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