The Health Services Utilization and Improvement Model (HUIM) as A Horizontal Participatory Implementation Program

Tataw, David Besong
March 2010
American Journal of Health Studies;2010, Vol. 25 Issue 1, p60
Academic Journal
This paper illuminates the participatory character of the Health Services Utilization Improvement Model (HUIM) and draws distinctions between classical implementation models such as the Top Down and Bottom Up models, and the horizontal participatory approach actualized in the HUIM. Classical models are compared to the Horizontal Participatory approach utilized in the HUIM using the following criteria developed from the literature: Goal Clarity and ambiguity; Structural and Cultural relationships between the implementation and formulation settings; Number of participants or actors involved in the policy or program continuum; Attitudes of implementation setting towards the policy; Flexibility of implementation actors in adjusting policy/program goals or means; Degree of conflict among stake holders; Role of implementation players/actors in policy/program formulation; Fluidity of boundaries between implementation and formulation settings; and the role of evaluation. The author concludes that classical models do not capture the reality of health education and health promotion programs serving Head Start populations and similar at risk groups. A horizontal participatory implementation approach is recommended for health education and health promotion programs serving Head Start programs or other vulnerable populations.


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