Abstinence

Biomedical Research

Birth & Death Certificates

Birth Defects Registry

Brain & Spinal Cord Injury

CHARTS

Child Care Food Program

Children's Medical Services

Child & Adolescent Health

Chronic Disease Prevention

Communications

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Emergency Medical Operations

Environmental Health

Epidemiology

Father Registry

Health Statistics

HIPAA

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Licensure & Certification

Maternal & Child Health

MQA Enforcement

MQA Online Services

Permitting

Public Health Nursing

Reporting Diseases and Conditions

School Health

Women, Infants & Children (WIC)

Tobacco Prevention

Identifying Strategic Issues

Prioritizing Issues Exercise

Policy development begins within the phase of MAPP known as Identifying Strategic Issues. Once the four MAPP Assessments have been completed, the next step is to use the results to identify strategic issues. It is in this phase that community partners determine which issues are critical to the success of the local public health system and its vision of improved community health.

Identifying strategic issues can be compared to pouring the assessment findings into a funnel — what emerges is a distilled mix of issues that demand attention. The graphic in the handout — Four MAPP Assessments Flowchart — shows how the identification of strategic issues can be seen as a funneling process. Another handout graphic — How Do the MAPP Components Relate? — illustrates how strategic issues form the link between using the information uncovered in the assessments (which form the foundation for planning) and achieving the vision.

Ordering and Consolidating Issues to Identify Strategic Issues

At this point in the MAPP process, a large number of health and quality of life issues have been identified. To provide a manageable focus for developing strategies, issues should be consolidated to a limited number of discrete non-overlapping issues. The next step is ordering the issues through a prioritization process. The top three issues will most likely become your organization’s “strategic Issues”.

Directions

The master list of results identified during of the four MAPP assessments, will now be ordered and consolidated into no more than three or four main topics. To do this, examine all the results identified from the four assessments by asking the following questions: How are these results related? Do they share causes or influences that may make them strategic? What are the consequences of not addressing them? Can any results be combined without losing key perspective?

Once results from the master list have been consolidated, it is time to prioritize. Prioritizing issues can help reveal how they relate to each in a logical order, an impact order and temporal order (see below). After the ordering and prioritizing has occurred, the results will be organized under three to four main topics. See the handout “Example List of Outcomes of the Four MAPP Assessments”.

The next step is to agree that these few main topics will now become the “strategic issues” for which goals and objectives will be written followed by assigned activities, timelines and responsible agencies and persons. This marks the beginnings of the development of an action plan. The “Strategic Issues Identification Worksheet” can serve as a guide during the process of identifying strategic issues.

Strategic issues are best expressed in the form of a question. For example, if an issue the group identified is lifestyle behaviors related to chronic diseases, you may ask “How can we empower our citizens to become healthier?  Framing the health topic as a strategic issue in the form of a question allows for a topic to be looked at in greater breadth and encourages the brainstorming of creative activities for public health intervention. See the handout “Examples of Strategic Issues in Question Format”.

Ordering Strategic Issues

Strategic issues can be ordered in three ways:

1. Logical order — Present issues in the sequence in which they should be addressed. This is useful where the resolution of one issue is contingent on resolution of another.

2. Impact order — How strategic is an issue? How important are its consequences? How complex is an issue? Resolving easier issues first can build the momentum, teamwork, and consensus that can lead to solutions for more complex, controversial issues.

3. Temporal order — Resolve issues according to a timeline, using information such as coordination with upcoming events or a logical order for dealing with the issues. For example, an issue that seems to require a policy strategy may be timed to coincide with the state legislative cycle. Clarifying the meaning of “priority” may prevent resistance from participants who don’t find the issues they feel strongly about at the top of the list. While priority suggests importance, it can also mean order; it is this definition that should be stressed.