Review and Evaluation of Health Service Framework for Older People 2009-2016 in Australia

This report evaluates the Health Service Framework for Older People 2009-2016 in Australia using the Advocacy Coalition Framework. It analyzes the policy areas, stakeholders, political context, and effectiveness of the framework. Alternative strategies and limitations are also discussed.

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Public Health Policy

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Table of Contents
Introduction......................................................................................................................................3
Advocacy Coalition Framework (ACF):.........................................................................................4
Chosen Public Policy Framework: Health Service Framework for Older People 2009–2016........4
Describing Policy Areas:.................................................................................................................5
Identification of Stakeholders:.........................................................................................................7
Identification of Political Context and Influence of Previous Policies:..........................................7
Review of Current Policy Implementations:...................................................................................8
Effectiveness of Selected Public Health Framework:.....................................................................8
Evaluation of the Outcomes of Health Framework:........................................................................8
Impact of Current Policy on Public Health Principles:...................................................................9
Alternative Strategies and Likely Outcome/ Impact on Public Health:..........................................9
Limitations of the Framework:......................................................................................................10
Conclusion.....................................................................................................................................11
References......................................................................................................................................12

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Introduction
This report is formulated for conducting the review and evaluation of a public health policy of
Australia. The public health policy will be chosen in the area of healthy ageing. The analysis of a
contemporary Australian public health policy will be done by using Advocacy Coalition
Framework or ACF. This report will focus on analyzing the detailed understanding about
selected public health policy including the origin. It will facilitate different details about the
selected public health policy like influence of previous policies, political context and
identification of different stakeholders. Further section of this report will focus on summarizing
that what has been implemented under the selected policy, along with the comments on its
effectiveness for meeting the health and wellbeing of local residents of Australia. Final section of
this report will provide the alternative strategies that have been recommended by different
stakeholders. It will also summarize and elaborate the possible outcome and impact of these
alternative strategies on public health. Moreover, the report will help to understand usefulness
and limitations of selected theoretical framework selected in this report.

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Advocacy Coalition Framework (ACF):
The Advocacy Coalition Framework was originally propounded in 1980s. This is a
methodological and theoretical tool that can be taken into account for the study of policy
processes. There are mainly 3 principal theoretical domains of ACF such as policy change,
policy subsystems and the advocacy coalitions. According to advocacy coalition framework,
policy subsystems and advocacy coalitions are highly efficient techniques for organizing the
actors that have interest in the policy processes. The ACF is considered as an actor based
framework that focuses on analysis of policy change over a period of time (Ingold, Fischer &
Cairney, 2017, p. 461). Advocacy coalition can be explained as a belief system that comprises of
normative convictions and diverse collective actors and individuals including private companies,
journalists, scholars, government agencies and NGOs. The core focus of CF approach is on
carrying out policy debate and detailed analytical description on the policy processes. This
framework (i.e. ACF) has been planned to use in this report for the detailed analysis of Health
Service Framework for Older People 2009-2016.
Main aim of application of advocacy coalition framework is to explain policy changes. It is quite
helpful to develop knowledge about policies and priorities that exists in a dispute management.
These policies and priorities may result from the interaction of multiple actors and government
bodies in the policy formulation procedure. ACF framework is helpful to understand different
stakeholders and actors that played role in the formation of a particular health policy (Ingold et
al., 2017, p. 450). In other words, the ACF framework helps to understand the subsystems of the
policy such as group of actors and the knowledge resulting from their interaction in the policy
formation. In Australia, the policies related to healthy ageing are highly influenced by role of

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political parties in active domination in country and stakeholders like NGOs and private
healthcare organizations. The change in political parties and government has been seen in the
Australia from time to time. The new government comes with new opinions and beliefs and
makes changes in the health policy for ageing policy.
Broader Policy Context of Healthy Ageing in Australia:
The department of health and human services in Australia is taking initiatives for promoting the
healthy ageing in Australia. It is taking into account the broader healthy ageing approach rather
than just funding the discrete programs on any specific health issue. This department also
provides the education, support and assistance to staff and the organizations for working on the
healthy ageing approach in productive manner. The person centered approach is followed in the
Australia for ensuring the healthy ageing in Australia. Example of different programs that are
part of broader healthy ageing framework in Australia includes Count us in!, Making a Move,
HACC Active Service Model (HACC – Home and Community Care) and the Well for Life
(Victoria, 2018). These all programs are aimed at enhancing health and well being for older
people. Capacity building and service improvement is also an important approach that is
followed by the health and regulatory bodies of Australia for ensuring healthy ageing in country.
Under this approach, the focus is on enabling community, staff and organizations for improving
the health of older people across the Victoria state of Australia (Victoria, 2018, p. 4). The
department also provides financial support to different active and healthy ageing advisors across
the state of Victoria for promoting healthy ageing.
In the broader aspect, National Strategy for an ageing Australia was designed and implemented
by the government of Australia. The structure of national health strategy consists of different
components like world class care, healthy ageing, community support, life style and altitude and

