Health System Issues | State Level Coordination | Cultural Elements (socio-organizational) |
System Organization • System complexity • System fragmentation • Limited sphere of influence for coordination System Financing • Funding inadequacies • Assurance of safety-net funding post healthcare reform implementation | Fragmented State Effort • Federalism and state variation • Silos (inter and intra-agency) • Lack of policy coordination—legislative, regulatory, planning and prioritization Policy Standing of Cervical Cancer • Cancer coordination efforts • Agenda setting for policy and planning | Stigma • Normalizing of vaccination and gender inclusion • HPV screening adoption and movement away from pap smear • Policy framing issues Program and Practice Inertia • Reaching underserved populations • Adoption of new technologies |