Policy framework for building integrated care for TB patients in Romania: setting up the scene

State of Commitment to Universal Health Coverage

The State of commitment to universal health coverage (UHC) provides a multi-stakeholder consolidated view on the state of progress being made towards UHC at country and global levels.

The review is political, country-focused and action-oriented in nature and complements the more technical and global UHC monitoring report focusing on UHC indicators on service coverage and financial protection.

The State of UHC Commitment  follows the UHC Political Declaration’s Key Targets, Commitments and Follow-up Actions and support national accountability and advocacy processes to ensure political leaders are held accountable for their UHC commitments.

The synthesis report summarises the state of UHC commitment at both the country and global level. In 2020, the report focuses on how the world has coped to date with the extraordinary challenges posed by the COVID-19 pandemic. It shares short stories from people’s lived experiences, demonstrating the reality of UHC on the ground.

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Key role of governance and accountability to achieve integrated people-centred health services

Models of integrated care continue to evolve globally with the goal to deliver more integrated people-centred health services. These models are characterized by innovative collaborations and partnerships across sectors. One enduring question relates to the best governance structures for these complex, multi-player systems and networks. Governance encompasses all aspects of managing health services delivery to support health system goals, including financing, human resources, and technology, and it is a critical instrument to strengthen public and institutional performance.

The current pandemic is a good reminder that circumstances and environments strongly influence health and well-being. It emphasizes the need to focus on whole-systems health, which cuts across political, economic, and social landscapes. Whole-system health requires governance that is agile and can respond quickly to emerging changes to manage the complex interdependent partnerships in integrated health systems. It further points to the need for diffusion of governance from a state/health services centred ...

Towards integrated care systems (ICSs) Leading for integrated care

Leading across integrated care systems and integrated care partnerships (ICPs) requires a range of skills. These include being able to walk in other people’s shoes; having a constancy of purpose while retaining flexibility; and building the evidence base for change as a key tool for persuading the unconvinced of the need to redesign our model of care delivery.

Building on the recent report, "Leading for integrated care", this event will provide insights into the different leadership skills and behaviours needed to successfully secure more integrated care.

You will be able to hear from a range of different speakers from across the UK about how individual leaders from local government and the NHS are working in partnership to redesign services and in some instances place a greater emphasis on wellness.

Community health workers and accountability: reflections from an international “think-in”

Community health workers (CHWs) are frequently put forward as a remedy for lack of health system capacity, including challenges associated with health service coverage and with low community engagement in the health system, and expected to enhance or embody health system accountability. During a ‘think in’, held in June of 2017, a diverse group of practitioners and researchers discussed the topic of CHWs and their possible roles in a larger “accountability ecosystem.” While CHWs are often conceptualized as cogs in a mechanistic health delivery system, at the end of the day, CHWs are people embedded in families, communities, and the health system. CHWs’ social position and professional role influence how they are treated and trusted by the health sector and by community members, as well as when, where, and how they can exercise agency and promote accountability. To that end, this study put forward several propositions for further conceptual development ...

Innovation of the governance of integrated care

Interest in integrated care is growing. This is reflected in the rising numbers of scientific publications, IJIC’s increased impact factor and the increasing number of participants at IFIC’s international conferences. It is stimulating to see that organizations like the World Health Organisation are developing conceptual frameworks that embrace integrated care. At the same time we know that integrated care does not become reality automatically; it takes a long timeframe. That can be conflicting with ambitions like ‘implementing good practices as fast as possible’ and with the pressure to deliver results in politically set tight time frames.

Priority setting for health in the context of devolution in Kenya: implications for health equity and community-based primary care

Devolution changes the locus of power within a country from central to sub-national levels. In 2013, Kenya devolved health and other services from central government to 47 new sub-national governments (known as counties). This transition seeks to strengthen democracy and accountability, increase community participation, improve efficiency and reduce inequities. With changing responsibilities and power following devolution reforms, comes the need for priority-setting at the new county level. Priority-setting arises as a consequence of the needs and demand for healthcare resources exceeding the resources available, resulting in the need for some means of choosing between competing demands

Social accountability in primary health care in West and Central Africa: exploring the role of health facility committees

Social accountability has been emphasised as an important strategy to increase the quality, equity, and responsiveness of health services. In many countries, health facility committees (HFCs) provide the accountability interface between health providers and citizens or users of health services. This article explores the social accountability practices facilitated by HFCs in Benin, Guinea and the Democratic Republic of Congo. 

Centers of excellence in healthcare institutions: what they are and how to assemble them

Centers of excellence-specialized programs within healthcare institutions which supply exceptionally high concentrations of expertise and related resources centered on particular medical areas and delivered in a comprehensive, interdisciplinary fashion-afford many advantages for healthcare providers and the populations they serve. To achieve full value from centers of excellence, proper assembly is an absolute necessity, but guidance is somewhat limited. This effectively forces healthcare providers to pursue establishment largely via trial-and-error, diminishing opportunities for success. 

Governance and accountability in new care models

The current focus on new care models, and place-based systems of care, requires organisations to work together to deliver services. How well these new systems are led, directed and held to account will be crucial to their success. This one-day conference will help those who are considering how governance and accountability will work in these new, place-based systems.

