IPCHS 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. 30, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Creating an enabling environment

Introducing compassionate use treatment for extensively drug-resistant tuberculosis in Armenia

Compassionate use TB treatment with the experimental drug Bedaquiline was introduced by MSF in partnership with the Government of Armenia to expand treatment options available to XDR-TB patients; MSF’s prior experience of compassionate use initiatives in other contexts supported the initiative’s effective implementation and provided an immediate solution to the lack of available treatment options; donor support and a close partnership with the Ministry of Health allowed initial barriers, including the lack of a comprehensive legal framework, to be overcome; closely aligning reforms with ongoing programmes reduced the investment needed in new infrastructure and helped secure greater professional ...

Aug. 30, 2016 Europe

Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Developing multi-professional group practices in France

National and regional incentives and programmes were applied to encourage primary care providers to reorganize into multi-professional group practices (MSPs). MSPs enable providers to share resources and workloads and allow a wider range of services to be offered; sufficient autonomy for local actors spurred innovative solutions to local health system challenges, including the MSP concept; national frameworks and policies supported the widespread rollout of MSPs; financial incentives, including funding for initial start-up costs and pay-for-performance bonuses, stimulated providers to reorganize into MSPs; participation in MSPs was voluntary; this helped reduce stakeholder conflicts as change was not forced on providers.

Aug. 17, 2016 Africa

Engaging and empowering people and communities, Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Creating a sustainable model of spine care in underserved communities in Botswana

As identified in the Global Burden of Disease report (2012), spine disorders present an enormous burden on individuals, their families, communities and societies and are the leading cause of disability worldwide. In Botswana, the burden of low back pain has been estimated to be the 5^th leading cause of disability adjusted life years (DALYS) in 2013 and neck and back pain combined is ranked as the number 1 cause of years lived with disability (YLDs), increasing from the third position in 1990 to the first position in 2013. In the developing world the burden of spine disorders is expected ...

July 29, 2016 Americas

Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Telemedicine for improved access to diagnostic services for remote populations in Paraguay

Telemedicine system introduced to improve access to specialist services for remote populations; primary and secondary health centres now collaborate with specialists from tertiary level hospitals on diagnostic services; telemedicine system transmits medical images to specialists; specialists provide diagnostic services to isolated health centres.

June 24, 2016 Europe

Strengthening governance and accountability, Creating an enabling environment

Developing an integrated e-health system in Estonia

A system-wide electronic health information system was introduced by the government and a national e-health foundation was established to guide change; development of e-health aligned with a broader government information strategy, enabling change and motivating necessary political support; early introduction of legislation provided a clear framework for activities and the Estonian Health Information System Development Plan 2005–2008 mapped out the change process; legislation coupled with aligned incentives encouraged widespread uptake of e-health by providers; partnerships with the private sector, universities and research organizations helped drive innovation; features of the electronic system (including electronic medical records, digital imaging, e-prescriptions and ...

June 24, 2016 Europe

Engaging and empowering people and communities, Strengthening governance and accountability, Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

National rollout of Healthy Life Centres in Norway

Municipally-managed Healthy Life Centres staffed by multidisciplinary public health teams were established across Norway to advance local health promotion; government commitment to addressing chronic disease through strengthening health promotion provided a platform for change and fostered widespread scale-up of activities; the Healthy Life Centre concept was invented locally and continues to depend on locally-driven efforts, with municipalities given significant autonomy over activities; a structured approach to the rollout of Healthy Life Centres from the outset (including research, piloting and creation of national guidelines) ensured accountability and systematic evaluation; collaborative partnerships between primary care providers, Centre staff and patients proved integral ...

June 24, 2016 Europe

Strengthening governance and accountability, Creating an enabling environment

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 ...

May 26, 2016 Americas

Enhancing primary healthcare delivery in the inner-city community in Toronto, Canada

A very participatory evaluation process with broad involvement of all stakeholders, including patient and community members, led to consensus on priorities and gaps in services; prioritization of an innovative, patient-centred, model of health and social care led to development of an integrative Family Health team working from a social determinants of health lens; multiple partnerships support long-term sustainability and educational collaboration; supportive leadership and internal champions created momentum for change and mitigated internal and external barriers to change; active and ongoing engagement of patients, community and health team members in program design and implementation.

May 23, 2016 Europe

Engaging and empowering people and communities, Strengthening governance and accountability, Creating an enabling environment

Disparity reduction strategy in Israel’s Clalit Health Services

Creation of a composite disparity score allowed health disparities in Clalit Health Services to be identified, assessed and then targeted for intervention; top-down leadership from senior management within Clalit Health Services was essential for creating the conditions needed for change; locally-designed initiatives provided tailored solutions for achieving targets set by senior management; capitalizing on preexisting strengths and resources minimized the need for costly investments; data-driven performance measures were the backbone of the initiative and provided evidence of the need for intervention, helped incentivize performance improvements and allowed monitoring and evaluation of progress; regular feedback and monitoring fostered a culture of ...

May 20, 2016 Europe

Engaging and empowering people and communities, Coordinating services within and across sectors, Creating an enabling environment

Strengthening local capacity to implement integrated community health services in rural Romania

Through strengthening leadership capacity of local leaders, the initiative hopes to improve health and social services delivery within local communities; a longstanding international partnership built from experience collaborating on other projects was important for establishing the initiative; training was necessary to strengthen the management skills of local leaders to enable them to assess, coordinate and manage delivery of health and social services orientated to community needs; integration of health, social and community services at the local level was encouraged to support a comprehensive response to community needs, particularly for underserved groups.