IPCHS. Integrated People-Centred Health Services

Practices

Learn from real-life experiences with health services reform. We distinguish three types: emerging, promising and leading practices. Share your practice by clicking "Add practice".

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Aug. 9, 2017 Americas

Educating and empowering children to make healthy choices across Mexico

Problems: In Mexico, one in three children and adolescents are overweight or obese. This increases the risk of diabetes and hypertension, as well as learning and development issues. Additionally, many children are at risk of addiction, teenage pregnancy, and mental health issues.

Solutions: “Health at your school” is a joint strategy between the Secretary of Public Education and the Secretary of Health (MoH) to address these health risks. It encourages children and adolescents to maintain a healthy body, avoid risky behaviors and acquire healthy habits, through five components: educate for health; curricular autonomy; professionals and students of health at your ...

July 10, 2017 Europe

The House of Care: Re-imagining primary care in Scotland

The problem: Focus within Scottish general practice on single disease processes and meeting seemingly-arbitrary targets meant patients felt as though their care was fragmented; this focus also impacted staff morale: staff reported feeling feel burnt-out and disillusioned, which can affect recruitment and attrition; absence of strategic vision for primary care resulted in piecemeal policies that acted as band-aid solutions, without creating lasting change.

Solution Highlights: “House of Care” is a sequence of several interrelated, synergistic strategies, at the core of which is a patient-led care programme design; patients design their own care plan in consultation with practice nurses; patients report ...

March 6, 2017 Western Pacific

Strengthening universal health coverage through role delineation in the Solomon Islands

Problem: Health services are inadequate for people in rural areas. 80% of the population lives in rural areas and islands with weak health infrastructure; 73 out of 86 doctors are based at the National Referral Hospital; public perceptions of service quality results in large numbers of people travelling long distances to the national hospital for primary health services. This skews optimum allocation of the hospital’s resources including staff time.

Solution: To achieve effective coverage of services, Role Delineation Policy (RDP) was developed following extensive consultation. The RDP defines service delivery packages for six levels of health facilities: rural health ...

March 2, 2017 Western Pacific

At Risk Individuals (ARI) programme, Counties Manukau Health (CMH) Auckland, New Zealand

Problem: Demand for complex care needs among aged and low income populations; long wait times and frequent emergency visits; need to adopt a model of care that emphasises on patients achieving long-term behaviour change, while providing care in home settings.

Solution highlights: The model of care provides early and planned interventions, establishes general practice as the centre of coordinated healthcare, provides care based on patient set goals and improves access to a range of specialist and community services; uses risk profiling as means to identify and judge patient eligibility; care goals are set and progress overseen by an assigned care ...

Oct. 11, 2016 Europe

Strengthening primary care in Voznesensk, Ukraine

Problem: Service delivery concentrated in higher-level care settings; weak gatekeeping at the primary care level; care quality perceived by patients to be superior in higher-level care settings; health resources strained by overuse of specialized care.

Solution highlights: The district of Voznesensk experimented with initiatives, such as provider payment mechanisms, designed to align service delivery with the principles of family medicine, becoming an example for broader primary care reform across Ukraine; effective local leadership, combined with political and financial support, created a stable platform from which bottom-up reforms were built; aligning local initiatives with national priorities proved valuable for gaining legitimacy ...

Oct. 11, 2016 Europe

Strengthening community-based mental health services in Cyprus

Problem: Increasing national burden of mental health disorders; mental health care model focused on institutionalization and lacked community-based treatment alternatives; access inequities for mental health services existed between urban and rural populations.

Solution highlights: New political commitments to mental health reform led the government to pass the Mental Health Act in 1997 to promote community-based mental health care; a wide variety of community-based mental health services have been made available, with emphasis on services for prevention, early treatment, rehabilitation and home care; advocacy from the health workforce motivated reforms and helped define the vision for care transformations; strategic timing was ...

Oct. 11, 2016 Europe

Strengthening disease prevention services in Albania

Problem: High NCD burden, notably from cardiovascular disease; suboptimal population health linked to lifestyle-related risk factors such as poor dietary habits, tobacco use and high blood pressure; health services reactive in orientation, limiting focus on health promotion and disease prevention.

Solution highlights: The government, which was strongly committed to establishing universal health coverage, launched a four-year Free Check-Up Programme to introduce free screening services for chronic conditions; adopting a proactive approach to prevention was essential for reaching and engaging the target population (all citizens aged between 40 to 65 years); significant efforts were made to improve the systematic collection and ...

Oct. 11, 2016 Europe

Using medical trains to improve access to health services across Kazakhstan

Problem: Kazakhstan was ranked among countries with the lowest life expectancy in the WHO European Region; health professionals were distributed inequitably across the country and geographic disparities in health status were seen between rural and urban populations.

Solution highlights: The concept of transport medicine was conceived: Using the country’s existing transportation infrastructure, a series of trains now travel to stations across the country to provide health services to rural populations; aligning the initiative with overarching health system reforms (the State Health Care Development Programme for 2011–2015 “Salamatty Kazakhstan”), and gaining cross-sector buy-in from the government, helped to support ...

Oct. 4, 2016 Europe

Implementing early childhood development centres in Bosnia and Herzegovina

Problem: Low levels of early childhood education; low levels of childhood immunization; disparities in health and social indicators for vulnerable groups.

Solution highlights: As part of a wider initiative for the social protection of children in post-war Bosnia and Herzegovina, UNICEF partnered with cantons and municipal governments in 2010 to establish Integrated Early Childhood Development (IECD) Centres; a situational analysis and piloting of the approach supported a sharpening of priorities and the development of practical solutions; longstanding partnerships between government actors and development agencies allowed for gradual capacity-building at the subnational level, enabling local uptake of new roles and responsibilities ...

Oct. 4, 2016 Europe

Integrating nutrition programmes in primary care in Kyrgyzstan

Problem: Widespread evidence of micronutrient deficiencies among young children, particularly iron-deficiency anaemia; elevated levels of growth stunting among children under five.

Solution highlights: A programme to distribute micronutrient sprinkles, locally known as “Gulazyk”, was introduced with donor support. Following successful piloting of the programme, activities were scaled up nationally in 2011; aligning with existing infrastructure and services helped support and stabilize reforms implemented under the initiative; building trust between primary care providers and patients was essential for ensuring uptake of micronutrient supplementation; community health volunteers aided trust building; developing a consistent message across all providers, even those not directly involved ...