Defining and standardizing primary care in Georgia

Government reforms aiming to establish universal health care, increase state involvement in the health system and strengthen regulation have been introduced; articulating a clear government vision ensured a strong foundation on which to build reforms; learning from previous experiences and seeking expertise from international partners helped the initiative avoid potential difficulties; inclusion of stakeholders in the design process helped build local consensus for change; following the strategy development process, detailed plans were drawn up to guide proposed reforms.

Implementing clinical audits to improve care standards in Turkey

Clinical audits were implemented to improve adherence to national guidelines through increasing transparency and accountability for service delivery across health care institutions; lengthy discussions with stakeholders and clear communication of the initiative’s aims were essential for establishing sufficient buy-in to begin implementation; establishing data collection and analysis systems was a critical step for improving and optimizing care. Strong data collection, followed up with monitoring and evaluation, was paramount to the initiative’s success; while the initiative was led by the Ministry of Health, regional health authorities played an increasingly important role in supporting auditing processes and providing local oversight of audited institutions as the initiative expanded.

Campaigning to improve obstetric care in Poland

The Childbirth with Dignity Foundation was established to advocate for improved obstetric care through uniting the voices of thousands of women and bringing evidence to light on key issues. Advocacy efforts ultimately led the Ministry of Health to establish obstetric care standards; systematically collecting and documenting patient experiences served as an important advocacy tool and engaging with the target population helped build public support; leveraging a highly-visible public media platform lent sufficient credibility to information conveyed and gained needed attention for action; all stakeholders were engaged to effect change from both the bottom-up and top-down.

IHF 40th World Hospital Congress

The IHF 40th World Hospital Congress will be held 31 October – 3 November 2016 in Durban, South Africa with the theme: Addressing the Challenge of Patient-centered Care and Safety.

The World Hospital Congress of the International Hospital Federation (IHF) is a unique global forum that brings together key drivers of national and international policy, management, financial trends and solutions in healthcare management and service delivery. Through this forum multidisciplinary exchange of knowledge, expertise and experiences are facilitated, together with dialogue on best practices in leadership in hospital and healthcare management and delivery of services.

For further information please click here: IHF 40th World Hospital Congress

Enhancing governance and health system accountability for people centered healthcare: an exploratory study of community scorecards in Afghanistan

BACKGROUND:

The premise of patient-centered care is to empower patients to become active participants in their own care and receive health services focused on their individual needs and preferences. Afghanistan has evidenced enormous gains in coverage and utilization, but the quality of care remains suboptimal, as evidenced in the balanced scorecard (BSC) performance assessments. In the United States and throughout Africa and Asia, community scorecards (CSC) have proved effective in improving accountability and responsiveness of services. This study represents the first attempt to assess CSC feasibility in a fragile context (Afghanistan) through joint engagement of service providers and community members in the design of patient-centered services with the objective of assessing impact on service delivery and perceived quality of care.

METHODS:

Six primary healthcare facilities were randomly selected in three provinces (Bamyan, Takhar and Nangarhar) and communities in their catchment area were selected for the study. Employing a multi-stakeholder strategy ...

Partnering with patients to improve care: essential skills and strategies.

This link provides the contents from the conference organized by the McGill University Health Centre’s Institute for Strategic Analysis and Innovation (MUHC-ISAI), regarding patient centered health care systems.

The opening conference was performed by Angela Coulter, who reviewed the patient engagement history in health care systems and gave a broad overview on how patients could be involved in the entire functioning of the system.

In the website there can also be found the materials corresponding to the following six sessions:

• Patient engagement leadership.
• Patient partnership: recruitment, training, governance and evaluation.
• How does the patient experience drive improvement?
• Building capacity to lead quality improvement with patient partners.
• Engaging patients to improve the clinical encounter.
• Patient engagement in patient safety.

With these materials, the MUHC-ISAI shares an important amount of information and resources in order to improve the role of patients in current health systems.

Partnering with patients to improve care: essential skills and strategies.

This link provides the contents from the conference organized by the McGill University Health Centre’s Institute for Strategic Analysis and Innovation (MUHC-ISAI), regarding patient centered health care systems.

The opening conference was performed by Angela Coulter, who reviewed the patient engagement history in health care systems and gave a broad overview on how patients could be involved in the entire functioning of the system.

In the website there can also be found the materials corresponding to the following six sessions:

• Patient engagement leadership.
• Patient partnership: recruitment, training, governance and evaluation.
• How does the patient experience drive improvement?
• Building capacity to lead quality improvement with patient partners.
• Engaging patients to improve the clinical encounter.
• Patient engagement in patient safety.

With these materials, the MUHC-ISAI shares an important amount of information and resources in order to improve the role of patients in current health systems.

Going Universal: How 24 countries are implementing universal health coverage reforms from the bottom up

This World Bank Group book is an overview of how 24 developing countries have embarked on the long journey to Universal Health Coverage (UHC). This Universal Health Coverage Study Series (UNICO) offers knowledge and operational tools to help countries tackle UHC in ways that are fiscally sustainable and that enhance equity and efficiency, by providing examples and lessons learnt from the UNICO countries (individual case studies may be accessed at http://www.worldbank.org/en/topic/health/publication/universal-health-coverage-study-series). In these countries, which together represent one third of the world’s population, efforts to achieve UHC have mainly focused on fiscal expansion, accountability, and community health workers. The study finds that most of these countries, except for success stories such as Costa Rica and Thailand, are still struggling with establishing functional integrated care networks. However, the report recommends that developing countries should continue to empower their primary sector as gatekeepers ...