*4.2.1 Mega level*

*Public Health in Developing Countries - Challenges and Opportunities*

personal, organisational, community, and health policies levels [82].

describes the way humans and the public interact with their natural and artificial atmosphere [79]. The term "approach" incorporates the way people are in constant relation with each other and the setting in which they live [80]. However, these chains could either have an encouraging or discouraging effect on an individual. The system approach is applied in social work as a meta-paradigm which is regularly referred to as "a person in the neighbourhoods". This meta-paradigm explains the way a person and different multifaceted settings interact and impact each other [81, 82]. The primary emphasis of the SA is that people are part of and continuously interact with other organisms in the setting. The system approach has been applied in healthcare to establish intercessions targeted at shifting the intrapersonal, inter-

The system approach has four stages or levels of impact known as M4, namely a micro-system, meso-system, macro-system, and mega-system [83]. The microsystem is the stage where the individual belongs, and it includes the impact relating to the person, which can come from the individuals' family, peer groups, and the neighbourhood collectively stated as social agents. Social agents interrelate directly with an individual and affect a persons' health behaviour either positively or negatively. For example, using networked communication such as sneezes, it will be easier for individuals to inform their families and friends about risk factors associated with NCDs and possible prevention mechanisms through verbal expression. Sneezes are imperative in NCDs prevention, and healthcare leading organisations need to ascertain who they are and give them incentives and motivations to blowout the conversation of the mouse. The meso-system is the level where the social representatives will be operating, and it is interrelated to the micro-system where the family experiences are associated to the peers' experiences and the peers' experiences to the neighbourhood experiences—for example, by using schmoozed messages such as hive, a community who has a common culture, religion, custom, rules, beliefs, and traditions can increase the spread information related to NCDs and its associated risk factors, so that awareness can be easily created [83, 84]. The macro-system is the stage where organisations are involved and demonstrate an individual's activities within it. An organisation can affect an individual's life by encouragement or discouragement and vice-versa. For example, by using diversified mediums and amplifiers such as posters, images, slogans or phrases, school mini-media, television and radio broadcasts, short message services (SMS), webpages, and the internet as a means of transmitting information related to NCDs can increase the strength of information as it gets passed across a broad audience. The mega-system level illustrates the state that reflects the culture in which individuals live. Also, the mega-system level incorporates advancement, industrialisation, urbanisation, socio-economic status, poverty, religion, and ethnicity. For example, by applying velocity and smoothness through high government officials involvement, NCDs-related messages can swiftly and efficiently reach a higher number of the public who can be reminded to abstain from behavioural practices that lead to NCDs. Likewise, working with multi sectors such as governmental and non-governmental organisations, developmental partners, religious institutions, and urban planners to increase access and availability to parks, public open spaces, and recreational facilities can lead to effective transfer of information related to NCDs to a large number of the com-

The system approach, as illustrated in **Figure 5,** is constructed on a supposition that when an individual, community, healthcare organisations, and the

**20**

munity and its prevention [82–84].

**4.2 The view of the systems approach**

The mega-system level help to review and understand the existing NCDs prevention strategy, the practice of health information, the availability and status of data related to NCDs morbidity, mortality, and risk factors for decision-making at a national level. This level of the ecological system theory focuses on the status and availability of data related to NCDs at national level, so that plenty of information can be utilised in the healthcare system for effective decision-making for the prevention of NCDs. Availability of quality and timeous NCDs data and evaluating its status periodically help policymakers to redesign and strengthen the existing healthcare system to revert the growing burden of NCDs at national and international level [1, 4].
