and start-up preparation involves deciding on a collaboration model, developing partnership budget, agreeing on the work plan and negotiation terms and conditions of the partnership (Stibbe, Reid, and Gilbert, 2018). The processes are then reassessed by all partners before entering the implementation state. Reassessment is necessary to ensure that nothing is left out and that all the partners re aware of what they are entering into and they all agree with it.
The are several stakeholders who will be vital for the success of the partnership. The NGO from the home country will offer skills and services such as education, advocacy, information and research to help fight drug and substance addiction in Massachusetts. SAMHSA, on the other hand, has several treatment programmes and grants that will be useful to the organization and the addicts in Massachusetts at large. Other government agencies will also be needed to offer guidance and establish regulation aiding the fight against drug and substance abuse. The local government understand the geographical location and people better and thus their guidance is useful for the 12-month programme to be successful. The state of Massachusetts spends almost 22% of its budget on addiction where 1 cent for every dollar is used to cater for treatment and prevention services and the other 99 cents for every dollar used to cater for the consequences of addiction
Activity
Timeframe
Cost
Setting up the partnership
2
$5000
Marketing and branding the partnership
1
$40000
Research about drug and substance abuse in Massachusetts
2
$80000
Advocacy campaigns
2
$50000
Creating awareness and training residents about drug and substance abuse
2
$50000
Develop treatment and prevention programs
3
$100000
The cost for the activities will be obtained from grants, donor aid and from government budget that has supported organizations fighting drug and substance abuse in various ways.
Just like strategic planning programme evaluation is essential for the success of a partnership. Evaluation is important since it helps in the gauging of the partnership true impact by assessing whether the results of the operations are satisfactory. Since the partnership, in this case, is funded by the government among other donors the partnership must show a guarantee of success through reliable and accurate accountability. The partners must thus set clear objectives which will determine their rate of success when evaluated (Brandstetter et al., 2006). An evaluation may be done internally by those who participate in the running of operations, externally by some specialist or both. It is worth noting that using both external and internal evaluators is the most effective form of partnership evaluation. When implementing a monitoring and evaluation process all partners must be involved in the exercise, specialists are required in some evaluation stages and the evaluation and implementation process should be implemented at the start of the partnership. The partners agree on the indicators that will demonstrate the efficiency and relevance of their actions and long term partnership impact. The partners also identity the evaluation procedures and develop data collection tools. Specialists guide the partners about the evaluation process as well as verify and validate the partner’s indicators of choice (Haase and Pratschke, 2017). A budget should be provided and a basis for evaluation established at the beginning of a partnership to facilitate fair and accurate evaluation.
Some of the areas of evaluation for the program include the contribution and involvement of stakeholders and partners, achievement and completion of activities and objectives, good practice and interaction with other organization, and the planned and actual budget utilization among others. The programme relevance is evaluated to ensure that it addressed the problem it was intended to address. The effectiveness of the partnership is also addressed by assessing the objectives. Sustainability, best value and the management monitoring and appraisal of the organization is also evaluated. Evaluation is usually carried out when the disadvantaged residents of Massachusetts ought to be receiving the benefits of the comprehensive programme. Therefore much technical and financial information is collected and analyzed to evaluate the success of the programme. The evaluation information has to be factual while assessing whether the problem has been eliminated and if not reasons should be provided (EUROPEAN COMMISSION, 2005). The stakeholders are also interviewed to get their views on the programmed as well as understanding how changes in the environment and the society affected the programme. Variance analysis is prepared against all the plans, objectives, assumptions and indicators. The finances have to be kept up to date and checked whether they have been finalized and audited.
Drug and substance abuse is a major issue of family health in Massachusetts thus the need for a partnership to tackle the issue effectively. To combat the problem the partners, the government and the community at large must offer available resources for effective implementation of the partnership program. The process of partnership is not a simple one and thus much preparation is needed to establish the action plans and set objectives to be met by the program. The evaluation of the programme is hence useful to ensure that the programme is in line with the set objectives and if not devise strategies to align it with the objectives.