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the independence and self provision for older people. This strategy also emphasizes on
availability of employment for mature age workers (Andrews, 2018, p. 3). There are different
principles that are guiding the national strategy of Australia, the detail of which is as below:
 The ageing is a common element in the population of Australia. This element needs to be
addressed by the community, businesses and government.
 All the people of Australia should have access to appropriate care services, recreational
opportunities, cultural, transport, housing, learning, training and the employment
opportunities irrespective of their age.
 All the Australians should have access to opportunities for making a lifelong contribution
to the economy and society.
 The contribution is required from both private and public sectors for meeting the
aspirations and needs of older people.
Chosen Public Policy Framework: Health Service Framework for Older People 2009–2016
“Health Service Framework for Older People 2009–2016” has been mainly designed for purpose
of improving the health and well being of older people in Australia. This framework is
anticipated to provide plan investment and strategies in a way that the future health service needs
in entire South Australia will get improve. The vision statement of this health framework is to
ensure presence of healthy lives to the older people at their homes, to ensure functional and
wellness independence of older people, to enhance resilience, to ensure availability of high
quality of care with respect and dignity till the end of life (Gov AU, 2018, p. 4). The purpose of
this health policy framework is also to ensure presence of access to right healthcare services, at
right place and at right time with all the old age people in country.

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There are different objectives of Health Service Framework for Older People 2009–2016. One of
the objectives of this framework is to enhance time duration, in which the old age individuals can
maintain good health and well being. The purpose of this health framework is also to minimize
the length of time period, in which the old age people becomes dependent on others due to ill-
health. It is also a core purpose of this health policy and framework that the offered health care
services is delivered to all the old age people in need (Gov AU, 2018, p. 7). It aims to help old
people to avoid any need of hospitalization through better life style and better level of health and
well being programs for healthy lifestyle. The main goal of this health service framework is also
to minimize the reliance on old aged care sector and health sector for living a high level of
healthy life at the stage of old age.
Describing Policy Areas:
In simple words, the ageing can be explained as the stage of life, in which an individual or a
person starts to face problem of body balance and mobility, motor sensory skills, memory loss,
problem in hearing skills, and the impact on sights of person (Allen, Hutchinson, Brown &
Livingston, 2014, p. 350). It is also a medical/ healthcare fact that increased symptoms of old age
comes with the problems of chronic disease like cancer. The old age is influenced by different
factors like surrounding environment of the person, behavior and the family genes. The
environmental factors and socio economic disadvantages also impacts the disability and disease
at later stage of people. The risk of occurrence of some other disease also increases in the human
body in old age like Parkinson’s disease, dementia and cancer (Allen et al., 2014).
According to the selected health service policy or framework, there are different service delivery
enablers (i.e. enabling factors and opportunities) in the stepped health system of Australia.
Example of these enablers includes capacity of individuals and community for their health and

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well being, community and other health facility settings, community and aged care services and
the specialized health services for older people. The overall purpose of these healthcare enablers
is to optimize the health and well being of older people across Australia (Gov AU, 2018, p. 6).
The core focus of the Health Service Framework for Older People 2009–2016 is on
implementing the state ageing plan that is termed as “Improving with Age” in order to meet the
strengthen healthy ageing goal of Government of Australia. The goal of this public health
framework is also to improve the positive image of senior citizens and older people residing
across the Australia.
The Health Primary Prevention Plan of the South Australia has included the primary prevention
strategies for the old age people. According to this plan, the base for healthy ageing can be
developed at the initial stages of life and is continued throughout the further stages of life. This
plan consists of early intervention strategies, health promotion and the secondary/ tertiary
prevention strategies in order to achieve the health and well being of older people in association
with their potential capacity (Lawless et al., 2018, p. 521). It is also pointed out by the
framework that health cannot always be fixed in the childhood. Small improvements in the
health initiatives can be ensured in different stages of life through appropriate preventive steps.
Identification of Stakeholders:
Example of different stakeholders includes the older people residing across South Australia, as
they are the core customers or beneficiaries of this public health framework. In addition to this,
the healthcare agencies, regulators and carers are also the stakeholders of this policy framework.
These include the health service carers, the aged community service sector firms, leading
clinicians and the health regions of South Australia (Pinto, Molnar, Shankardass, O’Campo &
Bayoumi, 2015, p. 180). The NGOs playing important role in the development, improvement and

