IPCHS. Integrated People-Centred Health Services


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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Sept. 6, 2016 Europe

Comprehensive health system reform to improve health in Azerbaijan

Problem: Vertical, disease-oriented arrangement of health service delivery; weak gatekeeping at the primary level; outdated health system infrastructure due to limited public investment; inefficient use of health system resources and high out-of-pocket expenditures for patients; low population health literacy and limited patient decision-making in care.

Solution highlights: A health sector reform project was launched by the Government of Azerbaijan with the financial and technical support of the World Bank, leading to the adoption of a comprehensive National Master Plan for health in 2008; a strong understanding of the political context and environment proved important in determining an acceptable pace for ...

Sept. 6, 2016 Europe

Piloting integrated health networks to improve type 2 diabetes care in Andorra

Problem: High prevalence of type 2 diabetes; suboptimal patient education on diabetes for self-monitoring and lifestyle adaptations; growing dissatisfaction of primary care providers regarding their weak gatekeeping function.

Solution highlights: Primary care nurse-physician teams were introduced to lead new diabetes health networks, with the aim of connecting providers across sectors and strengthening primary care gatekeeping; collaboration with stakeholders in the early design stages of the initiative encouraged multistakeholder buy-in from the outset; updated evidence-based care pathways published in a guidebook helped streamline and standardize care; extensive patient education and coaching on self-management skills enabled patients to engage in their own ...

Aug. 30, 2016 Europe

Establishing a unified emergency medical service in Latvia

Problem: Decentralized management of prehospital emergency medical services resulting in fragmentation, lack of coordination and service inefficiencies; regional disparities in access to ambulance services and inequitable distribution of resources; lack of standardized care guidelines for prehospital emergency medical services.

Solution highlights: Latvia’s 39 separate emergency service organizations were merged to form the single, centralized State Emergency Medical Service; implementing a unified structure for the provision of prehospital emergency medical services reduced fragmentation, standardized care and improved the coordination of services; formalizing provider training and education embedded new practices as the professional norm and helped ensure high-quality care delivery according ...

Aug. 30, 2016 Europe

Identifying high-risk chronic patients for targeted primary care intervention in Veneto, Italy

Problem: Ageing population with increasing chronicity and multimorbidity; acute, reactive health system model.

Solution highlights: Adjusted Clinical Groups were introduced in primary care as a means to proactively target patients at high risk for chronic disease with personalized health interventions and preventive services; when designing the initiative, leaders sought out existing solutions from abroad which could be adapted for application in Veneto; gradual implementation of the initiative through a three-phase pilot project allowed time to explore, verify and refine activities before scaling up across Veneto; services were reoriented to become more proactive, nurses were awarded additional responsibilities related to patient ...

Aug. 30, 2016 Europe

House of Generations Schwaz: A one-stop shop for providing health and social services in Austria

Problem: Increasing demand for municipal health and social services due to an ageing population with narrowing family structures; growing frustration over fragmented local health and social services provision linked to suboptimal organization; rising unmet health and social needs, particularly for vulnerable groups.

Solution highlights: The Municipality of Schwaz reorganized local health and social services around the purpose-built House of Generations; co-location of services increased coordination and improved access for vulnerable groups; shared living spaces, group activities and cooperative initiatives within the House of Generations generated a sense of community, fostering a supportive and inclusive environment for vulnerable groups; strong leadership ...

Aug. 30, 2016 Europe

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

Problem: Growing concern over high rates of MDR-TB and XDR-TB; high rates of treatment failure and death among MDR-TB and XDR-TB patients; limited number of approved treatment options for MDR-TB and XDR-TB patients.

Solution highlights: 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 ...

Aug. 30, 2016 Europe

Developing multi-professional group practices in France

Problem: Anticipated decline in the number of general practitioners, particularly in rural areas; widening geographic disparities in accessing primary care, to the disadvantage of rural communities; growing dissatisfaction among general practitioners with the current systems for primary practice.

Solution highlights: 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 ...

Aug. 17, 2016 Africa

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

Problem: 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.[1] In Botswana, the burden of low back pain has been estimated to be the 5th 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. [2] In the developing world the burden of spine ...

July 29, 2016 Americas

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

Problem: Lack of access to specialist diagnostic services in remote communities; limited response capacity of local health system.

Solution highlights: 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

Developing an integrated e-health system in Estonia

Problem: Fragmented flow of information between health providers; poor management of the growing number of patients with chronic care needs.

Solution highlights: 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 ...