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promotion are also the major stakeholders of this health policy framework. Apart from this, the
political parties governing in the countries are major stakeholders of this policy, as passing and
implementation of this health policy in country is an achievement for their government for the
next election in country.
Identification of Political Context and Influence of Previous Policies:
The successful launch and implementation of the Health Service Framework for Older People
2009–2016 has occurred in South Australia due to full support from the political party in
domination. The Commonwealth government of Australia has provided support for passing the
new healthcare framework for ensuring healthy ageing in country (Baum, Freeman, Lawless,
Labonte & Sanders, 2017, p. 6). There is huge influence of previous health care policies and
framework in the field of healthy ageing sector on the Health Service Framework for Older
People 2009–2016 (Baum et al., 2017, p. 8). Example of these policies includes the SA Health
Reconciliation Action Plan 2008–2010, South Australian Aboriginal Cultural Respect
Framework, SA Aboriginal Health Policy and National Strategic Framework for Aboriginal and
Torres Strait Islander Health 2003–2013.
Review of Current Policy Implementations:
The implementation of this health care framework is done in different ways. It has focused on
implementation of prevention and health promotion strategies in order to help older people with
the issues of dementia. With the implementation of this policy, the diagnosis and management of
dementia among older people have improved. This has been carried out in partnership with
society based health professionals and general practitioners (Gov AU, 2018, p. 3).
Implementation of this health policy is also visible in the form of adoption of delirium

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prevention and management tactics among old age people for better treatment of health issues of
deteriorating brain function.
Effectiveness of Selected Public Health Framework:
The implementation of selected old age health policy or framework has proved to be quite
effective in order to improve the health and wellbeing of older people across South Australia. For
example, the improvement have been observed in the health service responsiveness towards
health and well being need of older persons with the issues of dementia. Application of selected
health framework has also resulted in improvement in the early diagnosis and treatment of
dementia across South Australia (Gov AU, 2018, p. 5). In addition to this, the implementation of
indicated health framework can also resulted in improvement in access of the older people
towards treatment of Parkinson’s disease in the form of psycho-geriatric medical services and
specialist geriatric medicine. It has also resulted in enhanced uptake of advance directives and
advance care planning.
Evaluation of the Outcomes of Health Framework:
There are different approaches adopted for evaluation of the outcomes of implementation of the
Health Service Framework for Older People 2009–2016. The evaluation of the implementation is
anticipated to occur at different points like ongoing adaption and piloting of the innovations,
service level reforms and system, analysis of the midpoint report of progress of 2012 of the
health framework, and the development of new statewide strategic plan for 2017 (Knight, Bryan,
Wilson, Hodgson & Murphy, 2015, p. 63).
Impact of Current Policy on Public Health Principles:
There is positive impact of the implementation of Health Service Framework for Older People
2009–2016 on different public health principles like social justice, equity and addressing social

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determinants. It is supporting the principle of social justice. For example, this health framework
has been designed and implemented for valuing the older people, promoting respect of personal
choice and independent decision making for older people, promoting a value based culture for
older people in society and promoting the healthy ageing (Gov AU, 2018, p. 4). In context of
equity principle, the current health policy or selected health framework has emphasized to ensure
fair and equitable health opportunities to all people irrespective of their gender and religion. The
health framework is focused to avail access of every person in need to full health opportunity in
South Australia.
Alternative Strategies and Likely Outcome/ Impact on Public Health:
Example of alternative strategies suggested by different stakeholder groups includes transition
care program, short term nursing care and personal care program (Delany et al., 2014, p. 701).
These all programs can be funded by the state and commonwealth government of Australia.
Transition care program can be highly effective for the older people that require long term health
care service for the recovery from serious illness (Delany et al., 2014, p. 710). The positive
impact will be seen from these alternative strategies on the public health and effectiveness of
selected health framework.
Limitations of the Framework:
One of the limitations of ACF framework is that it has roots to American pluralism. In this
context, the ACF framework cannot be applied in the countries that have democratic corporatist
traditions (Nohrstedt and Olofsson, 2016, p. 20). In other words, the ACF framework cannot be
applies in Europe and other countries of the world. But this model has helped to understand the
development of health policy framework in this report.

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Conclusion
On the basis of above analysis, it can be concluded that Health Service Framework for Older
People 2009-2016 is an effective health framework of the government of Australia for promoting
healthy ageing in country. It has resulted in improvement in healthcare service responsiveness
towards needs of older people with different disease like dementia and Parkinson’s disease. It
has also resulted in enhanced uptake of advance directives and advance care planning. One of the
limitations of this framework is that it is not much effective for availing healthcare services for
older people for long term for serious intermittent episodes.

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References
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an-Ageing-Australia.pdf
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between comprehensive and selective primary health care? Evidence from a five-year
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